The Cost of Vision report estimated total costs at $139 billion, based on 2013 US dollars and the 2011 US population estimate. The 2014 projected costs presented in this analysis are expressed in 2014 dollars based on the 2014 population projection, which together increase the baseline real cost estimate to $145.2 billion and the nominal expenditure estimate to $150.47 billion. Nominal costs are higher in the baseline year because we assume inflation beginning in 2014. Based on this assumption, real and nominal costs were the same in 2013. Real costs and nominal expenditure projections are shown in Figure 4.1 and Table 4.1.
Real costs in 2014 dollars are projected to increase by approximately to $373 billion by 2050, a more than 2.5 fold increase over 2014 costs. Of the $228 billion increase in costs, $118 billion is from demographic changes and $110 billion is due to projected increases in medical care utilization and intensity. Nominal costs adjusted for projected impacts of general inflation, wage growth and excess medical cost inflation will increase at a much faster rate, reaching $717 billion in 2050.