Health care in Maryland was a $13.3 billion industry in 1993, according to a new report commissioned under the state's health care reform law, but the study's authors stopped short of using it to call for any major changes in the way health care is regulated and financed.
"The most important policy direction is to keep our eye on how things are changing," said John Colmers, executive director of the state's Health Care Access and Cost Commission, which published the study. "This [report] will raise more questions than it answers, and they will be good questions."
The General Assembly told the commission in 1993 to come up with basic information about where the state's health care dollar comes from and what it is spent on.
Yesterday's report, as a result, was less a call to arms than a quantification of many broad trends that officials had already realized were under way.
The report was only the beginning, and officials admitted as they released it that the data are already out of date because health care is changing so rapidly. A new report on 1994 and 1995 figures is due in October.
Health care spending worked out to an average of 11.5 percent of Marylanders' personal income, or $2,524 per person. Mr. Colmers said spending here was about as high as the national average.
But Marylanders receive more coverage from managed care plans than the nation as a whole, and they get less of their health care dollar from the federal government than other Americans.
Just over 20 percent of Maryland's medical spending came from the Medicare program for the elderly, while almost 14 percent came from the Medicaid program for lower-income patients, which includes nursing home care. Seven percent came from other government programs.
By contrast, almost 30 percent of all Maryland health care in 1993 was paid for by private insurers.
About 10 percent was paid by health maintenance organizations, and 19 percent was paid out of pocket by consumers.
The biggest share of the money was spent on primary care and basic medical evaluation, the report said. Primary care consumed 31 cents of the health care dollar, with surgery claiming a quarter. Radiology was the only other specialty that commanded as much as 10 percent of the medical dollar.