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Health care spending is projected to grow at a historically low 7.5 percent for 2013, according to a report from PricewaterhouseCoopers’ Health Research Institute.

It’s the fourth straight year of relatively flat growth compared to inflation. Historically, the medical cost growth has been in the double digits, but since 2009, growth has slowed considerably. That’s a reflection of the sluggish economy, increased focus on cost containment by the industry, lower use of services by cost-conscious patients and efforts by employers to hold down expenses, the report explains.

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