OECD countries vary enormously in how
much they spend on health and the rate at which health spending grows. This reflects a
wide array of market and social factors, as well as countries' diverse financing and
organisational structures of their health systems.
The United States continues to
outspend all other OECD countries by a wide margin. In 2009, spending on health goods and
services per person in the United States rose to USD 7 960 (Figure 7.1.1) - two and a half times the average of all OECD countries. The
next highest spending countries, Norway and Switzerland, spend only around two-thirds of
the per capita level of the United States, but are still more than 50% above the OECD
average. Most of the northern and western European countries, together with Canada and
Australia, spend between USD PPP 3 200 and 4 400, between 100% and 130% of the OECD
average. Those countries spending below the OECD average include Mexico and Turkey, but
also the southern and eastern European members of the OECD together with Korea. Japan also
spends less on health than the average in OECD countries, despite its above-average per
capita income. By comparison the fast growing economies, China and India, spend less than
10% and 5% of the OECD average on health.
Figure 7.1.1 also shows the breakdown of per capita spending on health into
public and private components (see also Indicator 7.5 "Financing of health care" ). In general, the ranking
according to per capita public expenditure remains comparable to that of total spending.
Even if the private sector in the United States continues to play the dominant role in
financing, public spending on health per capita is still greater than that in most other
OECD countries (with the exception of Norway, Luxembourg and the Netherlands), because
overall spending on health is much higher than in other countries. In Switzerland also, a
large proportion of health care financing comes from private sources, and its public
spending on health is lower than in certain other countries, although overall spending is
higher. The opposite is true in Denmark where most health care is mostly financed through
Per capita health spending
over 2000-09 is estimated to have grown, in real terms, by 4% annually on average across
the OECD (Figure 7.1.2 and Table A.6). In many countries,
the growth rate reached a peak prior to 2004 and slowed in more recent years.
In general, the countries that have
experienced the highest growth in health expenditures per capita over this period are
those that had relatively low levels at the beginning of the period. Health expenditure
growth in the Slovak Republic and Korea, for example, has been more than twice the OECD
average since 2000, resulting in a degree of convergence between OECD countries over
In countries such as Italy,
Switzerland and Germany, health spending per capita has increased at a much slower rate
over the period - at an annual average of 2% or less. This reflects, in part, a period of
relatively low economic growth over the period as a whole and the effect of deliberate
Figure 7.1.3 shows the familiar association between GDP per capita and health
expenditure per capita across OECD countries. While there is an overall tendency for
countries with higher GDP to spend a greater amount on health, there is wide variation
since GDP is not the sole factor influencing health expenditure levels. The association is
stronger among countries with low GDP per capita than among OECD countries with a higher
GDP per capita. Even for countries with similar levels of GDP per capita there are
substantial differences in health expenditure at a given level of GDP. For example,
despite Germany and Finland having similar GDP per capita, their health spending per
capita differs considerably with Germany spending around 25% more than Finland. The United
States spends much more on health than what might be expected based only on its GDP
Definition and comparability
Total expenditure on health
measures the final consumption of health goods and services (i.e. current health expenditure) plus capital investment in health care
infrastructure. This includes spending by both public and private sources on medical
services and goods, public health and prevention programmes and administration.
Differing estimation methodologies
for long-term care spending, in particular the allocation of spending between health
and social care, continue to limit the overall comparability of total health spending.
See Indicator 7.3
"Health expenditure by function"
"Long-term care expenditure" for further details.
Countries' health expenditures are
converted to a common currency (US dollar) and adjusted to take account of the
different purchasing power of the national currencies, in order to compare spending
levels. Economy-wide (GDP) PPPs are used as the most available and reliable conversion