Comparisons with other countries


Organization for Economic Cooperation and Development (OECD) policy brief.  Private health insurance in OECD countries. September 2004.

Around the world, private health care funding is regressive, bars access to care, and may encourage cost inflation


Organisation for Economic Co-operation and Development.

Factors that contribute to the discrepancy between health outcomes and health expenditures in the United States: inequitable access to medical services and subsidized private insurance policies; and inefficiencies in public health insurance.


World Health Organization. Multiple sites.

Selected indicators of health expenditure ratios,1999–2003.World Health Report 2006.

World Health Organization. Annex Table 2 Selected indicators of health expenditure ratios, 1999–2003.World Health Report 2006.


World Health Organization, The World Health Report, 2000, Annex tables

Annex 10: US #37 overall in health care

Annex 4: 17% of US health expenditures are out of pocket

Annex 4: US ranks #54 in access to health care

Annex 4: US ranks low on Disability-Adjusted Life Expectancy (DALE), life expectancy at 60.

In 2002, cost of health care at 15.2 percent of US GDP

Summary measures of public health, US ranks 37th in the world.

Schoen C, Davis K, How SKH, Schoenbaum SC. US health system performance: A national scorecard. Health Affairs Web exclusive, November/December 2006; 25(6): w457-w475,

Summarizes Commonwealth Fund statistics

US ranked last among developed nations in providing universal access to health care

US ranked last among developed nations in “avoidable mortality” from treatable disease. 2006: “The US Health System is not the best on quality of care, nor is it a leader in health information technology.”

Americans lead at 34% of citizens believing their system needs complete rebuilding

Spending on health care will account for 18% of GDP in 2009—an expected total of $2.5 trillion—and is projected to exceed 20% in 2018 to about $13,000. Federal spending accounts for roughly one-third of those totals, and federal outlays for the Medicare and Medicaid programs are projected to grow from about $720 billion in 2009 to about $1.4 trillion in 2019. Over the longer term, rising costs for health care represent the single greatest challenge to balancing the federal budget….despite spending more per capita than other nations, the United States lags behind lower-spending nations on several metrics, including life expectancy and infant mortality. … compared with other industrialized countries, the United States also had higher mortality rates for conditions that are considered amenable to medical care.


Preker AS. The introduction of universal access to health care in the OECD: lessons for developing countries. In: Achieving Universal Coverage of Health Care. Nitagyarumphong ES, Mills A (editors). Ministry of public health, Bangkok, 1998, p.103

Universal programs in other countries contain costs better than us without restricting access to essential health care.


CIA. The World Factbook.

US life expectancy at birth is #47


Tommy Douglas rated the greatest Canadian of all time.


Steven Katz, et al. Phantoms in the snow: Canadians’ use of health care services in the US. Health Affairs, May/June 2002, p.19

Few Canadians use US instead of waiting


Waiting times for Care? Medical News Today, July 10, 2007

Germans spend less time waiting for health care than Americans


Nolte E, McKee CM.. Measuring the health of nations: updating an earlier analysis. Health Affairs, Jan/Feb 2008, p. 71

US mortality from curable disease is twice that of best countries (France, Japan, Spain)

US ranked last of 23 in “healthy life expectancy at 60 years old”

US ranked last of 23 in infant mortality


Mark Pearson, Head Health Division, OECD, Written statement to Senate Special Committee on Aging, 30 September 2009. Disparities in health expenditures across OECD countries: Why does the United States spend so much more than other countries?

US: 16% of GDP, average OECD 8.9%

US: $7,290 per capita, average OECD: $2,984

US: government spending per capita $3,200 exceeds most OECD nations, ave $2600

Admin costs = $516 per capita, $154 billion total, 7% of total expenditures twice OECD.

Admin and insurance = $516 per capital (OECD ave $132) 4x average.


Michael Linden. Health Care Spending Is Driving Future Deficits. Without Reform, CBO Projects Medicare and Medicaid Spending Will Grow Rapidly. Center for American Progress, October 26,2009.

Federal spending on health care by 2019 will be the largest category of federal spending,

outstripping defense, social security and all other programs.

Health care is 25% of our federal budget.


American Association of Medical Colleges. Questions and Answers About the AAMC’s New Physician Workforce Position

750,000 active physicians in the US in 2009, The available supply is also about to decrease: (1) one-third (250,000) of active physicians are over age 55 and likely to retire by 2020


American Association of Medical Colleges. 2009 State Physician Workforce Data Book, Center for Workforce Studies, November 2009

Nationally in 2008, there were 219.6 physicians active in patient care2 per 100,000 population. Massachusetts had the highest number of patient care physicians per 100,000 population (316.2), while Mississippi had the lowest (159.2) (see Figure 2 and Table 2). = 660,000 active MDs

In 2008, there were 79.4 primary care physicians active in patient care per 100,000 population in the US, ranging from a low of 57.5 in Utah to a high of 111.4 in Vermont.


Kaiser Family Foundation data on world health