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National Health Expenditures. The Centers for 

Medicare and Medicaid Services (CMS) of the U.S. 

Department of Health and Human Services publish 

annual data on total aggregate health care expenditures of the 

United States, referred to as National Health Expenditures 

(NHE). Total health care expenditures include expenditures 

for health care by all sources in the United States economy, 

including public and private sources. There are three major 

conceptual reasons for differences between Consumer 

Expenditure Survey (CE) and NHE estimates; populations 

covered by the surveys, service category definitions, and the 

scope of included covered services. NHE data cover U.S. 

citizens living abroad, military personnel, inhabitants of U.S. 

territories, and parts of the institutional population―a larger 

population than covered by the CE. In particular, the NHE is 

designed to cover the nursing home population, whereas the 

CE is not. In addition, NHE categories are defined according 

to the type of establishment that collected the revenue, 

whereas, CE categories are defined by the type of services 

provided. For example, NHE physicians services category 

includes outpatient care expenditures, while the CE classifies 

these types of expenditures as other professional services. 

The CE and NHE also differ with respect to the covered 

services included as health care expenditures, whereby NHE 

captures expenditures not collected in the CE. These services 

are considered in scope in the NHE but not in the CE, such as 

non-patient revenue (parking lot revenue, for example). U.S. 

Bureau of Labor Statistics staff compared estimates of outof-pocket personal health care expenditures from NHE with 

those from the CE. Out-of-pocket expenditures for health care 

include expenditures for medical care that are not covered 

by personal health insurance or other sources of payment. 

Such expenditures can include co-payments and deductible 

amounts required by health insurance plans. To derive its 

out-of-pocket estimates, CMS uses data from administrative 

and industry sources, as well as CE data. 

Text table 5 shows CE estimates of aggregate expenditures 

for health care (excluding health insurance, nonprescription 

vitamins, nursing home care, and repair and rental of medical 

equipment), and ratios to NHE estimates of out-of-pocket 

health care expenditures (excluding nursing home care). As 

reported in the CE, aggregate medical care expenditures, 

excluding those expenditure items listed above, were $144.3

billion in 2005, or 66 percent of the NHE estimate of $217

Consumer Expenditure Survey 

comparisons with National Health 

Expenditures and the Current 

Population Survey

billion (excluding nursing home care expenditures). Of the 

CE total, $68.2 billion was spent on medical commodities 

and $76.1 billion on medical services. These amounts were

71 percent and 63 percent of the NHE estimates, respectively.

Data show variations in the CE-to-NHE ratios over the

2002–2005 period for both medical commodities and 

medical services. Fluctuations can reflect volatility in 

spending on personal health care due to changes in health 

insurance coverages. In addition to the conceptual differences

in population, definition and scope, the comparison of

health care expenditures may reflect underreporting in

the CE. 

Current Population Survey. The U.S. Census Bureau collects 

income data in the Supplement to the Current Population 

Survey (CPS). The CPS is a household interview survey of 

approximately 60,000 households. Using data collected for 

calendar years 2003 through 2005, comparisons are made 

with Consumer Expenditure Survey (CE) estimates of total 

consumer unit income before taxes and by source of income. 

CPS estimates of aggregate income by source of income 

are derived from Census Bureau estimates of mean income 

of persons and the number of persons with the specified 

income. 

There are several differences between the CE and the 

CPS in the concepts and methods of measuring income. The 

CPS collects data in March for the previous calendar year. 

By comparison, the CE estimates of income are obtained in 

the second and fifth interviews of the consumer unit. These 

estimates refer to the prior 12 months; and, due to the rotating

panel design of the survey, the interviews may occur at any 

time during the year. The Census Bureau imputes CPS income 

data that are missing (due to nonresponse to income questions) 

based on demographic characteristics. In contrast, prior to 

2004, CE income data that were missing due to nonresponse 

were not imputed as part of the CE estimation procedure; 

instead, CE income estimates were based on complete income 

reporters only. However, beginning in 2004, the CE began 

multiple imputation of income data that allow income values 

to be estimated when they are not reported. (See the section 

“Changes to the 2004 and 2005 Consumer Expenditure 

Survey Published Tables and Selected Highlights” for a 

discussion of income imputation.) Correspondingly, the ratio 

of CE to CPS money income before taxes increased from 88 
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percent in 2003 to 91 percent in 2004, and to 93 percent in

2005. Neither procedure accounts for underreporting.

In addition to the differences between the CE and the 

CPS described above, beginning in 1993, computer-assisted

personal interviews (CAPI) were used to collect the CPS 

income data. By comparison, the CE began using computerassisted personal interviews to collect its data in 2003. Prior 

to that time, CE data were collected by traditional paper and 

pencil interview.

Text table 6 shows that the CE estimates of total income 

before taxes are 88 percent, 91 percent, and 93 percent of

CPS for the 2003, 2004, and 2005 periods, respectively. This 

reflects comparable levels of estimates from the two surveys 

for three of the largest sources of income: Wages and salaries 

(largest source); Social Security and Railroad Retirement 

Income; and self-employment income (for 2004 and 2005). 

The ratio of CE to CPS self-employment income increased 

significantly from 69 percent in 2003 to 100 percent in 2004. 

Also, some of the other sources of income were generally 

comparable between the two surveys: Pensions and annuities; 

and alimony, child support, and other regular financial support. 

Some differences in the estimates are expected because of the 

methodology differences between the two surveys described 

above and because the CPS is designed specifically to collect 

income data, whereas the CE is designed primarily to collect 

expenditure data. In addition, the CPS population is slightly 

greater than that of the CE. Some of the variation in the 

ratios reflects the difficulty of obtaining income information 

via household survey that is experienced by both the CE and 

CPS.

Text table 5. Comparison of aggregate expenditures for health care: Consumer Expenditure Survey and National Health 

Expenditures program, 2002-2005

Aggregate consumer expenditures Ratio of Consumer

Consumer Expenditure Survey Expenditure Survey to

Expenditure category (in billions) National Health Expenditures1

2002 2003 2004 2005 2002 2003 2004 2005

Health care, total2 ....................... $125.2 $124.5 $133.1 $144.3 0.69 0.64 0.65 0.66

Medical commodities, total...... 60.6 60.3 62.6 68.2 .74 .69 .68 .71

 Drugs and supplies.............. 52.2 51.8 53.6 59.4 .75 .69 .68 .72

 Medical equipment .............. 8.4 8.5 8.9 8.7 .69 .66 .68 .64

Medical services, total............. 64.6 64.2 70.6 76.1 .65 .60 .62 .63

 Professional services .......... 54.7 56.2 60.0 65.0 .65 .63 .63 .65

 Physicians services ......... 16.5 16.6 17.0 18.1 .41 .39 .38 .38

 Dental services ................ 25.4 26.2 28.0 29.8 .79 .76 .77 .78

 Other professional

 services.......................... 12.7 13.4 15.0 17.1 1.08 1.06 1.09 1.18

 Hospital care ....................... 9.9 8.0 10.6 11.1 .63 .47 .57 .55

1 The National Health Expenditures data are out-of-pocket 

expenditures. 2 Excludes health insurance premiums, nonprescription vitamins, 

nursing home care, rental of medical equipment, and repair of medical 

equipment.

NOTE: Sums may not equal totals, due to rounding. Consumer 

Expenditure Survey categories have been grouped as needed to 

match those used in the National Health Expenditures program.

SOURCE: The National Health Expenditures data used to obtain 

the ratios are from the U.S. Department of Health and Human Services, 

Centers for Medicare and Medicaid Services. Data are available 

online at http://www.cms.hhs.gov/NationalHealthExpendData/

downloads/tables.pdf. 
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Text table 6. Comparison of money income before taxes: Consumer Expenditure Survey and Current Population Survey

(CPS), 2003-2005

Aggregate consumer expenditures Ratio of Consumer

Income category Consumer Expenditure Survey Expenditure Survey to

(in billions) CPS1

2003 2004 2005 2003 2004 2005

Money income before taxes2 ................................................ $5,870 $6,300 $6,857 0.88 0.91 0.93

Wage and salary income .................................................. 4,753 5,023 5,433 .92 .94 .96

Self-employment income .................................................. 247 350 443 .69 1.00 1.10

Social Security and railroad retirement 

income .............................................................................. 382 401 431 .93 .93 .96

Unemployment, workers compensation, and 

veterans benefits .............................................................. 31 28 24 .34 .32 .26

Public assistance and Supplemental Security 

Income.............................................................................. 27 25 30 .76 .69 .79

Pensions and annuities .................................................... 264 279 290 .87 .88 .86

Interest, dividends, rents, royalties, estates 

and trusts.......................................................................... 127 147 162 .41 .45 .45

Alimony, child support, and other regular 

financial support ............................................................... 40 48 45 .90 1.03 1.03

1 Consumer Expenditure Survey data are for complete reporters 

of income for 2003. 2 Excludes the value of food stamps, meals as pay, rent as pay, 

and other income from the Consumer Expenditure Survey and 

educational assistance and other income from the CPS.

NOTE: Sums may not equal totals due to rounding. CPS 

categories have been grouped as needed to match those in the 

Consumer Expenditure Survey.

SOURCE: CPS data for 2003-2005 are from the U.S. Census 

Bureau Annual Demographic Survey, March Supplement, available 

on the Internet at http://www.bls.census.gov/cps/ads/adsmain.

htm.