Healthcare expenditure is one of the most important policy items for any country’s government, affecting people at a fundamental level. The COVID-19 pandemic has made this an even more pressing subject, with a country’s ability to combat the disease contingent on its existing healthcare infrastructure. These statistics on healthcare costs by country will give you an idea not only about the resources spent on health at home and across the world but also on the effectiveness of this expenditure. Sadly, as you will learn, high costs don’t necessarily translate into high quality.
Statistics on Healthcare Costs by Country (Editor’s Choice)
- Global spending on healthcare grew at 3.9% a year between 2000 and 2017.
- Health spending is growing at a faster pace than the economy.
- High-income countries represent 81% of global health spending but have 16% of the world population.
- Among OECD countries, the USA has the highest health expenditure as a percentage of GDP in the world at 16.9%.
- The USA has the highest per capita health expenditure in the world at $10,586.
- The USA has the highest pharmaceutical spending per capita in the world at nearly $1,220.
Cost of Healthcare Worldwide
1. Global spending on health rose to nearly 10% of GDP in 2017, equal to $7.8 trillion.
The latest global health spending report by the World Health Organization (released in 2019) suggests that global spending on health continues to rise. Between 2000 and 2017 alone, global health spending in real terms grew at 3.9% a year, outpacing global GDP which rose at a 3% pace. Out of the total 2017 expenditure, 60% was public and 40% private.
2. Between 2000 and 2017, health spending in low-income countries grew at 7.8% a year.
Based on healthcare expenditure by country, this growth was greater than middle-income or high-income countries, where health spending grew by about 6.3% a year and 3.5% a year, respectively. In all cases, however, the surge in health spending was higher than GDP growth which was 6.4%, about 6%, and 1.8% a year in low-income, middle-income, and high-income countries, respectively. These figures show that, barring some exceptions, in most parts of the world, health spending is growing faster than the economy.
3. High-income countries represent 81% of global spending on health but have 16% of the world population.
The high-income countries’ share, however, has come down from 87% in 2000. As shown by healthcare spending by country, middle-income countries have been closing the gap in health spending, with their share of global spending rising from 13% in 2000 to 19% in 2017. Income growth in countries like China and India is the main driver behind this change. In 2000, more than 40% of the world population lived in low-income countries with a less than 5% share in global health spending. In 2017, the population share had gone down to less than 10%, and the health spending share had decreased further to about 1%.
4. For low-income countries, per-capita spending on healthcare was only $41 in 2017.
Despite the overall growth in healthcare spending across the world, the distribution of global healthcare spending per capita remains highly unequal. By comparison, the spending per capita for high-income countries was $2,937 in 2017, more than 70 times higher than that in low-income countries. That said, even across countries with similar incomes, healthcare spending patterns can be very different, e.g., Brazil spends more than twice per capita on health compared to Turkey, even though they have similar per-capita GDP.
5. Global public spending on health grew at 4.3% a year between 2000 and 2017, faster than other sources.
A comparison of healthcare costs by country shows that the overall global health spending growth has been dominated by government spending in the 21st century. The role of government spending is the most prominent in high-income countries, where the average per capita public spending in 2017 was close to $2,000. The corresponding figures for low-income, lower-middle-income, and upper-middle-income countries were approximately $10, $60, and $260, respectively.
6. Out-of-pocket spending more than doubled in low- and middle-income countries and increased 46% in high-income countries from 2000 to 2017.
Economic growth has made this substantial increase in out-of-pocket spending possible. However, as data on healthcare costs per capita by country shows, this increase was slower than that of government spending; therefore, the share of out-of-pocket spending in overall health expenditure has been declining in all income groups since 2000. The implication is that the health sector worldwide has been growing less reliant on people’s out-of-pocket spending and more so on public expenditure.
7. Per-capita out-of-pocket spending grew from $14 in 2000 to $18 in 2017 in low-income countries.
The even greater growth in public spending meanwhile meant that the share of out-of-pocket spending came down in percentage terms, from 50% to 41%. Per capita out-of-pocket spending in lower-middle-income, upper-middle-income, and high-income countries rose from $30 to $50, $93 to $132, and $427 to $565, respectively. Per capita healthcare spending by country data, however, shows that the share of out-of-pocket spending in overall spending in these income groups fell from 50% to 41%, from 36% to 32%, and from 24% to 22%.
8. Donor funding represented 0.2% of global health spending in 2017.
The share of donor funding in global healthcare expenditure has continued to fall. That said, for low-income countries, it still holds significant value, where it accounts for 27% of the overall health spending on average. The countries where donor funding accounts for a particularly high share include Micronesia (72%), South Sudan (68%), Mozambique (61%), Central African Republic (55%), and Malawi (52%). The total value of donor funding globally toward healthcare in 2017 was $16 billion, down from $ 18 billion in 2014.
Cost of Healthcare by Country
9. At 16.9, the USA has the highest health expenditure as a percentage of the GDP among OECD countries.
As per the latest World Bank data, the USA also ranks at the top among all large countries (including non-OECD) in this regard. Despite a high GDP and a high percentage of it spent on healthcare, the US doesn’t necessarily have the best functioning health system. Factors like high physician salaries and high pharmaceutical costs push up the health expenditure in the country. Switzerland (12.2%), Germany (11.2%), France (11.2%), Sweden (11%), and Japan (10.9%) follow the US as of 2018 based on the percentage of GDP spent on healthcare by country.
10. The USA has the highest per capita health expenditure in the world at $10,586.
As of 2018, the USA had the most expensive healthcare worldwide, with the other top-ranked countries spending significantly lower on each citizen. The per-capita figures for Switzerland, Norway, Germany, Sweden, Austria, Canada, France, and the UK were, respectively, $7,317, $6,187, $5,986, $5,447, $5,395, $4,974, $4,965, and $4,070.
11. As of 2018, healthcare expenditure per capita exceeds $3,000 for 24 countries.
Those at the lower end of this 24-country set include the Czech Republic ($3,058), South Korea ($3,192), Spain ($3,323), and Italy ($3,428). The average per capita expenditure for OECD countries is $3,992. Turkey is among the developed European countries with the lowest per capita health spending at $1,227.
12. India has among the lowest per capita health expenditures in the world at $209.
India also ranks low in terms of healthcare expenditure as a percentage of GDP (3.6%). Other notable countries with relatively low per capita healthcare spending include Indonesia ($301), China ($688), South Africa ($1,071), and Mexico ($1,137). In India, China, and Indonesia, part of the reason for the low per capita expenditure is the very high population.
13. Switzerland has the highest per capita out-of-pocket healthcare expense at $2,069.
Out-of-pocket payments are costs borne directly by patients and not by insurance or any other government-offered measure. These expenses include cost-sharing, self-medication, and other costs directly paid for by private households. The latest figures on out-of-pocket healthcare costs by country show that other countries with high per capita expenditure are Austria ($1,362), Malta ($1,285), USA ($1,212), South Korea ($1,048), and Cyprus ($1,016). At the other end of the spectrum, the figures for South Africa, Indonesia, India, and China are $86, $112, $136, and $247, respectively.
14. Switzerland has the highest voluntary per capita spending on healthcare at $2,656.
Voluntary spending refers to health insurance provided by non-governmental entities. The figures for some of the other top-ranked countries — the USA, Australia, Canada, Austria, and Malta — based on voluntary per capita spending on healthcare by country are $1,637, $1,538, $1,508, $1,362, and $1,353, respectively. High numbers in this category indicate a well-developed private insurance industry. The lower-ranked prominent countries on this criterion include Indonesia ($123), India ($146), Colombia ($254), Turkey ($269), and China ($277).
15. The USA has the highest per capita government spending on healthcare at $8,949.
Government spending, in this case, includes compulsory health insurance. Note that despite the highest government spending per capita, the share of public healthcare expenditure is lower than private expenditure. Based on government spending on healthcare by country, other names at the top are Norway ($5,289), Germany ($5,056), Switzerland ($4,660), and Sweden ($4,569). On the flip side, large countries that have among the lowest per capita government spending on health include India ($51.8), Indonesia ($136), China ($399), South Africa ($460), and Brazil ($551).
16. Among developed countries, the USA has the highest per-person healthcare administrative costs at $2,497.
For comparison, Canada spends $551 on administrative costs per person. The main reason for this vast difference in healthcare administrative costs by country is believed to be the disparate system of private providers and insurers used in the US. Insurers’ overhead, the largest category among healthcare administrative costs, totaled $275.4 billion in 2017, i.e., nearly 8% of all national health expenditure, and was responsible for the largest increase in administrative spending in the US since 1999. It is believed that if US administrative costs were to be brought down to Canadian levels, the country would save more than $ 600 billion in a year.
US Healthcare Spending Statistics
17. In the USA, private health expenditure accounts for more than 50% of the total health expenditure per capita.
The US is the only country among those with high per-capita health expenditure where private spending surpasses public spending. This is one of the reasons for the high cost of healthcare in the country. The shares of public expenditure in overall per capita health expenditure for Switzerland, Luxembourg, Norway, and Germany were 63.6%, 82.9%, 85.2%, and 84.5%, respectively.
18. The USA has the highest pharmaceutical spending per capita in the world at nearly $1,220.
A reason for the USA having the most expensive healthcare in the world is the high cost of medicines. The country spends more per person on pharmaceuticals by far compared to other top-ranked countries. For example, the figure for Switzerland, the second-ranked country as of 2018, is $963. The figures for Japan, Canada, and Germany are $838, $832, and $832, respectively. Unlike many other countries, drug prices in the US are not government-regulated but open to market competition.
19. Physicians in the US have an average income of $313K, higher than any other country.
The higher cost of living and the higher medical school fees in the US are two of the reasons for higher compensation, adding to healthcare costs. If you compare healthcare costs by country, the International Physician Compensation Report 2019 shows that average physician earnings in the UK, Germany, France, Spain, Brazil, and Mexico (after conversion at the August 2019 currency exchange rate) are $138,00, $163,000, $108,000, $63,000, $58,000, and $22,000, respectively.
20. The USA performs 15.6 hip replacements per 1,000 population aged 65 and above.
According to experts, the relative higher rates of elective surgeries and advanced testing procedures contribute to the USA topping the list of average healthcare costs by country. Only Switzerland has more inpatient hip replacement procedures per 1,000 population than the US, with the OECD average being 10.5. Similarly, the USA has one of the highest rates of MRI scans per 1,000 population at 111. France and Germany have higher rates, but the OECD average is just 65.
(The Commonwealth Fund)
21. Among OECD countries, the USA has the lowest percentage of population covered by government/social health insurance.
Almost all OECD countries have provided social insurance for 100% or more than 90% of their population according to the most recent data on healthcare costs by country. Germany and Mexico are just under the 90% mark, while Chile has made it available to about 75% of its population. In the US, however, government or social insurance covers just about 36% of the population. About 55% of the US population is under private health insurance coverage. For the remaining 9% uninsured, the high costs of healthcare in the country can prove particularly trying.
22. Among OECD countries, the USA has by far the lowest life expectancy at 78.6 years.
A sign of the efficacy of the expenditure on healthcare is the average life expectancy of the population. Among countries that spend the most on healthcare, the USA scores the lowest on this front. The OECD average is 80.7 years, while the life expectancies in Switzerland, France, Canada, the UK, and Germany are 83.6 years, 82.6 years, 82 years, 81.3 years, and 81.1 years, respectively. The US also has the highest chronic disease burden and an obesity rate that is twice the OECD average.
(The Commonwealth Fund)
23. Among OECD countries, the USA has the lowest number of physicians (2.6) per 1,000 of the population.
The number of physicians stateside per 1,000 population compares to 4.8 in Norway, despite the highest healthcare costs by country in the USA. Other countries with high numbers of physicians are Switzerland (4.3), Germany (4.3), and Sweden (4.1). One result of the low relative number of physicians is that Americans visit the doctor less frequently than elsewhere. Germany leads on this front, with 9.9 average physician visits per capita, followed by the Netherlands (8.3) and Australia (7.7). The figure for the US is 4.
(The Commonwealth Fund)
24. Hospitalizations for diabetes and hypertension in the US are nearly 50% higher than the OECD average.
Diabetes and hypertension are among the conditions considered preventable with access to primary care. The USA had 204 and 159 annual discharges per 100,000 population for diabetes and hypertension, respectively, according to the latest data on costs of healthcare by country. Only Germany had higher rates of hospitalization for these two conditions. For hypertension-related cases, the US rate was nearly eight times that of the Netherlands, the UK, and Canada, the best-performing countries. For diabetes-related cases, the US rate was nearly four times that of the Netherlands and nearly three times the UK’s.
(The Commonwealth Fund)
25. In the USA, 68% of adults aged 65 and above had a flu vaccine in 2016, much higher than the OECD average of 44%.
Among OECD countries, only the UK has a higher rate of flu vaccination, with the figure being as low as 35% and 34% in Germany and Norway. Being top-ranked in terms of per capita healthcare costs by country has had positive outcomes for the US in some areas. The USA also has one of the highest percentages (80%) of women aged 50 to 69 screened for breast cancer against the OECD average of 60%. As a result, the country also has the highest average five-year survival rate for breast cancer.
(The Commonwealth Fund)
Overall improvement in economic conditions has helped increase the expenditure on healthcare in most parts of the world. At the same time, as these statistics on healthcare costs by country show through the US example, higher expenditure needs to be coupled with the right policies to ensure the benefits reach the population to the fullest.