Where America’s $5.3 trillion health bill goes — and where roughly 1 in 4 dollars leaks out as waste.
The surprise: the biggest leak isn’t fraud or provider overcharging — it’s paperwork and prices.
Sources & method
Spending (the bill):CMS National Health Expenditure Accounts, 1960–2024 — Table 02, by type of expenditure. The 15 tiles sum to the $5,278.6B 2024 national total. The YEAR slider resizes every tile to that year's spending; hover shows that year's per-tile growth.
Breakdown by payer:CMS NHE Accounts, 2024 — by type of service and source of funds. The toggle splits each service into payer sub-tiles sized by dollars (out-of-pocket, private insurance, Medicare, Medicaid, other/public). Capital, public-health, and research spending isn't billed to insurers, so those lines drop out in the breakdown.
What's measured vs. estimated: The two views use different data. Measured: spending tile values are CMS 2024 actuals; the six waste category totals are published research ranges scaled to 2024 dollars. Estimated: the sub-tile sizes within each waste category reflect relative ordering from the literature, not independently audited dollar splits. Waste is also a cross-cutting estimate — it doesn't map one-to-one onto the spending tiles, because some waste lives inside every service category.