Growth in the U.S. health care bill accelerated in 1998, driven by rising costs for prescription drugs and increased insurance premiums.

Total health care spending rose 5.6 percent in 1998, compared with 4.7 percent in 1997, according to an annual report from the Health Care Financing Administration. The increase in spending was the biggest since an 8.7 percent rise in 1993.

The report was published in the public policy journal Health Affairs, which was to be released today.

Private health care spending increased by 6.9 percent in 1998, compared with a 4.8 percent rise in 1997. Growth in government spending--on programs such as Medicare, for the elderly and disabled--slowed to 4.1 percent.

Overall, health care spending rose to $4,094 per person in 1998, or a total of $1.1 trillion, up from $3,912 per person in 1997.

Spending on prescription drugs grew more than any other category, climbing by 15.4 percent in 1998 to $90.6 billion.

Private insurance premiums rose 8.2 percent in 1998, more than double the increases in each of the three previous years--3.5 percent in 1997, 3.3 percent in 1996 and 2.8 percent in 1995.

Government costs for Medicaid health insurance for the poor grew by 6.6 percent in 1998, compared with 4.6 percent in 1997.

Spending on Medicare slowed to 2.5 percent in 1998 from 6 percent in 1997, largely because of cost-cutting measures and fraud and waste curbs enacted by Congress and the Clinton administration. Treasury Department reports show that in fiscal 1999, Medicare spending fell for the first time in history, by 1 percent.

Medicare costs are not expected to continue to drop, however. The costs are expected to jump sharply once members of the nation's huge baby boom generation start to become eligible for the retiree health insurance program after 2010.