(Bloomberg) — Health care spending in the U.S. grew at less than half the pre-recession level for the third straight year, as employers shifted more costs to strapped workers and state governments limited payouts for the poor.

Spending on hospital visits, medications and other care grew 3.9% to $2.7 trillion in 2011, matching the slowest growth in 52 years of recordkeeping, the Centers for Medicare and Medicaid Services say in a report this week in the journal Health Affairs. Growth was close to 8% before the United States entered an 18-month recession in December 2007.

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