Exceptional Medicine and U.S. Health Spending — methodology summary
Data vintage: 2026-08-16

1. The accounting base is CMS 2024 historical National Health Expenditures: $5,278.588 billion.
2. The 2025-2034 figure is the sum of ten CMS projected nominal years: $72,135.310 billion.
3. Procedure and patient counts come from national registries where available. Missing complete national measures are NULL, not zero.
4. Administration, prices, low-value care, improper payments, and high-complexity care are overlapping evidence embedded in the NHE service categories. They are not added to the accounting table.
5. Conservative scenario: all CMS NHE research plus a high billed-charge envelope for current solid-organ transplant volumes.
6. Central scenario: conservative scenario plus 25% of all cancer care and 50% of domestic pharmaceutical business R&D.
7. High scenario: all CMS NHE research, the transplant charge envelope, all cancer care, and all domestic pharmaceutical business R&D.
8. Scenario assumptions are disclosed sensitivity choices. They are not observed CMS allocations, confidence intervals, or forecasts.
9. The international comparison uses the ten specified wealthy peers and OECD 2024 expenditure / 2023 price-volume measures.

Full source links and limitations are in evidence.csv and on the web page.