Health care spending in the US nearly double of other wealthy nations: report

Story at a glance


  • In the U.S., health care spending made up 17.8 percent of GDP in 2021.

  • This is nearly double that of other high income countries.

  • Obesity rates are also higher in the U.S.

In 2021, the U.S. spent 17.8 percent of GDP on health care, nearly double the average of 9.6 percent for high income countries, according to a new report from The Commonwealth Fund. Health care spending per capita in the U.S. was three or four times greater than for countries like South Korea, New Zealand and Japan.

Researchers compared data from the Organisation for Economic Co-operation and Development (OECD) Health Statistics 2022 database and the Commonwealth Fund International Health Policy Survey 2022.

Their analysis suggests that overall health in the U.S. is worse than in other high income countries. Life expectancy at birth for the U.S. is three years below the OECD average. And the obesity rate in the U.S. is nearly double the OECD average at about 43 percent compared to the OECD average at 25 percent. The next highest countries include New Zealand (34 percent), Australia (30 percent) and the U.K. (28 percent).

In addition, the rate of avoidable deaths in the U.S. was 336 deaths per 100,000 people in 2020, while the OECD average was 225.

This may be partially also due to differences in the level of violence in the U.S. There was a significant gap in the number of deaths by assault in the U.S. compared to other OECD countries, with about 7.4 deaths per 100,000 people in the U.S. while many other countries were far below at 0.2 to 1.3 deaths per 100,000.

“Americans are living shorter, less healthy lives because our health system is not working as well as it could be,” says report lead author Munira Gunja, who is a senior researcher for the Commonwealth Fund’s International Program in Health Policy and Practice Innovations, in a press release. “To catch up with other high-income countries, the administration and Congress would have to expand access to health care, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population.”

People in the U.S. may be more likely to be living with multiple health complications than people in other high income countries.

About 30 percent of adults surveyed in the U.S. had two or more chronic conditions, like asthma, cancer, depression, diabetes, heart disease or hypertension, according to the Commonwealth Fund International Health Policy Survey 2022. Ten other countries were included in this survey, with results that ranged from 17 percent in France to 20 percent in Germany, to about 26 percent in Australia.

The report authors highlight that the U.S. is the only high income country that does not guarantee universal health care. People in the U.S. also tend to visit doctors at a lower rate compared to countries like Germany and Japan.

“This analysis continues to demonstrate the importance of international comparisons,” says Reginald D. Williams II, who leads the Commonwealth Fund’s International Program, in the press release. “It offers an opportunity for the U.S. to learn from other countries and build a better health care system that delivers affordable, high-quality health care for everyone.”