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The nation’s health care tab is on track to hit $4.6 trillion in 2020, accounting for about $1 of every $5 in the economy, government number crunchers estimate in a report out Thursday. How much is that? Including government and private money, health care spending in 2020 will average $13,710 for every man, woman and child, says Medicare’s Office of the Actuary.

By comparison, U.S. health care spending this year is projected to top $2.7 trillion, or about $8,650 per capita, roughly $1 of $6 in the economy. Most of that spending is for care for the sickest people. The report from Medicare economists and statisticians is an annual barometer of a trend that many experts say is unsustainable but doesn’t seem to be slowing down. A political compromise over the nation’s debt and deficits might succeed in tapping the brakes on health care, but polarized lawmakers have been unable to deliver a deal.

The analysis found that President Barack Obama’s health care overhaul would only be a modest contributor to growing costs, even though an additional 30 million people who would be otherwise uninsured stand to gain coverage.

Government, already the dominant player because of Medicare and Medicaid, will become even more important. By 2020, federal, state and local government health care spending will account for just under half the total tab, up from 45 percent currently. As the health care law’s coverage expansion takes effect, “health care financing is anticipated to further shift toward governments,” the report said.

Estimates from previous years had projected that the government share would already be at the 50 percent mark, but the actuary’s office changed its method for making the complex calculations. Under the previous approach, some private payments such as worker’s compensation insurance had been counted in the government column. Technical accuracy — not political pressure — was behind that change, said Stephen Heffler, one of the experts who work on the estimates.

Separately, another new report finds that the United States continues to spend far more on health care than other economically developed countries. The study by the Commonwealth Fund found that U.S. health care spending per person in 2008 was more than double the median — or midpoint- for other leading economies. Although survival rates for some cancers were higher in the U.S., the report found that quality of care overall was not markedly better.

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