Imrpovements to health have not grown with America’s $2.7 trillion healthcare industry, which has doubled as a percentage of the economy during the past 30 years and employs some 21 million workers.

In a systemic analysis, investigators from The Boston Consulting Group and the University of Rochester used public datasets to analyze trends in the U.S. healthcare system from 1980 to 2011, presenting their findings at a Journal of the American Medical Association briefing in Washington, D.C., on Tuesday.

By 2011, the system employed 15.7 percent of the U.S. workforce and had doubled since 1980 to 17.9 percent of the nation’s gross domestic product of slightly more than $15 trillion, a growth that outpaced other industries during this century’s first decade at 2.9 percent — during the Great Recession, no less. Only the government, of which healthcare comprises much, increased as a general economic category, growing an average of 3.3 percent per year last decade, according to a press release.

Although real-term costs tripled during the past 20 years, the average rate of cost increases has declined consistently since the mid-1970s, and sharply so during the past decade.

Over time, as Americans squabble over “socialized medicine” and how much of healthcare belongs within the government purview, funding from government sources has grown from 31 percent at the beginning of the Reagan Revolution to 42 percent, following the Bush and Clinton eras of entitlement growth.

Driving cost increases were several common factors: An increase in the prices charged for professional services, drugs, medical devices, and administrative costs, accounting for 91 percent of the cost increases since 2000. An aging population and ostensibly greater demand for healthcare services were not major drivers of cost increases, however, contrary to popular assumption.

Chronic illnesses in 2011 accounted for 84 percent of healthcare costs, including elderly and younger people alike. In fact, care for younger people with chronic illnesses accounted for 84 percent of healthcare spending in America.

Yet, despite increasing resources devoted in the United States to healthcare, many measures of population health trailed other developed nations, including life expectancy, disease mortality, and others. Explaining part of the disconnect between healthcare spending and patient outcomes is money allocated to technology upgrades, in which value remains “elusive,” according the analysts.

Tension between competing values of economic performance and health outcomes also concerns experts. “Measurements of cost and outcome, applied to groups, are supplanting individuals’ preferences,” Hamilton Moses III, of the Johns Hopkins School of Medicine, told reporters at the National Press Club, according to the statement. “Clinicians increasingly are expected to substitute social and economic goals for the needs of a single patient."

Thus, Moses recommended a “national conversation” guided by the best data to attain improved understanding of the “choices, tradeoffs, and expectations” of an evolving — and certainly growing — American healthcare system.