Total Health Spending Per Capita (US$ PPP) (2020): $5,468

(Note: “Health spending measures the final consumption of health care goods and services (i.e. current health expenditure) including personal health care (curative care, rehabilitative care, long-term care, ancillary services and medical goods) and collective services (prevention and public health services as well as health administration), but excluding spending on investments. Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”) as well as voluntary health insurance and private funds such as households’ out-of-pocket payments, NGOs and private corporations (“Voluntary”). This indicator is presented as a total and by type of financing (“Government/compulsory”, “Voluntary”, “Out-of-pocket”) and is measured as a share of GDP, as a share of total health spending and in USD per capita (using economy-wide PPPs).”

Source: OECD (2021), Health spending (indicator). doi: 10.1787/8643de7e-en (Accessed on 3 December 2022).

Current Health Expenditure As Percentage Of Gross Domestic Product (2019): 11.06%

Source: Global Health Observatory. Current health expenditure (CHE) as percentage of gross domestic product (GDP) (%). Geneva: World Health Organization. Last accessed July 26, 2022.

Current Health Expenditure Per Capita (USD) (2019): $4,492

Source: Global Health Observatory. Current health expenditure (CHE) per capita in US$. Geneva: World Health Organization. Last accessed July 26, 2022.

Out-Of-Pocket Expenditure As Percentage Of Current Health Expenditure (2019): 9.26%

Source: Global Health Observatory. Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed July 26, 2022.

Out-Of-Pocket Expenditure Per Capita (USD) (2019): $416

Source: Global Health Observatory. Out-of-pocket expenditure (OOP) per capita in US$. Geneva: World Health Organization. Last accessed July 26, 2022.

Domestic General Government Health Expenditure as Percentage of General Government Expenditure (%) (2019): 15.1%

Source: World health statistics 2022: monitoring health for the SDGs, sustainable development
goals. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.

Annual out-of-pocket payment in current USD PPP per capita, 2019: $416

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed July 21, 2022.

Out-of-Pocket Spending as Share of Final Household Consumption (%) (2019): 2.0%

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.

“Health spending in France accounted for 11.1 % of GDP in 2019, the highest share in the EU along with Germany and above the EU average of 9.9 %. On a per capita basis, health spending was the seventh highest across the EU, at EUR 3 645 in 2019 (Figure 7).”

Source: OECD/European Observatory on Health Systems and Policies (2021), France: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

“Inpatient care in public and private hospitals is the largest category of health spending, accounting for about 32 % of the total in 2019 – slightly higher than the EU average of 29 % (Figure 8). Around 28 % of health spending was allocated to outpatient care, including primary, specialist and dental care. Retail pharmaceuticals and medical devices made up almost one fifth of health spending, and long-term care (LTC) over one sixth. Spending on prevention accounted for less than 2 % of all health spending, a share lower than the 3 % EU average. However, as in other countries, this only includes spending dedicated to organised prevention programmes, resulting in an underestimation of real spending on prevention.”

Source: OECD/European Observatory on Health Systems and Policies (2021), France: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

“In France fee-for-service physician payment occurs within budget constraints set by parliament and the Ministry of the Economy and Finance. UNCAM [Union Nationale des Caisses d’Assurance Maladie] negotiates fees with representatives of the physicians unions. All physicians in the community and in private for-profit hospitals are reimbursed according to this fee schedule. Most public hospital physicians are paid on a part-time or full-time salaried basis. Although the state is not officially involved, it closely monitors the negotiations between UNCAM and the physicians unions.”

Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.

“As a result of fee negotiations within expenditure targets, physicians in all three countries earn lower incomes than their US counterparts. For example, in 2016 generalist physicians in the US earned an average of $218,173. In comparison, generalists in France and Germany earned $111,769 and $154,126, respectively. Similarly, specialist physicians in the US earned an average of $316,000 in 2016, compared with $153,180 in France and $181,253 in Germany.³ Japanese physicians earned, on average, $124,558 in 2016; however, this is an average of generalist and specialist incomes.

“Policy makers in the US have been concerned that fee-for-service payment results in an excessive volume of services. The French response to excess volume was to impose expenditure targets in 1996 and 2010, but France exceeded its budget targets frequently.^12,25 Within the past decade physician fee increases and total annual spending have been held in line. This success reflects tighter political control by parliament, the Ministry of the Economy and Finance, and the Ministry of Social Affairs and Health, which has made budget constraints explicit for UNCAM [Union Nationale des Caisses d’Assurance Maladie] in negotiations with physicians unions.”

Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated Dec. 3, 2022 by Doug McVay, Editor.