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It’s a shell game. Can you follow the marker as the shells move around? Or: Can you follow the money to figure out why healthcare—and health insurance—has gotten so expensive?

At Save Our States, we’re following the money. There is an answer, one big cost driver, and it’s hospitals. Even if most people see the costs in their insurance premiums, the increases are coming from hospitals. We know this because hospitals—or “hospital systems,” or whatever these massive corporations call themselves—are the largest single area of healthcare spending.

Nearly a third of all healthcare spending goes to “hospital care.” Another 16% goes to physician services and 5% to clinical services, both of which are often provided by a hospital corporation. Altogether, those categories account for 52% of healthcare spending.

Prescription drugs account for less than 9%, while nursing and home healthcare together account for less than 8%. While those costs have grown as new drugs have been invented and the population has aged, they are too small to be major drivers of cost increases.

Save Our States has exposed the bizarre priorities that drive spending at some of these major hospitals. We will continue to dig, to follow the money, and to expose the real reasons why our healthcare costs continue to go up.