(CNN) American households spent more than $1 trillion on health care in 2018, reaching a pricey milestone, according to federal data released Thursday.

That includes out-of-pocket expenses for medical services and premiums for employer coverage, individual policies and Medicare, as well as Medicare payroll taxes. The figure grew by 4.4% from a year earlier.

Progressive candidates such as Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts argue that the best way to reduce costs is to have the federal government take over the health insurance industry, while moderates such as former Vice President Joe Biden and South Bend, Indiana, Mayor Pete Buttigieg advocate less radical steps, such as a government-run health insurance option.

Overall, US health care spending rose 4.6% to $3.6 trillion last year, faster than in 2017 but the same as 2016, according to the report, issued by the Centers for Medicare and Medicaid Services. It accounted for 17.7% of the economy, slightly less than a year earlier.

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