The total was 1.5 percent higher than the $427.5 billion in 1988, the study said.
In fact, the new study says, its use was just two and a half times as high.
A study says culture or language often stand in the way.
Whether the schools were large or small did not make a difference, the study said.
Because of those social costs, the state might even have lost money in the long run, the study said.
From 1991 to 1993, more than three million children lost their private insurance, several studies say.
But let me tell you what this new study said.
Now a new study says the drugs do not really help.
China's share last year was more than $42 billion, the study said.
Studies say that school age children need about 10 to 11 hours of sleep.