One approach to tracking state and local health spending

National health system reform proposals continue to emphasize states' shared responsibility for their citizens' health care. In view of this increased interest, this Data Watch examines how much state and local governments spend for health care, using primarily data from the U.S. Bureau of the Census. Significant discrepancies exist between these data and other sources of state and local health spending data. Nevertheless, census data are the most comprehensive source of information on state and local spending. In the 1980s the gross rate of state spending on health was exceeded only by spending on corrections; later reports indicate that health has now overtaken corrections. Health and hospital spending varies widely among states, ranging from $1.79 per $100 of personal income in New York (after federal funding and charges are subtracted) to $0.36 per $100 in Nebraska. Continued work is needed to unravel the differences between data sources and to improve the collection and use of data at the state and local levels.