First, once again: we have a nationalized health care system for injured veterans. They not only have a separate payer system but also a separate provider system.

Second: I have followed health policy for quite awhile, and it's not clear to me at all what impact you believe your parenthetical callouts had on health costs.

First: I know you're not stupid so I have no idea what you aren't understanding when it comes to veteran care costs increase during wartime. Of course they have a separate payer and provider system. That system is included in the growth rate statistics. It should be fairly obvious that people being regularly shot at have higher healthcare costs.

Bankruptcy Law: In 2005 there were 2,000,000 bankruptcy filings, in 2006 there were 600,000. This was a result of the passing of the BAPCPA in 2005. At that point in time 46% of bankruptcies were due to medical bills. This change increased the expected value of delinquent accounts which in turn should lead to lower costs for medical services.

Great Recession: People put off non-essential medical expenses, or delay usage of medical services. Someone who might get braces doesn't, someone might take care of a parent themselves instead of hiring an in-home nurse, etc.

ACA Signed: Marker for before and after growth rates.

ACA Taxes + Exchanges Open: The two main policies of the ACA intended to curb healthcare costs go into effect. I would classify these two years as overestimation of savings and regression to the mean. Most insurance companies had to backtrack after their financial projections did not materialize.

No, I do not believe veteran health care is included in the statistics you are citing, and I am similarly dubious of your explanations for how each of those other 4 events impacted health care costs, because everything I've read suggests that the impacts are way more complicated than they look (for instance, much of the health cost impact from the "Great Recession" wasn't felt until years after).

Here's the dataset that I'm referencing.[0] From the summary documents, "DOD spending in the NHEA excludes spending that occurs outside of the United States." I'm not certain whether this does or does not include forward operating bases. (Post offices count those as being in the United States so I believe they are included; but I could be wrong) Nevertheless it does include domestic spending on veterans.

Also, many veterans get care outside the VA. From my own experience working with these people, they cite long waiting times or broken relationships with the government for not wanting to take part in that system.

I'm not trying to downplay the complexity of the healthcare market, it's really complex. However, it I were to pick the things the government had control over and impacted the marketplace the most over the last 15 years, I still would pick the same things I did. I could fill several books with other changes that impacted the cost of American healthcare. (switching to e-prescriptions, subsidies for electronic medical records, medicare part D, certificate of need laws, FSA changes, HSA changes, consolidation of pharmacy benefit managers, health system consolidation, the opioid epidemic, the rise of the physicians's assistant, the expanding role of nurse practitioners, etc.)

I'd rather spend my time continuing fixing the things I know I can make better.

[0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

Here are some more links, since I can't nest further.

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

https://www.chcf.org/publication/us-health-care-spending-who...

The main one you might be interested in is this one though, https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

I've excerpted this from page 34 for your convenience.

"Other public programs include health insurance coverage provided by the Department of Veterans Affairs (VA) and the Department of Defense (DOD). Enrollment for other public programs for 1987-2011 was estimated using the levels from the enhanced CPS (SHADAC) and for 2012, 2013, and 2014 estimates were extrapolated using the CPS. "

None of these appear to contain the table you posted at the root of the thread, the table you now claim also includes the increased cost of veteran care due to the wars in Afghanistan and Iraq. Can you just tell me how you made that table, so I can look at the source and evaluate your claim that it incorporates increased costs in the VA along with private health care?

The raw data comes from the following sublink from the first link in that group "NHE Summary including share of GDP, CY 1960-2017 [ZIP, 27KB]"[0] I computed the table by hand. You can recompute it if you like.

[0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

Oh, for God's sake. The Kaiser foundation just tracks the stat we're actually talking about directly. Here's the numbers for employees covered by group insurance provided by their employers:

    1999  2196 
    2000  2471 12.52%
    2001  2689 8.82%
    2002  3083 14.65%
    2003  3383 9.73%
    2004  3695 9.22%
    2005  4025 8.93%
    2006  4242 5.39%
    2007  4479 5.59%
    2008  4704 5.02%
    2009  4824 2.55%
    2010  5049 4.66%
    2011  5429 7.53%
    2012  5615 3.43%
    2013  5884 4.79%
    2014  6025 2.40%
    2015  6251 3.75%
    2016  6435 2.94%
    2017  6690 3.96%
    2018  6896 3.08%

Can you provide a reference for this data, I'm not 100% sure what I'm looking at. I deleted a previous comment on why I think the data I used is better for analysis but I want to confirm that this is what I think it is before I comment further.

It's the chart data from:

https://www.kff.org/interactive/premiums-and-worker-contribu...

I'm sorry for getting snippy, I just couldn't untangle your numbers from your source even after you pointed to the raw XLS you got it from.

If we just stay focused on commercial health care, we don't have to litigate whether the Iraq War (materially) impacted health care costs prior to the ACA. And: this thread is about whether employer shifts to HDHPs and (more broadly) the ACA has impacted those specific costs, not the total government cost of providing all health care services.

Can you give me a deeper link to the specific data from which you drew the table you posted above? There's a lot of stuff hanging off the link you just posted.