Organization for Economic Cooperation and Development (OECD) OECD Health Data 2006
How Does the United States Compare
Total health spending accounted for 15.3% of GDP in the United States in 2004, the highest share in the OECD and more than six percentage points higher than the average of 8.9% in OECD countries.
The United States also ranks far ahead of other OECD countries in terms of total health spending per capita, with spending of 6,100 USD (adjusted for purchasing power parity), more than twice the OECD average of 2,550 USD in 2004.
Between 1999 and 2004, health spending per capita in the United States increased in real terms by 5.9% per year on average, a growth rate exceeding the OECD average of 5.2% per year.
The public sector is the main source of health funding in all OECD countries, except for the United States and Mexico. In the United States, only 45% of health spending is funded by government revenues, well below the average of 73% in OECD countries. The public share of total health spending remains the lowest among OECD countries. On the other hand, private insurance accounts for 37% of total health spending in the United States, by far the largest share among OECD countries.
Despite the relatively high level of health expenditure in the United States, there are fewer physicians per capita than in most other OECD countries.
The number of acute care hospital beds in the United States in 2004 was 2.8 per 1000 population, also lower than the OECD average of 4.1 beds per 1000 population.
http://www.oecd.org/dataoecd/29/52/36960035.pdf
Comment:
By Don McCanne, M.D.
These numbers confirm once again that the United States has the highest spending on health care per capita, and as a percentage of its GDP. The rate of growth in spending also continues to exceed that of OECD averages.
We should take a closer look at the reported health spending that is funded by the government (45 percent), and that funded by private insurance (37 percent). Steffie Woolhandler and David Himmelstein, in a 2002 Health Affairs article, have demonstrated that those numbers should be adjusted to improve our understanding of the spending.
The OECD calculations do not include two important sources of government funding of health care: (1) the funding of private insurance for government employees, an undisputed government expense, and (2) the tax subsidy received by employers providing insurance for their employees, since employer-sponsored coverage is deductible to the employer but is not taxable income to the employee. When these are included, the United States government funds 60 percent of health care.
Since the number of individuals covered by employer-sponsored plans is much larger than individual plans, employers have had a major influence on health policy. Although a great many individuals are covered through their employment (about 60 percent of those under age 65), these are working individuals and their families who are comparatively healthy and thus have lower health care costs. If we exclude government employees and look at those covered by private employers, then only 19 percent of health care costs are paid by employer-sponsored plans (or only 11 percent if you were to assume that the tax subsidy accrues to the employer rather than the employee).
What is the lesson? Since we already pay so much through the tax system, policies need to be directed to providing greater health care value for our public dollars. Perpetuating a highly dysfunctional system of funding health care merely to cater to the private insurance industry should be abandoned as irrational and irresponsible public policy.
Steffie Woolhandler and David Himmelstein, Paying for national health insurance–and not getting it:
http://www.healthaffairs.org (Use Quick Search for abstract)