Comment by smallmancontrov
17 hours ago
No, this absolutely does not explain the US's wildly off-base per-capita expenditure because uninsured people still go in the denominator of the per-capita figure! I'm sure the per-insured-capita figure is worse but that's not what we are comparing!
Americans are constantly trying to exclude uninsured people from their statistics (and, worse, from the care itself) but the comparable countries don't do this so it is utterly ridiculous to propose that the correct statistical comparison is one in which the US excludes the undesirables while other countries don't.
https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
Total health spending per capita in PPP$
2024 2023 2022
United States 14,885 13,818 12,898
Switzerland 9,963 9,301 9,089
Norway 9,393 8,909 8,533
Germany 9,365 8,503 8,652
Netherlands 8,436 7,615 7,517
Austria 8,401 7,697 7,700
Luxembourg 8,087 7,173 6,854
Sweden 7,871 7,364 6,977
Ireland 7,813 7,027 6,748
Belgium 7,750 7,178 6,906
Australia 7,469 7,015 6,907
The fun part is when you break those numbers down between government and non-government expenditure. You’ll find that US governmental spending on health care per capita is higher than every other country’s entire (gov and non-gov) spending per capita.
https://www.oecd.org/en/publications/health-at-a-glance-2025...
Could this be because US gov healthcare spending takes place mostly via Medicare, which is specifically for people 65+?
Per capita stats are computed based on population, not per treatment or per person eligible for treatment. The US spends more per head on giving only a fraction of them subsidised healthcare than other nations manage on universal health, [more years of] education, [more generous] welfare payments etc. Some of that is down to medical professional salary discrepancies, but some of it is down to a terrible system...
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The spending per capita, unless I’m mistaken, is just “per person in the country” not “per person insured by the government”.
That means that even though government insurance in the US only covers a relatively small percent of the population, we pay more than other countries that cover the whole population.
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That number seems hard to believe? Specifically that non government spending would be this low. Presumably "compulsory" includes way more than direct government spending.
https://data.worldbank.org/indicator/SH.XPD.GHED.PP.CD?locat...
According to the world bank it's closer to 40:60 (government spending still being the majority). So that puts it behind Switzerland but still more than combined spending in just about any other country.
In that link, government/compulsory for the United States seems to indicate times when an insurance company covered it. Voluntary/Out of Pocket is when insurance company wasn't required to cover and did or person paid out of pocket.
Even if it's US Government only per capita with people the government insures, it makes sense it would be so high because only people on government insurance are the poor/disabled AND old. Two groups that have extremely high utilization.
That interpretation would require me to believe that a Canadian pays, on average, only 12% less out of pocket than an American. $2483/yr vs $2186/yr.