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The nation's annual bill for health care has risen to a record $1.2 trillion, with prescription drugs accounting for nearly 10 percent of the costs and expected to grab an even larger share of what Americans pay to get or stay healthy, government estimates show.

Overall health-care spending will more than double to $2.6 trillion by 2010, in part because drug costs are projected to rise on average 12.6 percent every year, federal health economists said in an annual report being published today.

Overall health-care spending includes such things as hospital- construction costs, but close to 90 percent is personal health- care spending: doctors' visits, hospitals stays, medicines and other medical services.

The drug spending boom -$996 billion in 1999, the latest year for which figures were available -comes not only with an aging population, but as more patients ask for newer, high- priced drugs marketed to them on television and take drug treatments at home for conditions that once landed them in hospitals, the repon said.

Those trends could slow with an economic slowdown, then some employers and insurers could pass thc growing costs onto consumers accustomed to low co-payments and other fees, said economists at the Health Care Financing Administration, which runs Medicare.

"There are going to be trade-offs," said Katharine Levit, economist on the spending report. "It puts increased pressure on all ofus -the government, employers, providers -to somehow make choices in terms of how we spend our money."

Consumer advocates say that patients who need prescription drugs will suffer in other ways if they do not get increased access to lower-cost generic drugs, expansive drug-coverage policity and lower premiums. "The personal cost is very real and very dramalic," said Gail Shearer, who handles health- cost issues for the Consumers Union, publisher of Consumer Reports magazine. "Children won't be getting the medicines they need to make them better. People of every age group will be suffering or they will have to neglect other basic needs.