The economic downturn, not the Affordable Care Act, was the cause of about 70 percent of the recent decline in health care spending growth from 2009 to 2011, according to a new study published in Health Affairs. As the economy starts to recover, health care spending may start to increase at a faster pace.

The researchers at Northwestern University set out to investigate the impact that the economic downturn had on the health care spending of the privately-insured, working-age population. They looked at 2007 to 2011 private insurance claims data from the Health Care Cost Institute, which accounts for almost 47 million individuals with employer-sponsored insurance.

They found that health care spending growth slowed down by 2.6 percent from 2009 to 2011 compared to the previous two years. They then calculated the overall decline in employment during that period and determined that health care spending growth would have been 1.8 percent higher if the economy did not wane in 2008.

Therefore, they concluded that 70 percent of the decline in health care spending growth was due to the sluggish economy.

Since the study focused on the privately-insured population, it shows that the decrease in health care spending growth was not just caused by those who lost their jobs and employer-provided insurance but also those who retained their jobs.

"Even if you have not lost your job, the recession does change your economic prospects in a couple of ways," Craig Garthwaite, one of the authors of the study and assistant professor at the Kellogg School of Management at the university, told DOTmed News. He added that an individual's spouse could have lost their job or they could be worried that they might lose their job in the future.

The researchers also compared health care spending in areas of the country that were affected by the ailing economy with areas that weren't affected and found that that areas that were affected the most had less of an increase in spending.

Las Vegas, Nevada was hit hard from 2008 to 2009 with a 5.6 percent decrease in the amount of people working, and they only had a 5.4 percent increase in health care spending. However, Trenton, New Jersey had a 1.6 percent decrease in the amount of people working and an increase of 29 percent in spending.

The researchers made the decision to look into what caused the decrease in health care spending growth because of the debate revolving around it. "We were hoping to shed some light on this question and take advantage of some new data that has come to light," said Garthwaite.

Some people credited it to the decline in the rate of technological adoption or the decrease in prescription drug spending after drugs came off patent. Some have suggested that it's the early effects of the ACA even though it wasn't passed until 2009 and it hasn't been implemented in full within the past year, said Garthwaite.

Garthwaite believes that it's important to know the effect that the economy has on health care spending because if the economy improves, the rate of health care spending may go up again.

"Going forward we should be concerned and we might start to see an increase again in health spending," he said. "There are other factors that are going on — the Affordable Care Act is actually in place so that might moderate some of that going forward, but it's important to know that that was not what was driving the decline."

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