Honolulu is among the few cities where spending for Medicare and private insurance are both low, a new study shows.

A look at 306 other places around the country found many that either had low spending on Medicare and high spending for private insurance, or vice versa.

Honolulu is the rare place where spending on Medicaid and private health insurance is low, a study found.

Honolulu is the rare place where spending on Medicare and private health insurance is low, a study found.


In Grand Junction, Colorado, for instance, the city is the third lowest when it comes to Medicare but 42nd highest for private insurance, according to the study, which the New York Times reported Tuesday.

Honolulu, being somewhat of an anomaly, is sixth lowest for Medicare and the lowest for private insurance ($1,707 per person in 2011), the study says. Napa had the highest spending per privately insured beneficiary at $5,515.

The New York Times used the study to show how the experts were wrong about the best places for better and cheaper health care when President Obama was making his case for the Affordable Care Act in 2009.

The study points at other interesting things — like how hospital prices in monopoly markets are 15 percent higher than those in markets with four or more hospitals — and relies on a huge new database on spending for the privately insured.

The study is by Zack Cooper (Yale University), Stuart Craig (University of Pennsylvania), Martin Gaynor (Carnegie Mellon University, University of Bristol, and the National Bureau of Economic Research) and John Van Reenen (Centre for Economic Performance, LSE and NBER).

“Virtually everything we know about health spending and most of the basis for federal health policy comes from the analysis of Medicare data,” Cooper told Yale News. “The rub is that Medicare only covers 16 percent of the population.

“The majority of individuals — 60 percent of the U.S. population — receive health care coverage from private insurers,” he said. “This new dataset really allows us to understand what influences health spending for the majority of Americans. This information is critical to creating better public policy.”

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