In the mid-2000s, American made roughly 160 million doctor visits/year. Since ’09, that number has fallen to 140 million, and has stayed there. Thus, real US per-capita spending on healthcare has been growing at just 2.1%/year, down from 4.3%/year earlier in the decade. Why? It’s a combination of a lousy economy, higher out-of-pocket expenses, a lack of new blockbuster drugs and lower government payments to providers. Collectively, it’s good news.