while the largest shares of future health expenditures will continue to go to hospitals and physicians smaller but faster rising components of health expenditure include government administration retail sales of prescription medicines investment in research and development and private health insurance all of which may double or more from amounts cmsoact the extent to which health care expenditures are financed by the state is a policy decision and some forecasting models explicitly consider scenarios related to the publicprivate cost split for example the netherlands bureau for economic policy analysis forecast public health expenditures to reach of gdp by with no policy action