Why Does United States spend twice as much for healthcare than other countries – Search
The United States has, by far, the most expensive healthcare system in the world. We might reasonably expect that our outsized expenditures on healthcare would produce significantly better health outcomes than in countries that spend far less.
But despite our massive investment, the United States consistently fares far worse than almost all of the rest of the world’s rich, democratic countries on a range of the most important basic health indicators.
Why It Matters©
The United States spends more per capita on health care than any other country in the world. Still, Americans tend to live shorter, less healthy lives than those in most other wealthy, highly-developed countries. While the United States lags behind other similar countries in key outcome measures, some American communities at the local level stand out for having exceptionally healthy populations, as reflected in both objective and self-reported indicators. The Unhealthiest Versus 34 of the healthiest counties in America.
In 2024, the United States spent 17.2 percent of its GDP on healthcare, substantially more than every other democratic country with a roughly comparable standard of living (Figure 1).
Figure 1
According to data from the Organization for Economic Cooperation and Development (OECD), US spending was almost five percentage points more than the level in the second-highest comparable economy, Germany (12.3 percent). In about half of the remaining comparable economies in Figure 1, the share was between 10.0 percent (Netherlands) and 11.8 percent (Austria and Switzerland). In the other half of countries, the share was below 10 percent.
Even with these much higher levels of healthcare spending, the United States performs poorly on foundational measures of health outcomes.
Life expectancy in the United States (78.4 years) is much lower than the vast majority of the other rich democracies in Figure 2, which range from 81.0 years in the United Kingdom to 84.2 years in Switzerland. The United States outperforms China (78.0 years) by a small margin, but lags behind Chile (81.6 years) by more than three years.
Figure 2
The infant mortality rate in the United States is also higher than every other comparable economy (Figure 3). About 5.6 of every 1,000 live births in the United States die within the first year of life. This rate is more than twice the rate in Spain (2.6), South Korea (2.5), Italy (2.5), Denmark (2.4), Sweden (2.1), and Norway (2.1), and more than three times the rate in Japan (1.8), Finland (1.8), and Iceland (1.4). The US rate is better than Chile (6.1), but worse than China (4.5).
Figure 3
The United States does particularly badly when it comes to maternal mortality (Figure 4). At 21.1 deaths per 1,000 live births, the United States is sandwiched between China (23.0) and Chile (15.0), with the Chilean rate 29 percent better than in the United States. Among comparable economies, the United States has a maternal mortality rate almost double Portugal (11.8), three times New Zealand (7.0), more than four times Ireland (5.0), and more than six times Spain (3.4).
Figure 4
Some defenders of the existing US healthcare system argue that it is wrong to judge US healthcare by this set of core indicators because the main drivers of these poor outcomes are tied to US patterns of diet, exercise, driving, and violent crime. To the extent that this is true, the generally much better results in peer economies still suggest that we could divert large portions of current healthcare spending to address those other causes of poor outcomes without having a negative impact on the quality of care we provide.
Data Notes
All the underlying data presented here were assembled and made internationally comparable by the OECD. See https://data-explorer.oecd.org/ for data and details.
For maximum comparability, countries included all were: relatively rich; democracies; and not part of the former socialist bloc countries. Including Eastern Europe countries where the data are available does not alter the relative position of the United States. To add an additional comparative element, the figures also include data for two lower-income countries, Chile and China.
Data on infant mortality do not control for some national differences in measurement. Controlling for these definitional differences does not affect the relative position of the United States, but would require excluding many of the countries in the figure.
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How does the quality of the U.S. health system compare to other countries?By Imani Telesford, Emma Wager Twitter, and Cynthia Cox KFF
October 6, 2025
Government Should Subsidize Doctors and Hospital – Search
The United States spends significantly more on healthcare than other countries, averaging $14,570 per person in 2023, compared to $6,514 per person on average in OECD countries. This disparity is primarily driven by higher payments to hospitals and physicians, as well as increased administrative costs. Despite spending more, the U.S. does not necessarily have better health outcomes. The aging population and rising healthcare prices are key factors contributing to this trend. The U.S. spends twice as much on healthcare per person as peer nations, with the largest category being inpatient and outpatient care.
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How does U.S. life expectancy compare to other countries?
What drives differences in life expectancy between the U.S. and comparable countries?
Despite spending nearly twice as much per capita on healthcare compared to similarly large and wealthy nations, the United States has a lower life expectancy than peer nations and the gap has grown for some measures since the COVID-19 pandemic
This chart collection combines various measures of quality of care in the United States and other large, high-income nations (based on total and per capita GDP) to show how the U.S. stacks up against its peers and how that has changed over time. Australia, Austria, Belgium, Canada, France, Germany, Japan, the Netherlands, Sweden, Switzerland, and the UK are included in this analysis.
Generally, the U.S. performs worse in long-term health outcomes measures (such as life expectancy), certain treatment outcomes (such as maternal mortality and congestive heart failure hospital admissions), some patient safety measures (such as obstetric trauma with instrument), and health system capacity (such as rate of general practitioners). The U.S. performs similarly to or better than peer nations in other measures of treatment outcomes (such as mortality rates within 30 days of acute hospital treatment) and some patient safety measures (such as post-operative complications).
The U.S. health system appears to perform worse than peer nations on more indicators than it does better. However, inconsistent and imperfect metrics make it difficult to firmly assess system-wide health quality. Some measures of quality – especially long-term measures, like life expectancy – are not only reflective of the health system itself, but also of differences in socioeconomic conditions and population behaviors that are largely outside of the domain of the health system.
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How does U.S. life expectancy compare to other countries?
Premature mortality during COVID-19 in the U.S. and peer countries
What drives differences in life expectancy between the U.S. and comparable countries?
Long-Term Health Outcomes
Life expectancy in the U.S. has rebounded to nearly pre-pandemic levels , but remains far below peer countriesLife expectancy at birth was similar in the U.S. and peer countries on average in 1980 (73.7 and 74.6 years, respectively), but the gap has grown substantially in the following decades as peer nations saw more rapid improvement in life expectancy. The COVID-19 pandemic further widened this gap, and life expectancy in 2023 was nearly 4 years shorter in the U.S. than in peer countries (78.4 years in the U.S. versus 82.5 years in comparable countries, on average).
The above data reflect period life expectancy estimates, based on excess mortality observed in each year. The period of life expectancy at birth represents the average age a cohort is hypothetically expected to live if current conditions persist into the future, not the mortality experience of a birth cohort.
Treatment Outcomes
30-day mortality rates for heart attacks and strokes are lower in the U.S. and peer nations, on average
Mortality within 30 days of being admitted to a hospital is not entirely preventable, but high quality of care can reduce the mortality rate for certain diagnoses. In 2022, the 30-day mortality rates after hospital admissions for heart attacks (acute myocardial infarction), hemorrhagic stroke (caused by bleeding), and ischemic strokes (strokes caused by blood clots) are lower in the U.S. than comparable countries on average. It is important to note that several individual peer nations have lower mortality rates than the U.S.
Maternal mortality rates in the U.S. are much higher than in peer countries
While wealth and economic prosperity are highly correlated with maternal mortality rates, the U.S. is an outlier with the highest rate of maternal deaths (18.6 deaths per 100,000 live births in 2023) when compared to peer countries (5.1 deaths per 100,000 live births, on average).
Within the U.S., there are significant racial disparities in maternal mortality rates. The maternal mortality rate for Black mothers is significantly higher than the rate for White mothers — a disparity that persists across age and socioeconomic groups. However, every racial, ethnic, socioeconomic, and age group in the United States sees higher maternal mortality rates than the average in comparable countries
Hospital admissions for congestive heart failure and diabetes were more frequent in the U.S. than in comparable countries, on average – Search
Hospital admission rates in the U.S. are higher than in comparable countries for congestive heart failure and complications due to diabetes, and lower than comparable countries for COPD. Access to and use of primary care and preventive services can play a role in preventing some hospital admissions.
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How does U.S. life expectancy compare to other countries?
Premature mortality during COVID-19 in the U.S. and peer countries
More cesarean sections are performed in the U.S. than in comparable countries
Cesarean sections are one of the most commonly performed surgical procedures in the U.S. and have become a key indicator of quality of care in maternal health. Cesarean sections can be lifesaving. However, when not medically indicated, they can pose unnecessary risks for mothers, including an increased chance of blood clots, infections, and other complications that require further surgery.
The U.S. has consistently had higher cesarean section rates than most of its peers, though rates have plateaued slightly in recent years. In 2021, the rate of cesarean sections per 1,000 live births was 321 in the U.S. and an average of 242 in comparable countries.
Patient Safety
Obstetric trauma during vaginal delivery is more common in the U.S. than in most comparable countries, especially when medical instruments are involved
Obstetric trauma is more likely to occur in deliveries where medical instruments are utilized (i.e., forceps). The rate of obstetric trauma during deliveries with an instrument in the U.S. was 11.7 per 100 vaginal deliveries in 2022, higher than most comparable countries with available data. The rate of obstetric trauma during deliveries without an instrument in the U.S. was 1.7 per 100 vaginal deliveries in 2022, on the lower end among comparable countries with available data.
Post-operative complications – such as pulmonary embolism – are less common in the U.S. than most peer countries
Rates of post-operative complications are an important measure of hospital safety. Pulmonary embolisms and deep vein thrombosis can arise as complications from surgeries or extended hospital stays. The U.S. has the third lowest rate of pulmonary embolisms following hip or knee surgery in 2022 compared to peer countries.
Preventive Services
Americans are less likely to have a regular place of care than peer countries, on average
A regular source of care includes medical facilities where a patient usually goes for medical advice. Continuous care is an important measure of health system quality as it facilitates better health outcomes. Within the United States, different demographic groups have varied rates of usual sources of care, with young adults being the least likely to have one.
On average, adults in the U.S. are less likely than peer nations to have a regular doctor or place of care in 2023. Americans are more likely, on average, to use the ER for non-urgent conditions
Emergency room visits for conditions that could have been treated in a primary care setting may indicate poor access to outpatient care. In the U.S. about 20% of young and middle-aged adults report experiencing non-cost related barriers to receiving healthcare including lack of appointment availability and inability to find a provider during regular hours. In addition, potentially avoidable ED visits are costly and can contribute to ER overcrowding.
In 2023, 16% of adults ages 19-64 years old in the U.S. used an ER for care that could have been provided by a regular doctor or because they did not have a regular doctor (compared to 11% of adults 19-64 years old on average in peer countries).
Health System Capacity
In 2022, the U.S. had 0.6 general practitioners per 1,000 individuals while peer nations had an average of 1.3 general practitioners per 1,000 individuals (about 74% difference). The U.S. has fewer general health practitioners than most peer nations – Search
The U.S. has faced a growing physician shortage since the early 2000s. This shortage is particularly notable among general practitioners, including primary care providers. As of 2024, 53% of the U.S. population lived in areas that have been designated as not having enough primary care providers for the population.
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