Special Report

Countries Spending the Most on Health Care

National health care systems are designed to improve residents’ health, and by and large — especially when compared to countries outside the OECD — larger health budgets lead to better health outcomes. However, among OECD nations, this relation is not clear. “We cannot explain higher spending in terms of higher quality health care,” Lorenzoni said. The highest expenditures do not necessarily mean residents are the healthiest.

Life expectancies in the countries with the highest per capita health expenditures were just in line with the OECD average of 80.2 years. Life expectancies at birth in the U.S. and Denmark were actually lower than the average for OECD member states, at 78.7 and 80.1 years, respectively.

Other health outcomes were also not meaningfully linked to health spending. Obesity, for example, was exceptionally high in several countries spending the most on health. More than 35% of Americans and 25% of Canadians were overweight in 2012, both among the highest in the OECD.

Many of these countries also displayed a number of unhealthy habits, which may drive up health spending. Seven of the countries with the highest health expenditures, for example, consumed substantially more alcohol than the average for the OECD.

Looking at OECD countries allows for comparison between different health care systems. One significant difference is whether health expenditures come predominantly from public or private sources. In eight out of the 10 highest spending countries, public health expenditure — funding from government sources — accounted for more than 70% of total spending on health. While public spending has grown in the U.S. at 4.8% annually in recent years, its share of total health spending remained at just about 50%.

There are disadvantages to this system. “In the U.S. health care system, insurance coverage is very much linked to employment,” Lorenzoni said. This means that during economic crises, the public sector plays a larger role in overall health care spending because it must act as a buffer for people who lose their jobs and health insurance.

In contrast to the U.S., continual budget problems and calls for fiscal austerity in Europe have been shrinking the portion of health expenditures from public sources amidst economic downturns. According to the OECD report, recessions disproportionately affect publicly funded health care systems, evidenced by shrinking health care expenditures in Europe since 2009.

Based on figures for the 34 developed countries that are members of the OECD from its 2014 Health Statistics Report, 24/7 Wall St. identified the 10 countries with the highest health expenditure per capita. Data from the OECD are from 2012. We also relied on the OECD’s recently published report in The Lancet: “Health-Care Expenditure and Health Policy in the U.S. Versus Other High-Spending OECD Countries.” Included in the OECD’s report were a number of statistics on health spending and costs, as well as data on smoking rates, alcohol consumption, obesity, and life expectancy.

These are the countries spending the most on health.