Average Health Care Spending per Capita, Adjusted for Differences in Cost of Living

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1 Average Health Care Spending per Capita, Adjusted for Differences in Cost of Living 3 Dollars ($US) * 21 Source: OECD Health Data 213. US ($8,58) NOR ($5,669) SWIZ ($5,643) NETH ($5,99) CAN ($4,522) DEN ($4,495)* GER ($4,495) FR ($4,118) SWE ($3,925) AUS ($3,8)* UK ($3,45) JPN ($3,213)* NZ ($3,182)

2 Health Care Spending as a Percentage of GDP, Percent * 21 GDP refers to gross domestic product. Source: OECD Health Data 213. US (17.7%) NETH (11.9%) FR (11.6%) GER (11.3%) CAN (11.2%) DEN (11.1%)* SWIZ (11.%) NZ (1.3%) JPN (9.6%)* SWE (9.5%) UK (9.4%) NOR (9.3%) AUS (8.9%)*

3 Health Care Spending per Capita by Source of Funding, 211 Adjusted for Differences in Cost of Living 5 Dollars ($US) 9, 8,58 8, 987 Out-of-pocket spending 7, Private spending Public spending 6, 3,454 5,643 5, 4, 3, 1, ,522 4,495 4, , ,925 3, , ,213 3, , 1, 4,66 3,661 3,183 3,827 3,436 3,161 3,24 2,578 2,821 2,638 2,631 US SWIZ CAN DEN* GER FR SWE AUS* UK JPN* NZ * 21. Source: OECD Health Data 213.

4 Retail Price Indexes for Basket of In-Patent Pharmaceuticals, 21 Price level US is set at US GER SWIZ FR CAN AUS UK Note: Calculations weighted relative to U.S. consumption patterns. U.S. retail prices were discounted from manufacturer prices according to the rebates obtained by the Medicaid program. Source: P. Kanavos, A. Ferrario, S. Vandoros et al., "Higher U.S. Branded Drug Prices and Spending Compared to Other Countries May Stem Partly from Quick Uptake of New Drugs," Health Affairs, April (4):

5 Diagnostic Imaging Prices, MRI scanning and imaging fees CT scanning and imaging fees (head) $1,2 $1,121 $6 $566 $1, $928 $5 $8 $4 $6 $554 $3 $252 $31 $328 $4 $319 $335 $363 $2 $124 $175 $183 $2 $1 $ NETH UK FR NZ SWIZ US $ CAN UK FR NETH NZ SWIZ US Notes: US refers to the commercial average. MRI refers to magnetic resonance imaging; CT refers to computed tomography. Source: International Federation of Health Plans, 212 Comparative Price Report.

6 Dollars ($US) 24, 21,18 2, Hospital Spending per Discharge, 211 Adjusted for Differences in Cost of Living 29 16, 15,433 13,25 12, 8, 11,968 11,374 11,36 9,894 9,611 8,478 8,363 7,842 5,339 4, US* CAN* NETH SWIZ DEN* NOR* SWE* AUS* NZ FR OECD Median GER * 21. Source: OECD Health Data 213.

7 Dollars ($US) $1,8 $1,634 $1,6 $1,4 Physician Fee for Hip Replacement, 28 Adjusted for Differences in Cost of Living Public payers Dollars ($US) $4,2 $3,6 $3,996 Private payers 3 $1,2 $1, $8 $6 $1,251 $1,181 $1,46 $674 $652 $3, $2,4 $1,8 $1,2 $2,16 $1,943 $1,34 $4 $2 $6 $ US GER UK AUS FR CAN $ US UK AUS FR Source: M. J. Laugesen and S. A. Glied, Higher Fees Paid to U.S. Physicians Drive Higher Spending for Physician Services Compared to Other Countries, Health Affairs, Sept (9):

8 Physician Incomes, 28 Adjusted for Differences in Cost of Living 31 Dollars ($US) 5, 442,45 45, Orthopedic surgeons Primary care doctors 4, 35, 3, 324,138 25, 2, 15, 1, 28,634 22, ,69 154,38 186, , ,89 125,14 95,585 92,844 5, US UK CAN GER AUS FR US UK GER CAN FR AUS Source: M. J. Laugesen and S. A. Glied, Higher Fees Paid to U.S. Physicians Drive Higher Spending for Physician Services Compared to Other Countries, Health Affairs, Sept (9):

9 Number of Practicing Physicians per 1, Population, SWE* GER SWIZ NOR DEN** AUS OECD Median FR UK NZ US JPN* * 21. ** 29. Source: OECD Health Data 213.

10 Spending on Health Insurance Administration per Capita, 211 Adjusted for Differences in Cost of Living $US 18 $7 $6 $66 $5 $4 $3 $2 $1 $35 $55 $7 $128 $148 $199 $237 $266 $277 $ NOR SWE AUS NZ CAN NETH GER SWIZ FR US * 21. Source: OECD Health Data 213.

11 Insurance Complexity and Restrictions Create Concerns for Patients and Doctors Adults, 213 Insurance did not cover as expected/ spent a lot of time on paperwork in past year* Percent 75 Primary care physicians, 212 Insurance coverage restrictions pose major time concern** * Adults spent a lot of time on paperwork or disputes over medical bills and/or insurance denied payment or did not pay as much as expected in the past year. ** Amount of time doctor or staff spend getting patients needed medications/treatments because of coverage restrictions is a major problem. Source: 212 and 213 Commonwealth Fund International Health Policy Surveys.

12 Percent 6 Cost-Related Access Barriers and Out-of-Pocket Costs in the Past Year Experienced cost-related access problem* Spent US$1, or more out-of-pocket * Did not fill/skipped prescription, did not visit doctor with medical problem, and/or did not get recommended care. Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

13 Serious Problems Paying or Unable to Pay Medical Bills in the Past Year 7 Percent UK SWE NOR CAN GER AUS NETH NZ SWIZ FR US Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

14 Gaps in Dental Care 8 Percent 75 6 Did not visit dentist/hygenist/dental clinic in past two years Skipped dental care because of cost in past year GER SWE NOR NETH SWIZ CAN UK FR US AUS NZ Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

15 Cost and Access Problems in the Past Year for U.S. Adults, by Insurance Status 9 Experienced costrelated access problem Serious problems/ unable to pay medical bills Uninsured Insured all year Spent $1, or more out-of-pocket Percent Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

16 Access to Doctor or Nurse When Sick or Needed Care 11 Same-day or next-day appointment Waited six days or more for appointment Percent Note: Question asked differently in Switzerland. Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

17 Wait Times for Specialist Appointment 16 Less than four weeks Two months or more Percent Base: Needed to see specialist in the past two years. Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

18 Percent 1 Flu Immunization Among Adults Age 65 or Older, AUS** NETH** UK US NZ CAN GER** OECD Median FR JPN* SWIZ* DEN* NOR * 21. ** 29. Source: OECD Health Data 213.

19 Percent Breast Cancer Five-Year Relative Survival Rate, (or nearest period) US JPN CAN NOR SWE NZ NETH GER DEN UK Source: OECD Health Data 213.

20 In-Hospital Mortality After Admission for Acute Myocardial Infarction per 1 Patients, DEN NOR SWE** AUS NZ CAN US* SWIZ* OECD Median UK NETH** GER JPN* In-hospital case-fatality rates within 3 days of admission. Age-sex standardized rates. * 28. ** 27. Source: OECD Health Data 213.

21 Foreign Object Left in Body During Procedure per 1, Hospital Discharges, DEN** SWE GER US* FR UK NZ CAN AUS SWIZ* Note: Age-sex-SDX standardized rates. * 28. ** 21. Source: OECD Health Data 213.