Americans and public and private health insurers spent $1.9 trillion in 2004 for hospital care, physician services, and prescription drugs, according to a report by the Centers for Medicare & Medicaid Services (CMS).

According to "Heath Care Spending Growth Rate Continues to Decline in 2004," the national average for health care spending per person was $6,280 in 2004, compared to $3,759 per person in 1998. And the Centers for Medicare and Medicaid Services (CMS) project health care spending in the U.S. to grow 7.4 percent in 2005 and 7.3 percent in 2006, eventually surpassing the $2-trillion mark.

Another report, "CMS Reports 1998 Health Care Spending in the States" shows per-person spending for health care can vary by nearly $2,000 from state to state with a high of $4,810 per resident in Massachusetts to a low of $2,731 in Utah. Residents who pay the most live in the nation's capital: Residents of Washington, D.C., spend $5,656 per capita.

"Research has suggested many reasons for differences in health care spending among states," according to CMS, "including socioeconomic and demographic factors, incidence of illness, access to and type of insurance coverage, availability of resources (hospital beds and physicians), and diversity in practice patterns."

Per-person spending for health care tends to be higher in the Northeast and lower in the western states. Four states had average health spending of 15 percent or more above the U.S. average in 1998: Massachusetts, New York, Connecticut, and Rhode Island. Five states had average spending of at least 15 percent below the national average: Utah, Idaho, Arizona, Nevada, and New Mexico.

The 10 most expensive states for health care spending are:
      1. Massachusetts
      2. New York
      3. Connecticut
      4. Rhode Island
      5. Delaware
      6. New Jersey
      7. Pennsylvania
      8. Florida
      9. West Virginia
      10. Maine

According to CMS, between 1991 and 1998, average annual growth in per-person health care spending ranged from 3.5 percent in California to 7.3 percent in Maine. The far West showed the slowest regional per-person growth between 1991 and 1998 at 3.8 percent, while the Plains region showed the fastest average annual growth at 5.9 percent.

The states with the lowest health spending growth over this same span are Arizona (3.7 percent), California (3.5 percent), Colorado (4.3 percent), Florida (4.5 percent), Nevada (4 percent), and Washington (4.1 percent).

Fastest growth was in Maine (7.3 percent), Mississippi (6.8 percent), West Virginia (6.7 percent), North Carolina (6.5 percent), and South Carolina (6.5 percent).