A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Keeping Global -- Health Spending around the Globe

Keeping Global -- Health Spending around the Globe

July 13, 2005

The new issue of the policy journal, Health Affairs, presents data on health spending in industrialized nations, especially the US. (Sorry, it's a subscription journal -- so I'll give you some key findings.) In 2002, the US spent $5,267 per capita on health care, $1,821 more than Switzerland, the second highest spender. Even after adjusting for higher US incomes and cost of living, we spend $2,037 more than median spending in 30 developed nations of $2,193. You may wonder, how come?

Maybe it's because we have so much more of everything in the good old USA? Except for MRI scanners, the answer is "nope."
US 30 Nation Median
Hospital Beds per 1,000 persons 2.9 3.7
Physicians per 1,000 2.4 3.1
Nurses per 1,000 7.9 8.9
MRIs per 1,000 8.2 5.5
CT Scanners per 1,000 13.3 12.8

OK then, it must be malpractice -- those greedy lawyers, as Pres. Bush reminds us. Nope. Total malpractice awards per capita in 4 nations: US -- $16 (out of $5,267), United Kingdom -- $12, Australia -- $10, Canada -- $4. "In all four countries, however, malpractice payments represent less than 0.5% of health spending ... The cost of defending US malpractice claims, including awards, legal costs, and underwriting costs, was an estimated $6.5 billion in 2001 -- 0.46% of total health spending."

Dammit then, what's the cause? -- "...the prices of care, not the amount of care delivered, are the primary differences between the United States and other countries. These higher prices are increasingly making health care unaffordable for many Americans. Equally troubling, the more-costly U.S. health care has not resulted in demonstrably better technical quality of care or better patient satisfaction with care. Future U.S. policies should focus on the prices paid for health services and on improving the quality of those services."