As Alzheimer’s Numbers Rise, Who Will Pay?

The latest estimates for Alzheimer’s in the United States are that more than 5 people have the disease, with projections that up to 14 million people could have it by 2050.

Given the heavy cost of caring for those with the disease, is the country fiscally prepared to pay for it?

In a session with National Press Foundation fellows, William Hoagland, senior vice president of the Bipartisan Policy Center, laid out some of the challenges coming in the nation’s health care budget. Hoagland had a long career in Washington politics and policy, including time as a staff member and director of the Senate Budget Committee and as one of the first employees of the Congressional Budget Office.

Hoagland gave a tutorial on the federal budget process as a way to explain the looming problems in funding the nation’s health care programs.

In the 2018 fiscal year, total health care spending for the country is $3.6 trillion, about 18 percent of gross domestic product. Of all that spending, about half is public spending and half is private. But the sticky point is that health care spending is growing – and fast.

“The fastest growing area of the federal spending will be health care,” said Hoagland (bio, Twitter).

Within that are programs such as Medicare (federal health services for those 65 and over) and Medicaid (the federal-state health program for the poor that is the largest payer of Americans’ nursing home bills).

Total spending on Alzheimer’s in 2019 is expected to be $290 billion, and of that $146 billion will come from Medicare, $49 billion from Medicaid, $63 billion out-of-pocket by patients or their families, and $32 billion from other sources.

Hoagland estimates that one of every 10 Medicare recipients has Alzheimer’s. And those people are far more costly than those without the disease: a total of about $49,000 per person a year in Medicare, Medicaid and other spending, compared with $14,000 for those without.

“This is a tremendous burden outside of the public expenditures going forward,” he said.


This program is funded by AARP. NPF is solely responsible for the content.

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