Special Report

Countries Spending the Most on Health Care

6. Germany
> Health expenditure per capita: $4,811
> Expenditure as a pct. of GDP: 11.3% (5th highest)
> Pct. obese: 14.7% (12th lowest)
> Life expectancy: 81.0 years (tied-16th highest)

Health expenditures accounted for 11.3% of GDP in Germany in 2012, two percentage points higher than the OECD average. Nearly 77% of that expenditure came from public sources in 2012, compared to an OECD average of roughly 72%. Germany’s expenditure on pharmaceuticals was $668 per capita, the fifth highest among OECD nations. Between 2011 and 2012, pharmaceutical spending was down across the OECD. In Germany, the decline was the result of legislation that froze drug prices until 2013. Similar efforts towards cost containment have likely contributed to an annualized health expenditure growth rate of 1.8% since 2000, well below the U.S. and OECD average growth rate of 3.9%. German life expectancy was about a year longer than the OECD average.

5. Austria
> Health expenditure per capita: $4,896
> Expenditure as a pct. of GDP: 11.1% (6th highest)
> Pct. obese: 12.4% (8th lowest)
> Life expectancy: 81.0 years (tied-16th highest)

Austria apportioned 11.1% of its GDP to health care expenditures in 2012, the sixth highest proportion in the OECD. Slower health care expenditure growth in Austria was likely the result of declining pharmaceutical costs, which came after the government reduced the value added tax on medicines by 50% in 2009. Austrian medical schools graduated 19.6 doctors per 100,000 residents, the most of any country in the OECD. Many of these doctors likely remain in Austria, as the country has the second highest physician density in the OECD. The higher proportion of doctors could increase the country’s health expenditures in the future. Austrians’ poor health habits may also be driving up costs. Smoking rates were more than two percentage points above the OECD average rate, and obesity rates have increased from 9.1% in 1999 to 12.4% in 2006. While this was not among the highest obesity rates, the startling growth in self-reported obesity has experts worried about future cost containment.

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4. Netherlands
> Health expenditure per capita: $5,099
> Expenditure as a pct. of GDP: 11.8% (2nd highest)
> Pct. obese: 12.0% (6th lowest)
> Life expectancy: 81.2 years (15th highest)

As is the case in all the countries with the highest health care expenditures, the Netherlands has an exceptionally strong economy. The country’s GDP per capita was estimated at $41,711 in 2013, higher than all but a handful of OECD nations. The Dutch government paid the vast majority of health care costs, with nearly 86% of all spending coming from public sources in 2012, the highest proportion in the OECD. Much of these resources likely contributed to a robust medical profession. In 2012, there were 12 nurses per 1,000 residents and 14.7 medical graduates per 100,000 residents, both among the highest rates in the OECD.