Let's look at the top 3 - hospital services, college tuition and college textbooks. Hospitals have more high tech equipment and tests than 20 years ago. What used to be an inexpensive X-ray is now an expensive MRI or CAT scan. Government regulations about staffing and equipment have driven up administrative costs. Hospitals throw away huge amounts of bed side plastic equipment because it can't be reused once it's out of the package (even if the patient never touched it). There is some justification for higher costs. College tuition covers administrative costs such as staff, buildings and professors. Those haven't changed in 20 years unless the college built new buildings because they had excess cash. Costs should be about same as 20 years ago (adjusting for inflation). College textbooks should be cheaper than 20 years ago because technology has made layout and editing faster and easier.