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Comparison of U.S. healthcare with other countries
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Healthcare
A Comparative Look Among Select Nations
SourcesOECD Organization for Economic Cooperation and Development - Originally OEEC; administrative arm of Marshal Plan - Became OECD 1961; now 34 member nations - Promotion of Democracy and Free Enterprise - Raise standards of living
CIA Central Intelligence AgencyISSA International Social Security AssociationCEPR Center for Economic & Policy Review
Canada Single Payer
• Universal coverage for necessary health care services provided on the basis of need, rather than the ability to pay. Medicare
• Not one system: Each province has its own plan, oversight & some funding by the national government.
• Private providers paid by government• Dental care, eye care and outpatient
prescriptions not covered; private insurance. Illegal to insure care that is covered by Medicare.
France Hybrid model
• Government pays about 80% of medical bills• Complementary Insurance (private) covers rest• Employer/Labor federations jointly control the funds
under the State’s supervision. • Health authorities plan the size and numbers of hospitals
and allocation of technical equipment• The public sector accounts for 65% of hospital beds.
Private hospitals (35%) are profit oriented, fee-for-service (set by federations)
• 40% physicians public; 60% private
Germany Bismarck model• Germans mandated to buy their insurance from
one of almost 300 regulated private,nonprofit Sickness Funds which bargain with doctors as a group.
• Premiums are pegged to patients' income. Split between employer and employee. (about $750)
• Co-payments: $15 every three months; some patients, like pregnant women, are exempt.
• 2 million permanent civil servants insured by the government;
• The wealthy can opt for private insurance; about 10% of the population does.
United Kingdom Socialized Medicine
• Public payment; public providers• Taxes fund the National Health Service (NHS)• Hospitals government owned;hospital doctors are paid
salaries. • General practitioners (GPs) are private; paid based on
the number of patients they see. No co-pays for most services; some co-pays for dental care, eyeglasses and 5 % of prescriptions. Young people and the elderly are exempt from all drug co-pays.
• Private insurance available for wealthy. A small number of specialists work outside the NHS and see private-pay patients. GP’s take private pay also.
United StatesThe Smorgasbord of Healthcare Systems
• Single payer (Social insurance): Medicare & Medicaid
• Nationalized (Socialist): VHA & Tri-Care• Private Insurance: Premiums paid by individuals
and employers to for-profit insurance co.’s• Cash: Deductibles, Co-pays; Un(der)insured• Other: Who pays for 50 million Uninsured?
Costs
• What we are paying for healthcare• Who is paying (public; private)• How our costs compare to other nations
Healthcare Expenditures as Per Cent of GDP2009 (OECD)
U.S. Canada France Germany U.K.17.4 11.4 11.8 11.6 9.8
0
2
4
6
8
10
12
14
16
18
U.S. Canada France Germany U.K.
Total Per Capita Healthcare Expenditures 2009 (OECD)
U.S Canada France Germany U.K. $7,960 $4,363 $3,978 $4,218 $3,487
0 2000 4000 6000 8000
U.S.
Canada
France
Germany
U.K.
Public Healthcare Expenditures Per Capita2009 (OECD)
U.S. Canada France Germany U.K.$3,797 $3,080 $3,099 $3,244 $2,933
0 1000 2000 3000 4000
U.S.
Canada
France
Germany
U.K.
Wait a Minute!
I thought those Socialist European countries paid way more in taxes for their healthcare. Let me see that slide again!
Public Healthcare Expenditures Per Capita2009 (OECD)
U.S. Canada France Germany U.K.$3,797 $3,080 $3,099 $3,244 $2,933
0 1000 2000 3000 4000
U.S.
Canada
France
Germany
U.K.
2010 Federal Healthcare Outlays (various government websites)
Federal Program Billions $$
Medicare & Medicaid 793Veterans’ Health Administration 48Tri-Care (active military) 49Federal Employees Health Benefits 40Children’s Health Insurance Program 10Total Federal Expenditures 940
0 1000 2000 3000 4000 5000
U.S.
Canada
France
Germany
U.K.
Private Healthcare Expenses Per Capita 2009 (OECD)
U.S. Canada France Germany U.K.$4,163 $1,283 $879 $974 $554
American employers bear a higher health care burden than their major trading partners. This undermines U.S. competitiveness in the global marketplace. (ISSA)
0 0.5 1 1.5 2 2.5
U.S.
Foreign weighted average manufacturinghealthcare costper man hour indollars
Healthcare Expenses As Share of GDP (OECD)
U.S. Canada France Germany U.K.
1980 9.0 7.0 7.0 8.4 5.61995 13.7 9.0 10.4 10.1 6.82009 17.4 11.4 11.8 11.6 9.8
0.02.04.06.08.0
10.012.014.016.018.0
U.S. Canada France Germany U.K.
198019952009
Benefits
What are we getting for our money?
Life Expectancy at Birth 2007(OECD)
U.S. Canada France Germany U.K. 77.9 80.7 80.9 80.0 79.7
77
77.5
78
78.5
79
79.5
80
80.5
81
U.S. Canada France Germany U.K.
Life Expectancy at Age 652009* (OECD)
*Canada 2007; France 2008
16
17
18
19
20
21
22
U.S. Canada France Germany U.K.
MenWomen
Maternal Mortality 2008 per 100,000 births (CIA)
U.S. Canada France Germany U.K. 24.0 12.0 8.0 7.0 12.0
0
5
10
15
20
25
U.S. Canada France Germany U.K.
Infant Mortality 2008 Per 1,000 Births (CIA)
U.S. Canada France Germany U.K.6.06 4.92 3.29 3.54 4.62
22.5
33.5
44.5
5
5.56
6.5
U.S. Canada France Germany U.K.
Physician Consultations Per Capita 2008 (OECD) U.S. Canada France Germany U.K. 3.9 5.5 6.9 7.7 5.9
0
1
2
3
4
5
6
7
8
U.S. Canada France Germany U.K.
I thought it was impossible to see a doctor in Canada!
But the OECD says that the average
Canadian sees a doctor 40% more often than the average American? That’s right; the barrier to doctor consultations appears to be lower in Canada than in the United States.
Hospital Beds Per 1000 2008 (OECD)
U.S. Canada France Germany U.K.3.1 3.3 6.9 8.2 3.4
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U.S. Canada France Germany U.K.
Physicians Per 1000OECD 2009
U.S. Canada France Germany U.K.2.4 2.4 3.3 3.6 2.7
0
0.5
1
1.5
2
2.5
3
3.5
4
U.S. Canada France Germany U.K.
Health RatingInclusiveness, quality of service, perceived health
differences between highest/lowest income0 = worst, 10 = best (OECD)
5
5.5
6
6.5
7
7.5
8
U.S. Canada France Germany U.K.
Ways in Which our Healthcare System Makes Us Unique
• 50 million uninsured citizens• 750,000 families file for bankruptcy each year• 45,000 unnecessary deaths each year• Less competitive in the global marketplace• Hemorrhaging local, state and Federal budgets
The Calculator lets you see what projected U.S. budget deficits would be if we had the same per person health care costs as any of the countries listed below, The yellow line shows projected deficits based on baseline projections from the non-partisan Congressional Budget Office. (CEPR)
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