US spends most on healthcare but treats fewer patients, study finds

Healthcare spending in the United States exceeds other high-income countries, but Americans have far fewer hospital visits, according to a new study from The Commonwealth Fund.

Here are eight findings from the study, which included data from the Organization for Economic Cooperation and Development.

1. The analysis compared data from 13 high-income countries, including Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States. Much of the data is from 2013, and almost all data are for years before the major insurance provisions of the Affordable Care Act.

2. The United States spends the most on healthcare. The U.S. spent 17.1 percent of its gross domestic product on healthcare in 2013. The next highest spender, France, spent 11.6 of its GDP on healthcare, and the United Kingdom spent 8.8 percent of its GDP on healthcare costs. However, since 2009, healthcare spending has slowed in the U.S. and most of the other countries surveyed.

3. Private healthcare spending is highest in the United States. For out-of-pocked healthcare costs, the U.S. came in second only to Switzerland. An average U.S. resident spent $1,074 on out-of-pocket costs, but an average Swiss resident spend $1,630. However, for other private health spending, including private insurance premiums, the U.S. spent $3,442 per capita. Canada, the second highest spending country, only spent $654 per capita.

4. Although U.S. public spending is high, the country covers fewer citizens. Public healthcare spending in the U.S. was $4,197 per capita. The only countries with higher per capita spending were Norway ($4,981) and the Netherlands ($4,495). Yet the U.S. was the only country studied that didn't have a universal health system. While 34 percent of U.S. residents were covered by public programs in 2013, every resident in the United Kingdom was covered by the public system and spending was $2,802 per capita.

5. Americans have fewer hospital and physician visits. Although the U.S. spends more on healthcare, the average American had four physician visits per year in 2013. In 2012, the average Canadian had 7.7 physician visits per year and the average Japanese citizen had 12.9 visits. In addition, the U.S. had fewer practicing physicians in 2013 (2.3 per 1,000 population) than the median OECD country (3.2 physicians per 1,000 population).

6. Compared to other countries, healthcare prices in the U.S. are higher. According to data from the International Federation of Health Plans, hospital and physician prices for procedures were highest in the U.S. in 2013. While the price of bypass surgery was $75,345 in the U.S., the price for the same surgery in Australia was $42,130. The IFHP also found MRI and CT scans were the most expensive in the U.S.

7. The U.S. was the only country where healthcare spending was a greater share of the GDP than social services spending. A 2013 study by Bradley and Taylor found the U.S. spent 9 percent of its GDP on social services — including retirement and disability benefits and employment programs — but 16 percent of its GDP on healthcare. In contrast, France and Sweden both spent 21 percent of their GDPs on social services and 12 percent on healthcare.

8. The U.S. has poor population health despite its high spending on healthcare. In 2013, the United States had the lowest life expectancy at birth at 78.8 years. The OECD median life expectancy was 81.2 years. The U.S. also had the highest infant mortality rate at 6.1 deaths per 1,000 live births in 2011. The OECD median was 3.5 deaths. In addition, a 2014 Commonwealth Fund International Health Policy Survey found 68 percent of U.S. adults age 65 or older had at least two chronic conditions, while in Canada and the U.K. the rate was lower (56 percent and 33 percent, respectively).

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