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States Spending the Most on Health Care


The list of top 10 states that spend the most on health care per capita are overwhelmingly located in the Northeast and the Mid-Atlantic. However, it might be paying off as those with the highest spending have lower obesity rates.

The Wall Street Journal recently broke down health care spending per person by state (2009 data) and the biggest spender isn’t even a state — it’s the District of Columbia.

Northeastern and Mid-Atlantic states make up the vast majority of the top 10 and only two entries from elsewhere in the nation. Surprisingly, expensive California doesn’t make the top 10 and is actually in the bottom 10 for lowest overall spending per capita.

At the very least, none of the 10 biggest spenders were also in the top 10 for obesity rate, although it was close — West Virginia ranked 11 for spending ($7,667) and has the third highest obesity rate (32.4%).

The overall health care spending per person is based on a number of categories:

Hospital care

Hospital care is spending for services provided in hospitals, including outpatient care, operating-room fees and services of resident physicians.

Physician and clinical services

Treatments in the health professionals’ establishments

Dental services

Treatments in the dentists’ establishments

Other professional services

Other professional services include chiropractors; optometrists; physical, occupational and speech therapists; podiatrists; and private-duty nurses.

Home health care

Home health care includes medical services delivered in patients' homes, such as personal and companion care, 24-hour home care and speech therapy.

Prescription drugs and other nondurable medical products

Nondurable medical products include over-the-counter drugs such as cough and allergy medications and medical sundries such as surgical dressings or thermometers.

Durable medical products

Durable medical products include items such as contact lenses, eyeglasses, oxygen, orthopedic products and hearing aids.

Nursing home care

Nursing-home care includes services provided by freestanding nursing homes.

Other health, residential and personal care

Other health, residential and personal care includes services delivered in school and work-site clinics, residential mental-health and substance-abuse services.

(All spending figures are per capita based on 2009 data.)

The Grad Cities Art Fest in Grand Forks.

10. North Dakota

Overall overlays: $7,749

Despite landing in the top 10 for overall spending per capita, North Dakota has one of the lowest spending for physician and clinical services at only $1,306. However, it’s one of the highest for hospital care spending ($3,183) and for prescription drugs and other nondurables ($1,185).

State house in Concord. Wikipedia.com

9. New Hampshire

Overall overlays: $7,839

When it comes to dental services, New Hampshire is one of the biggest spenders ($459); same with physician and clinical services ($1,863). However, the state is mostly average in some of the other categories, like prescription drugs and other nondurables and nursing home care.


8. Rhode Island

Overall overlays: $8,309

In 2009, the per capita expenditures for prescription drugs and other nondurables was the second highest at $1,230. Expenditures for nursing home care and hospital care were among the highest in the nation as well. However, physician and clinical services were about average as was dental care.

Downtown Rochester

7. New York

Overall overlays: $8,341

Where New York’s spending gets really high is in when the care is coming to the individuals — home health care ($394) and other health, residential and personal care ($883). Nursing home care is also expensive ($607).

Downtown Wilmington and the Christina River. Copyright Tim Kiser.

6. Delaware

Overall overlays: $8,480

The state is a big spender when it comes to medical products with durable spending at $166 and prescription drugs and nondurables at $1,219. Delaware was also one of the highest spenders for physician and clinical services ($1,978).

Portland. Wikipedia.com.

5. Maine

Overall overlays: $8,521

Hospital care is costly in Maine at $3,268 per person and so are other professional services ($283), but Maine is by far the biggest spender out of the nation on other health, residential and personal care with $1,084.

Hartford. Flickr | Wikipedia.com.

4. Connecticut

Overall overlays: $8,654

In most categories Connecticut is among the highest spenders, except for nondurable medical products. It makes up for the low spending in that category by being the most expensive in the nation for nursing home care ($898), and prescription drugs and nondurable products ($1,269).

Anchorage. Frank K.

3. Alaska

Overall overlays: $9,128

In three categories Alaska is either the first or second for highest spending (hospital care, physician and clinical services, and dental services). However, otherwise, the state’s spending is fairly average.

Back Bay, Boston. Wikipedia.com.

2. Massachusetts

Overall overlays: $9,278

Massachusetts spends a lot on health care pretty much across the board, which explains why it’s second, with the exception of durable medical products. However, Massachusetts has the third lowest obesity rate (22.7%).

The Washington Monument during the Cherry Blossom Festival. Copyright Wendy Harman.

1. District of Columbia

Overall overlays: $10,349

In durable medical goods, prescription and nondurable goods and other professional services the District of Columbia spends below the nation’s average. But it’s a big spender in the other categories. However, it has paid off in the form of the fourth lowest obesity rate (23.7%).

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