Richard Meyer Article Summary

The U.S. spends more on health care yet has the lowest life expectancy

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  • The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations.
  • The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average.
  • Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.

In 2018, the U.S. spent 16.9 percent of gross domestic product (GDP) on health care, nearly twice as much as the average OECD country. The second-highest ranking country, Switzerland, spent 12.2 percent.


Per capita, health spending in the U.S. exceeded $10,000, more than two times higher than in Australia, France, Canada, New Zealand, and the U.K. Public spending, including governmental spending, social health insurance, and compulsory private insurance, is comparable in the U.S. and many of the other nations and constitutes the largest source of health care spending.

In the U.S., per-capita spending from private sources, for instance, voluntary spending on private health insurance premiums, including employer-sponsored health insurance coverage, is higher than in any of the countries compared here. At $4,092 per capita, U.S. private spending is more than five times higher than Canada, the second-highest spender. In Sweden and Norway, private spending made up less than $100 per capita. As a share of total spending, private spending is much larger in the U.S. (40%) than in any other country (0.3%–15%).

The average U.S. resident paid $1,122 out-of-pocket for health care, which includes expenses like copayments for doctor’s visits and prescription drugs or health insurance deductibles. Only the Swiss pay more; residents of France and New Zealand pay less than half of what Americans spend.

Despite the highest spending, Americans experience worse health outcomes than their international peers. For example, life expectancy at birth in the U.S. was 78.6 years in 2017 — more than two years lower than the OECD average and five years lower than Switzerland, which has the longest lifespan. In the U.S., life expectancy masks racial and ethnic disparities.

The average life expectancy among non-Hispanic black Americans (75.3 years) is 3.5 years lower than for non-Hispanic whites (78.8 years).4 Life expectancy for Hispanic Americans (81.8 years) is higher than for whites and similar to that in the Netherlands, New Zealand, and Canada.

Obesity is a key risk factor for chronic conditions such as diabetes, hypertension and other cardiovascular diseases, and cancer. The U.S. has the highest obesity rate among the countries studied — two times higher than the OECD average and approximately four times higher than in Switzerland and Norway. Overall, obesity rates were highest in English-speaking countries, all with rates of one-quarter or more of the total population. Issues that contribute to obesity include unhealthy living environments, less-regulated food and agriculture industries, and socioeconomic and behavioral factors.

What’s Going On Here?

In simple terms, healthcare has become too profitable, and everyone wants a share of healthcare dollars. The media continues to focus on drug prices, and to a certain extent, they are right. Still, they are ignoring two vast drivers of healthcare costs: our poor health due to preventable conditions and the billions of dollars that are wasted on paperwork.

Politicians are great at channeling the anger of voters towards drug prices but they are doing us all a disservice. With record deficits due to tax cuts for companies and the rich cuts are coming but where?