The United States spends more per person on health care than 13 other industrialized nations. But paying more has not meant getting more in return, according to a study published by The Commonwealth Fund.

 

In terms of health care expenditures, the U.S. is the undisputed leader. Its spending on doctors, health insurance and medical technology averages out to $7,960 per American. Some countries, like Japan and New Zealand, spend a third of this total. Norway is the closest to the U.S. at $5,352 per person.

 

Although the U.S. government spends more on health care per person than the governments of every other industrialized nation except Norway, what really makes the United States stand out is the amount spent on private insurance—$3,189 a person compared to second place Canada at $646 a person.

 

“This high spending cannot be attributed to higher income, an older population, or greater supply or utilization of hospitals and doctors,” writes David A. Squires, author of the study.

 

Squires attributed the higher spending to “higher prices and perhaps more readily accessible technology and greater obesity.” In 2009 the obesity rate in the U.S. was 33.8%. None of the other nations studied had a rate higher than 26.5% (New Zealand). This is balanced by the United States’ younger population and lower rate of smoking.

 

Squires concluded that health care quality in the U.S. “varies and is not notably superior to the far less expensive systems in the other study countries.”

 

Americans have a relatively low rate of doctors per capita and doctor visits per capita. However, Americans pay far more for hospital visits than the citizens of other countries—$18,132 median. Canadians pay the second most at $13,483 per discharge, while Germans’ pay $5,072 and the French $5,204. Drug prices are also higher in the United States, particularly non-generic brand name drugs. Finally, the use of expensive diagnostic imaging, such as MRIs and CT scans, is more common in the U.S.

 

Americans do get some positive outcomes for their money, such as a higher rate of survival for breast cancer. But for most conditions, the U.S. fatality rate was average or worse.

-David Wallechinsky, Noel Brinkerhoff

 

Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality (by David Squires, Issues in International Health Policy) (pdf)