Today in class I mentioned that in the United States the share of out-of-pocket health costs borne by individuals as a share of total medical expenditures had fallen over the last few decades. My statement was based on a recollection of a Washington Post Wonkblog item from back in February of 2013. Here you will learn that in 1970 the share of out-of-pocket costs relative to total healthcare expenditures was 39.6%. In 1990 that number was 22.5% and in 2010 it stood at 13.7%.
Such a decreasing share of the cost borne by the consumers of medical services, as opposed to publicly funded programs or private insurers, means that the scope for moral hazard in heath spending went up quite dramatically. As I stated in class, this is one of many explanations for rising healthcare costs in the United States.
Note how outraged some of the commenters seem to be about the blog post at the link, and how little understanding of the numbers they display (the main confusion is to mix up the dollar value of out-of-pocket expenses and their share of total expenditure - it is the latter that matters for moral hazard). This is a subject of enormous contention, and there is tremendous public pressure for lower out-of-pocket costs. I would not expect the share of out-of-pocket costs to start increasing back to previous levels anytime soon.
Further data can be found at the following links:
The Atlantic
The OECD (for international comparisons - the US does not have a particularly high out-of-pocket share)