Here’s a health economics riddle: what do one dime, one nickel, and four pennies get you in the year 2019?

Health care costs’ value carved out of every single dollar.

That’s the forecast coming out of the Centers for Medicare and Medicaid Services (CMS) in a report in Health Affairs, as of this year the payor of more than 50% of the health care bills in the U.S. Ironically, the government’s taken over health care, with or without Congressional Democrats or President Obama’s direct hand in the scenario.

That’s $4.5 trillion, the entire economic output of the United States of America.

Health Populi’s Hot Points: This CMS report illustrates another aspect of America’s Whac-a-Mole health system. When one part of the health economic goes down, another goes up. In this case, when the private sector health payors — employers — drop insurance, cut back , lay off employees so insurance enrollments fall — the public sector payor, Medicaid, picks up the slack. That is, when Governors and the Fed’s (that would be your tax dollars at work) can afford to do so.

Thus the CMS actuaries found that the Federal share of Medicaid costs grew from $185.7 billion to $247.7 — a 33% increase in just 2 years.

This is not rocket science: health care costs have been increasing faster than the general economy and inflation for many, many years. The outcome reported in the CMS report isn’t unexpected — just worse than it had been thought, given the downtrodden state of the economy.

So save your pennies…er, nickels…er dollars. You’re going to need them in 2020 to pay for your health care.