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U.S. health care spending is projected to approach $2.4 trillion in 2008; a large share will be paid by government outlays and tax subsidies. Other countries routinely conduct incidence analyses of public health care spending, yet we know of no recent and comprehensive incidence studies for the United States. We examined data for 2002 from the Medical Expenditure Panel Survey aligned to the National Health Expenditure Accounts and augmented with simulated tax subsidies. The public sector accounted for 56.1 percent of health spending within the civilian noninstitutionalized population. Our analysis highlights this sector's role in financing the care of seniors and people in poor health.

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Untreated or undertreated diabetes can cause debilitating complications such as blindness and amputations. Information about the factors associated with diagnosed but untreated diabetes may help target efforts to promote appropriate treatment. Using the Medical Expenditure Panel Survey, we examine: (1) use of insulin or oral medications, (2) use of diet only, and (3) no treatment. We analyze covariates of this trichotomous outcome using multinomial logit regression. Among adults diagnosed with diabetes, 87.0% used oral medications or insulin, 10.6% used diet only, and 2.4% were untreated. Lacking a usual source of care, poor mental health, being single, and being an Asian/Pacific Islander are associated with lack of treatment. Better health, lacking a usual source of care, and attitudes against medical care are associated with using diet only. Adults with diagnosed but untreated or undertreated diabetes may be difficult for service providers to reach, and multiple strategies are needed to initiate treatment.