Every once in a while it's useful to restate the basics about health care in the US and other countries. These are those basics. This is an older article (which has never been published on the Agonist) with stats from the early part of the decade, however I have seen nothing since then to change the general sense of the stats - the same relationships still exist.
I recently re-discovered that there are a lot of misconceptions amongst certain segments of the population as to how much money the US spends on health care and how much it receives in return. Let’s get spending out of the way first - as the above chart from the OECD [1] shows the US spends more money per capita than Canada or a number of countries (in fact the US spends more per capita than any OECD country.)
Much More After the Jump
The next chart (same source) shows historical spending as a share of GDP. What’s interesting is that up until about 30 years ago the percentage of GDP spent by the US and Canada was about the same. In fact the US spent slightly less. That changed around the time Canada changed to single payor health care and since then it has stabilized at Canada spending about two thirds of US spending - and still slightly more than the OECD average. Canada and the US are both large continental countries with populations spread out over large areas. Their health care costs should be comparable.
But at least the US isn’t spending a lot of public money on health care, right? Wrong. As of 2001 only Norway, Luxembourg and Sweden spent more public money per capita on health care than the US. Because of how much the US spends on health care its percentage of public money spent on healthcare is much less than the OECD average (44.2% vs. 72.2%).
So then - if the US is spending more per capita and a larger share of it’s GDP then it should be getting more for that spending, right?
Well it’ll probably come as no surprise that there are very few metrics on which the US outperforms the OECD average.
Let’s run through a few. According to the World Health Organization (WHO) male mortality for children under 5 in the US as of 2002 was 9 per thousand and female mortality under 5 was 7 per thousand. Canada’s equivalent numbers were 6 per thousand for males and 5 per thousand for males. The despised English health care system came in at 7 per thousand for males and 6 per thousand for females.
For straight out infant mortality, according to the OECD as of 2000 US infant mortality was 6.9 per thousand versus an OECD average of 6.5 per thousand.
The US does have less smokers than any OECD country but Sweden (the US is at 19%, Canada at 19.8%), a risk factor that is offset by the fact that it has the highest obesity rate (at 30.9% of the population) of any OECD nation. Canada has an obesity rate of 14.9%.
The US has 3 acute care beds per 1000 population - the OECD average is 3.8. Physicans per 1000 are 2.8, the OECD average is 3.1. Specialists per 1000 is 1.4 versus and OECD average of 1.6. (See Note 1)
US citizens spend less time in acute care per stay (5.8 days v.s. 7 for the OECD) but have more inpatient operations (87.4 per thousand vs. 70.5 for the OECD average).
There is one place that the US really shines. Elective surgery. 63% of waiting times are less than a month - Canada’s equivalent number is 37%.
So there you have it. The US spends more and either gets equivalent or worse results than Canada or the OECD average with the exception that elective surgery is much more available and that US physicians perform surgery more often than the OECD as a whole. All of this with 43.6 million people uninsured. (Note: that number is for 2001, the most recent number I've seen is about 46 million. [2])
Notes and Bibliography
1. I didn’t give stats for Canada in every area just because I can’t get them for free - except from the Fraser institute and their stats disagree violently with the statistics I have from elsewhere. They don’t crosscheck.
OECD Comparative Statistics (PDF) [3]
US HealthCare in an International Context [4] Elizabeth Docteur (OECD) Both Charts used in this post were taken from this report. (PDF)
Alliance for Health Reform’s Covering Health Issues: A Sourcebook for Journalists [5]
2001 OECD HealthCare Charts [6] (PDF)
Canadian Health Coaltion “Debunking Myths” Page. [7]