In addition to looking at costs on a nationwide basis, for the last five years the Index has looked at comparative healthcare costs in the same 14 cities across the country, including Chicago, Denver, and Los Angeles.
With a current annual cost of $24,965, Miami has topped the list for five years. Girod explains that Miami has a large number of healthcare practitioners and capacity helps drive the demand for healthcare services. Also, the practice of defensive medicine is more prevalent in the Miami area.
Phoenix was the least expensive with a cost of $18,365 for a family of four.
For the 2012 study, healthcare costs in 11 of the 14 cities exceeded $20,000 annually for a typical family of four. In 2011 only six of the 14 cities posted costs in excess of $20,000. While that could suggest an easing in the geographic differences in the cost of healthcare, Girod says a more likely explanation is that "the entire scale is shifting up, both at the bottom and the top, so we just ended up with more cities over that $20,000 threshold."
The report notes that so far the Patient Protection and Affordable Care Act has had "only a limited effect on total healthcare costs for the illustrative family of four."