On September 25, the Health Care Cost Institute (HCCI) released its Health Care Cost and Utilization Report: 2011.  For 2011, HCCI found that spending on health care for those younger than age 65 with employer-sponsored insurance (ESI) rose 4.6 percent to $4,547 per capita.  Per capita spending growth was higher than expected when compared to 2010 (3.8%), but still slower than growth seen in 2009 (5.8%).  Despite growth in out-of-pocket expenditure, the share of total expenditure between insureds and payers remained constant.  Spending growth was fastest for out