We pay more for our health care than most other countries, and we get less for our dollars. The U.S. infant mortality rate is the third-worst among OECD countries. And there's more...Comparing U.S. Healthcare Spending With Other OECD* CountriesRead this, too (It's only available in PDF form. I've provided pertinent summaries below.).
July 5, 2009
Some of the key points from this study comparing the U.S. health care system with other countries are listed below:
* In 2007, the total spending for health care accounted for 16% of the country’s GDP, the highest share among the OECD and almost double the OECD average
* On a per capita basis also the U.S. spent the highest with a total of $7,290 which is two-and-half times the OECD average
* The public share of health care expenditure in the USA (45%) is less than any other OECD country
* Despite spending the most, the U.S. provides health care coverage for only the elderly, disabled and some of the poor people
* In comparison, the same amount is enough to provide universal health care insurance by the government for all citizens in other OECD countries
* 35% of total health care expenditures is done by private health insurance which is the highest In OCED
* Despite the high medical expenditure,there are fewer doctors per capita in the U.S. than most other OECD countries
* Life expectancy in the U.S. is lower when compared with Japan,Switzerland, Canada and Australia
* Infant morality rates in the U.S. is higher than most OECD countries. In 2006, it was 6.7 per live births relative to OECD average of 4.7
* The proportion of daily smokers has fallen the most (> 50%) between 1980 and 2007 in the U.S. due to public awareness and high taxation
* Obesity rate among adults is the highest in the U.S. in the OECD countries at 34.3% in 2006. Higher obesity rates leads to higher health care spending in the future
*Organization for Economic Cooperation and Development
[more at link, including charts]
CRS Report for Congress U.S. Health Care Spending: Comparison with Other OECD Countries
September 17, 2007
Chris L. Peterson and Rachel Burton
Domestic Social Policy Division
Summary
The United States spends more money on health care than any other country in the Organization for Economic Cooperation and Development (OECD). The OECD
consists of 30 democracies, most of which are considered the most economically
advanced countries in the world. According to OECD data, the United States spent
$6,102 per capita on health care in 2004 — more than double the OECD average and
19.9% more than Luxembourg, the second-highest spending country. In 2004, 15.3%
of the U.S. economy was devoted to health care, compared with 8.9% in the average
OECD country and 11.6% in second-placed Switzerland.
Why does the United States spend this amount on health care? Economists
break health care spending into two parts: price and quantity (which includes the
number of visits to health care providers and the intensity of those visits). In terms
of quantity, OECD data indicate that the United States has far fewer doctor visits per
person compared with the OECD average; for hospitalizations, the United States
ranks well below the OECD and is roughly comparable in terms of length of hospital
stays. The intensity of service delivery is a different story: the United States uses
more of the newest medical technologies and performs several invasive procedures
(such as coronary bypasses and angioplasties) more frequently than the average
OECD country. In terms of price, the OECD has stated that “there is no doubt that
U.S. prices for medical care commodities and services are significantly higher than
in other countries and serve as a key determinant of higher overall spending.”
What does the United States get for the money it spends? Said slightly
differently, does the United States get corresponding value from the money it spends
on health care? The available data often do not provide clear answers. For example,
among OECD countries in 2004, the United States had shorter-than-average life
expectancy and higher-than-average mortality rates. Does this mean that the U.S.
system is inefficient in light of how much is spent on health care? Or does this
reflect the greater prevalence of certain diseases in the United States (the United
States has the highest incidence of cancer and AIDS in the OECD) and less healthy
lifestyles (the United States has the highest obesity rates in the OECD)? These are
some of the issues that confound international comparisons.
However, research comparing the quality of care has not found the United States
to be superior overall. Nor does the U.S. population have substantially better access
to health care resources, even putting aside the issue of the uninsured. Although the
United States does not have long wait times for non-emergency surgeries, unlike
some OECD countries, Americans found it more difficult to make same-day doctor’s
appointments when sick and had the most difficulty getting care on nights and
weekends. They were also most likely to delay or forgo treatment because of cost.
The OECD data and other research provide some insight as to why health care
spending is higher in the United States than in other countries, although many
difficult research issues remain. This report presents some of the available data and
research and concludes with a summary of study findings.
[Read the 65-page study on the PDF you can Google for.]
Summary of Findings
Total Spending. In 2004, the United States spent more than twice as much
on health care as the average OECD country, at $6,102 per person (compared with
the OECD average of $2,560). Health care spending comprised 15.3% of the U.S.
GDP in 2004, compared with an average of 8.9% for the average OECD country
(Figure 1). Although a country’s health expenditures are highly correlated with GDP
(Figure 2), U.S. health spending is nevertheless 60% greater than its GDP alone
would predict.
Health Care Resources. The United States has fewer hospital admissions
(Figure 3) and doctor visits (Figure 4) than the average OECD country. The United
States has a below-average number of hospital beds (Figure 22) and practicing
physicians per population (Figure 15), but its number of nurses per population is
roughly the same as the OECD average. The United States has a higher than average
number of staff per hospital bed (Figure 10) and nurses per bed (Figure 11). The
length of hospital stays in the United States are the same as the OECD average
(Figure 5).
The United States spent a per capita average of $2,668 on outpatient care in
2004 — three-and-a-half times the OECD average. In most OECD countries, visits
to general practitioners outnumber visits to specialists — but not in the United States.
The United States has a greater supply of advanced technological equipment than
other OECD countries, with nearly twice as many CT scanners per capita as the
OECD average (Figure 12) and three times as many MRI machines (Figure 13).
The United States also performs far more heart procedures per population than the
average OECD country (Figure 9), and an above-average amount of organ
transplants per capita, but does not perform more of all types of surgical procedures.
Pharmaceuticals. The United States spends more on prescription drugs per
capita than any other OECD country (Figure 18). The United States also consumes
more prescription drugs than most OECD countries, according to a nine-country
study (Figure 17). That study found that the United States paid more for brand name
drugs but less for generic drugs than other OECD countries (Figure 16).
Health Administration and Insurance. Spending on health administration
and insurance cost $465 per person in the United States in 2004, which was seven
times that of the OECD median (Figure 20). Americans pay less out-of-pocket for
health care (as a percentage of total health care spending) than residents of most
OECD countries (Figure 21).
Prices. Although OECD data does not compare prices of medical care, other
studies have found that the United States pays higher prices for medical care than
countries such as Canada and Germany. Part of the reason for this may be that U.S.
general practitioners and nurses are the highest paid in the OECD, and U.S.
specialists are the third-highest paid in the OECD (Table 2). Health professionals
in wealthier countries earn higher salaries than those in poorer countries (Figure 14),
but even accounting for this, U.S. health professionals are paid significantly more
than the U.S. GDP would predict (for example, specialists are paid approximately
$50,000 more than would be expected). However, U.S. health care professionals also
enter the careers with substantially more educational debt than in other OECD
countries. For example, in 2006, 62% of new U.S. medical school graduates had
educational debt exceeding $100,000.102
Population Risk Factors. The United States had a lower than average
proportion of the population that is elderly in 2004, and lower than average rates of
smoking and drinking. The United States consumes more calories and sugar per
capita than any other OECD country: the United States consumes 156 pounds of
sugar per person per year, compared with 99 pounds in the average OECD country.
In 2004, 34% of Americans were overweight and an additional 32% were obese.
Obesity is associated with a 77% increase in consumption of medications and a 36%
increase in inpatient and outpatient spending, according to one study.
Quality. In terms of quality of health care, a five-country study found that each
of the five countries studied (the United States, Canada, the United Kingdom,
Australia, and New Zealand) had the best and worst health outcomes on at least one
measure, but no country emerged as a clear quality leader. For example, the United
States had the highest breast cancer survival rate but the lowest kidney transplant
survival rate. A six-country study (the United States, Canada, the United Kingdom,
Australia, New Zealand, and Germany) found that Americans were most likely to
report receiving specific recommended preventive services for diabetic and
hypertensive patients, but were most likely to complain that their doctor did not
spend enough time with them and did not have a chance to answer all of their
questions.
Wait Times. The United States is one of eight countries in which wait times
for elective surgery are reported to be low. In a recent survey, a quarter to a third of
respondents in Canada, the United Kingdom, and Australia reported waiting more
than four months for a non-emergency procedure, compared with only 5% of
Americans. In terms of doctor visits to primary care physicians, a five-country
survey found that Americans had the greatest difficulty getting care on nights and
weekends and were the most likely to forgo care because of cost.
Health Outcomes. The United States has the third-highest percentage of the
population that reports their health status as being “good,” “very good,” or
“excellent” (Figure 23). However, the United States has below-average life
expectancy (Figure 24) and mortality rates (Table 5). The United States has the
third-highest rate of deaths from medical errors (Figure 25) and the highest infant
mortality rate among the eight countries that report this metric similarly (Figure 26).
However, such measures are often subjective or limited by differing measurement
methodologies. They may also reflect fundamental population differences (in
underlying health, for example) rather than differences in countries’ health care
systems. These are just some of the difficult research issues facing international
comparisons like those used in this report.
