National sections include detailed subsections on each nation’s health system, population health coverage, health system expenditures, financing, costs to consumers, outcomes, and much more. These include Beveridge-model systems (e.g. Sweden, UK); Bismarck-model systems (e.g. Germany, Japan); hybrid “Bev-Marck” systems (e.g. Austria, Costa Rica); and national health insurance model systems (e.g. Canada, South Korea).
Several attempts have been made to compare and rank national health systems, most notably the Health Access and Quality (HAQ) Index and the Sustainable Development Goals Health Index. For more information on those, see our section on Comparing National Health Systems.
“The level of per capita health spending, which covers both individual and population health care needs, and how this changes over time, depends on a wide range of demographic, social and economic factors, as well as the financing and organisational arrangements of the health system.
“In 2019, average per capita health spending in OECD countries (when adjusted for differences in purchasing power) was estimated to be more than USD 4,000, while in the United States it reached the equivalent of almost USD 11,000 for every US citizen. Switzerland, the next highest spender among OECD countries, had health expenditure of around two‑thirds of this level (Figure 7.4). In addition to Switzerland, only a handful of high-income OECD countries, including Germany, Norway and Sweden, spent more than half of the US spending on health, while others, such as Japan and the United Kingdom, were around the OECD average. Lowest per capita spenders on health among OECD member countries were Colombia, Turkey and Mexico, with health expenditure of around a quarter of the OECD average. Latest available estimates show that per capita spending in China was just under 20% of the OECD average, while both India and Indonesia spent between 6% and 8% of this figure.
“Figure 7.4 also shows the split of health spending based on the type of health care coverage – organised either through government health schemes or compulsory insurance (public or private), or through a voluntary arrangement such as private voluntary health insurance or direct payments by households (see indicator “Health expenditure by financing schemes”). Across OECD countries, more than 76% of all health spending is financed through government or compulsory insurance schemes. In the United States, since the introduction of the Affordable Care Act in 2014, this share stands at 85%, reflecting the existence of an individual mandate to purchase health insurance. Federal and state programmes such as Medicaid and Medicare continue to play an important role in purchasing health care.
“Between 2015 and 2019, average per capita spending on health care grew by an average of 2.7% across OECD countries (Figure 7.5). This compares with the low growth rates experienced in many countries in the years immediately following the global financial and economic crisis. In the 2015‑19 period, average annual growth of less than 1% was still seen in France, Greece and Mexico, while the Baltic countries and Korea continued to show strong average growth above 5%. With the onset of the COVID‑19 pandemic in 2020, preliminary estimates for a subset of OECD countries point to a sharp increase in overall health spending of around 4.7%, on average. This increase would represent the highest growth in average per capita health spending for around 15 years.”
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
“Japan, Switzerland and Spain lead a large group of 27 OECD countries in which life expectancy at birth exceeded 80 years in 2019. A second group, including the United States and a number of central and eastern European countries, had a life expectancy between 77 and 80 years. Mexico and Latvia had the lowest life expectancy, at less than 76 years. In general, life expectancy has increased for most of the last half-century, despite some slowdown in longevity gain in recent years. However, COVID‑19 has had a dramatic effect, with life expectancy in 2020 falling for 24 of 30 OECD countries with comparable data.
“Avoidable mortality rates (from preventable and treatable causes) in 2019 were lowest in Luxembourg, where less than 100 per 100,000 people died prematurely. Avoidable mortality rates were also relatively low (under 150 per 100,000 people) in Switzerland, Israel, Iceland, Japan, Italy, Korea, Australia, Sweden, Spain, the Netherlands and Norway. Latvia, Hungary, Mexico, Lithuania and the Slovak Republic had the highest avoidable mortality rates, at over 300 premature deaths per 100,000 people.
“Diabetes prevalence in 2019 was highest in Mexico, Turkey, the United States and Germany, with over 10% of adults living with diabetes (age‑standardised data). Prevalence rates have stabilised in many OECD countries, especially in Western Europe, but increased markedly in Turkey. Such upward trends are due in part to rising rates of obesity and physical inactivity.
“Almost 9% of adults considered themselves to be in bad health in 2019, on average across the OECD. This ranged from over 15% in Latvia, Korea, Lithuania and Portugal to under 3% in Colombia, New Zealand and Canada. However, socio-cultural differences, the share of older people and differences in survey design affect cross-country comparability. People with lower incomes are generally less positive about their health as compared with people on higher incomes, in all OECD countries.”
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
Breaking News
- Practice Consolidation and Access to Quality Care May 14, 2023May 14, 2023 The New York Times reports on a growing trend among healthcare organizations in the US, the impact of which may be of concern for patients and taxpayers. The Times reported on May 8, 2023 (“Corporate Giants Buy Up Primary Care Practices at Rapid Pace”) that: “CVS Health, with its sprawling pharmacy business and ownership ...
- Oregon Becomes First US State To Guarantee Its Residents Access To Affordable Healthcare January 20, 2023January 20, 2023 In the November 2022 general election, Oregon voters narrowly approved Oregon Measure 111, the Right to Healthcare Amendment. The measure amended the state constitution, adding a guarantee of access to affordable healthcare for all Oregon residents. According to Ballotpedia, last accessed Jan. 20, 2023: “Ballot title “The ballot title was as follows:“Amends Constitution: State must ...
- Massive Savings Possible In US Health System October 21, 2021October 21, 2021 The management consulting firm McKinsey & Company has issued a new report estimating that administrative changes and efficiencies could save the US health system more than a quarter trillion dollars. As noted in a Viewpoint article published in JAMA on October 20: “The analysis dissected profit and loss statements of individual health care organizations, estimated ...
- Health Care in the US Compared to Other High-Income Countries August 6, 2021On August 4, the Commonwealth Fund issued a new report entitled Mirror, Mirror 2021: Reflecting Poorly / Health Care in the US Compared to Other High-Income Countries. The report compares health care systems in eleven nations: the United States, Canada, Switzerland, France, Sweden, New Zealand, Germany, the United Kingdom, Australia, the Netherlands, and Norway. The report’s key ...
- Medical Debt in Collections in the US August 6, 2021On July 20, JAMA published an article on medical debt in collections in the US entitled “Medical Debt in the US, 2009-2020.” The researchers found: “In this retrospective analysis of credit reports for a nationally representative 10% panel of individuals, an estimated 17.8% of individuals in the US had medical debt in collections in June 2020 ...
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 April 26, 2023 by Doug McVay, Editor.
