State Healthcare Spending: New York, California & Massachusetts
This paper analyzes and compares healthcare expenditure data across three U.S. states — New York, California, and Massachusetts — using five key indicators: total employer-sponsored insurance spending, rates of uninsured adults, federal Medicare/Medicaid reimbursements, average cost per resident, and adult access to healthcare. Drawing on 2018 and 2020 data, the paper finds that New York performs consistently well, maintaining low uninsured rates and high Medicare reimbursements. California ranks lowest overall, while Massachusetts presents a paradox of high spending alongside a high uninsured population. The paper concludes by reflecting on what healthcare expenditure levels reveal about a state's economic health, human capital investment, and social welfare priorities.
- Introduction: Context for comparing state healthcare spending
- State Healthcare Data Overview: Five-indicator data table for three states
- Explanation of the Data: Row-by-row breakdown of each indicator and source
- Comparative Analysis: Rankings and findings across all three states
- Conclusion: Spending levels, human capital, and social welfare
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What makes this paper effective
- Uses a structured data table to anchor the comparative analysis, making abstract spending figures concrete and easy to evaluate side by side.
- Explains each data point's source, year, and any limitations (e.g., missing 2019 data for New York), which strengthens methodological transparency.
- Identifies a counterintuitive finding — Massachusetts has high spending yet the highest uninsured rate — and provides demographic context to explain it.
Key academic technique demonstrated
The paper demonstrates comparative data analysis using secondary public data sources. Rather than treating each state in isolation, it systematically ranks all three across each indicator, allowing patterns and anomalies to emerge. The Massachusetts paradox (high spending, high uninsured rate) is especially well handled, as the author does not simply report the data but interrogates it with supporting research on demographic factors driving the uninsured rate.
Structure breakdown
The paper follows a clear four-part structure: a brief introduction establishing the research context, a comparative data table presenting five indicators across three states, a row-by-row explanation of each indicator, and a synthesizing analysis section that draws conclusions about each state's healthcare performance. A short reflective conclusion ties the findings back to broader themes of economic performance and human capital, citing the Raghupati & Raghupati (2020) framework introduced at the outset.
Introduction
When a state makes healthcare expenditures, it is spending to provide better healthcare facilities and greater opportunities for access. Research on healthcare expenditure and economic performance demonstrates that human capital must be strengthened through enhanced productivity, which is only possible with high levels of health across all age groups, contributing to the fortification of the broader economy (Raghupati & Raghupati, 2020). This paper compares New York, the state of residency, against California and Massachusetts across several crucial healthcare indicators.
State Healthcare Data Overview
The following table presents five key healthcare indicators for each of the three states.
Explanation of the Data
One of the key factors used to illustrate healthcare system spending is total employer-sponsored insurance reimbursements for physician office services per enrollee for adults aged 18–64 years, measured in dollars (Commonwealth Fund, 2022). The data is taken for the year 2018, since data for 2019 was missing for New York, although it was available for the other two states.
The total number of uninsured adults in the three states shows that the lowest rate of uninsured adults is in New York. This is a positive sign when compared to Massachusetts and California, both of which have higher rates of uninsured adults. It can be inferred that New York has better health coverage plans than the other two states. The data for this indicator is taken for the year 2020 for all three states.
The third row shows total Medicare reimbursements for inpatient hospitals per enrollee. New York again ranks highest compared to the other two states, indicating higher reimbursements for Medicare plans for its citizens, while Massachusetts and California do not reach the same level. This data is also taken for the year 2020 for all three states.
The average cost per resident is measured as primary care spending on adults aged 65 years and above for Medicare beneficiaries. The exact data for average cost per resident was not available on the source website; therefore, this factor was selected as a proxy for comparing average spending across the three states. New York has the highest cost under this measure, while Massachusetts has the lowest among the three. The data is taken for the year 2020 for all three states.
Access to healthcare for adults aged 18 years and above is taken as another crucial indicator of healthcare status. Among the three states, New York ranks second after Massachusetts, with California in third place. The data is taken for the year 2020 for all three states.
Conclusion
Healthcare expenditure represents the consumption of a state's resources to provide and restore its people's health in support of better employment, education, and economic consolidation. The resources consumed in a given year are crucial indicators of how effectively an economy promotes the health of its population.
When a state spends more on its people's health, it signals that it is taking healthcare concerns seriously and seeking to support its residents' progress. However, higher spending does not always translate to better outcomes. Certain segments of the population may be underserved, or there may be a rising prevalence of chronic and critical health conditions that drive up costs. Higher expenditures may also reflect population growth, with more children, working-age adults, and older residents all requiring coverage on a broader scale.
The key learnings from this analysis include an understanding of the relationship between healthcare expenditures and state economic performance, the significance of human capital and population health for overall state productivity, and the importance of social welfare programs that serve all age groups equitably.
References
Commonwealth Fund. (2022). Doctors' office visit employer-sponsored insurance spending per enrollee.
Nelson, D., & Rushakoff, J. (2019). Massachusetts' remaining uninsured: Who they are and how to cover them. https://www.hks.harvard.edu/sites/default/files/degree%20programs/MPP/files/PAE%20Final%20-%20Nelson%20Rushakoff%20NO%20LOGO%20NO%20NAME.pdf
Raghupati, V., & Raghupati, W. (2020). Healthcare expenditure and economic performance: Insights from the United States data. Frontiers in Public Health, 8, 156. https://doi.org/10.3389/fpubh.2020.00156
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