National Health Expenditure Projections, 2023-32: Payer Trends Diverge As Pandemic-Related Policies Fade.

Health care spending growth is expected to outpace that of the gross domestic product (GDP) during the coming decade, resulting in a health share of GDP that reaches 19.7 percent by 2032 (up from 17.3 percent in 2022). National health expenditures are projected to have grown 7.5 percent in 2023, when the COVID-19 public health emergency ended. This reflects broad increases in the use of health care, which is associated with an estimated 93.1 percent of the population being insured that year. In 2024, Medicaid enrollment is projected to decline significantly as states continue their eligibility redeterminations. Simultaneously, private health insurance enrollment is projected to increase because of the extension of enhanced subsidies for direct-purchase health insurance under the Inflation Reduction Act (IRA) of 2022, as well as a temporary special enrollment period for qualified people losing Medicaid coverage (after eligibility redeterminations). Over the course of 2024-26, the IRA expands Medicare's drug benefit generosity and implements drug price negotiations for beneficiaries; concurrently, the extended enhanced subsidies for direct-purchase health insurance expire in 2026. During 2027-32, personal health care price inflation and growth in the use of health care services and goods contribute to projected health spending that grows at a faster rate than the rest of the economy.

Perseveration on a reversal-learning task correlates with rates of self-directed behavior in nonhuman primates.

In humans and several nonhuman animals, repetitive behavior is associated with deficits on executive function tasks involving response inhibition. We tested for this relationship in nonhuman primates by correlating rates of normative behavior to performance on a reversal-learning task in which animals were required to inhibit a previously learned rule. We focused on rates of self-directed behavior (scratch, autogroom, self touch and manipulation) because these responses are known indicators of arousal or anxiety in primates, however, we also examined rates of other categories of behavior (e.g., locomotion). Behavior rates were obtained from 14 animals representing three nonhuman primate species (Macaca silenus, Saimiri sciureus, Cebus apella) living in separate social groups. The same animals were tested on a reversal-learning task in which they were presented with a black and a grey square on a touch screen and were trained to touch the black square. Once animals learned to select the black square, reward contingencies were reversed and animals were rewarded for selecting the grey square. Performance on the reversal-learning task was positively correlated to self-directed behavior in that animals that exhibited higher rates of self-directed behavior required more trials to achieve reversal. Reversal learning was not correlated to rates of any other category of behavior. Results indicate that rates of behavior associated with anxiety and arousal provide an indicator of executive function in nonhuman primates. The relationship suggests continuity between nonhuman primates and humans in the link between executive functioning and repetitive behavior.