Average Health Care Spending per Capita, 1980 2011 Adjusted for Differences in Cost of Living

Average Health Care Spending per Capita, 198 211 Adjusted for Differences in Cost of Living 3 Dollars ($US) 9 8 7 6 5 4 3 2 1 198 1984 1988 1992 1996 2 24 28 * 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)

Health Care Spending as a Percentage of GDP, 198 211 4 Percent 18 16 14 12 1 8 6 4 2 198 1983 1986 1989 1992 1995 1998 21 24 27 21 * 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%)*

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, 1,455 527 4,522 4,495 4,495 666 593 593 75 672 465 4,118 37 65 3,925 3,8 635 86 733 49 3,45 338 246 3,213 3,182 464 348 111 23 2, 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.

Retail Price Indexes for Basket of In-Patent Pharmaceuticals, 21 Price level US is set at 1 27 1 1 95 88 8 6 61 5 49 46 4 2 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 213 32(4):753 61.

Diagnostic Imaging Prices, 212 28 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.

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.

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. 211 3(9):1647 56.

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 22,771 187,69 154,38 186,582 159,532 131,89 125,14 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. 211 3(9):1647 56.

Number of Practicing Physicians per 1, Population, 211 11 5 4 3 3.9 3.8 3.8 3.7 3.5 3.3 3.2 3.1 2.8 2.6 2.5 2.2 2 1 SWE* GER SWIZ NOR DEN** AUS OECD Median FR UK NZ US JPN* * 21. ** 29. Source: OECD Health Data 213.

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.

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** 19 54 5 25 4 4 7 8 15 16 17 19 23 25 32 1 11 12 12 18 2 23 24 28 41 * 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.

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 6 5 4 37 41 3 2 1 4 6 1 13 13 15 16 18 21 22 2 3 7 7 9 11 14 17 24 25 * 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.

Serious Problems Paying or Unable to Pay Medical Bills in the Past Year 7 Percent 4 3 2 1 23 13 6 7 7 8 9 1 1 4 1 UK SWE NOR CAN GER AUS NETH NZ SWIZ FR US Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

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 45 41 3 25 19 19 22 23 21 33 26 27 27 2829 2 32 15 1 1 12 11 8 11 6 GER SWE NOR NETH SWIZ CAN UK FR US AUS NZ Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

Cost and Access Problems in the Past Year for U.S. Adults, by Insurance Status 9 Experienced costrelated access problem 27 63 Serious problems/ unable to pay medical bills 15 42 Uninsured Insured all year Spent $1, or more out-of-pocket 39 42 2 4 6 8 1 Percent Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

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 1 75 76 72 63 58 58 57 52 52 48 5 25 41 5 14 14 15 16 16 22 26 28 33 Note: Question asked differently in Switzerland. Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

59 54 51 51 46 Wait Times for Specialist Appointment 16 Less than four weeks Two months or more Percent 1 75 8 8 76 75 72 5 25 39 3 3 6 7 1 17 18 18 19 26 29 Base: Needed to see specialist in the past two years. Source: 213 Commonwealth Fund International Health Policy Survey in Eleven Countries.

Percent 1 Flu Immunization Among Adults Age 65 or Older, 211 17 8 74.6 74. 74. 66.9 65.5 64.4 6 4 56.1 55.7 55.2 53. 46. 45.6 2 14.1 AUS** NETH** UK US NZ CAN GER** OECD Median FR JPN* SWIZ* DEN* NOR * 21. ** 29. Source: OECD Health Data 213.

Percent Breast Cancer Five-Year Relative Survival Rate, 24 29 (or nearest period) 22 1 89.3 87.3 87.1 86.5 86. 84.5 84.4 83.3 82. 81.3 8 6 4 2 US JPN CAN NOR SWE NZ NETH GER DEN UK Source: OECD Health Data 213.

In-Hospital Mortality After Admission for Acute Myocardial Infarction per 1 Patients, 29 24 1 9.7 8 6.8 6 4 2.3 2.5 2.9 3.2 3.2 3.9 4.3 4.5 4.6 5.2 5.3 2 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.

Foreign Object Left in Body During Procedure per 1, Hospital Discharges, 29 25 15 13.8 12 9 8.7 9.7 9.8 6 4.9 5.5 5.7 3 1.8 2.6 3.4 DEN** SWE GER US* FR UK NZ CAN AUS SWIZ* Note: Age-sex-SDX standardized rates. * 28. ** 21. Source: OECD Health Data 213.