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Advanced Economies on Average With Lower Share of Out-Of-Pocket Spending in Health Expenditure


This article is published in collaboration with Statista

by Florian Zandt


According to the Global Health Expenditure Database by the World Health Organization (WHO), the global average out-of-pocket expenses related to health across 192 countries made up 30 percent of all health expenditures per capita in 2022. This type of spending includes over-the-counter medicine, health aids or, as is the case for the U.S. healthcare system, deductibles or co-pays. While most high and upper-middle-income countries have a lower share of out-of-pocket spending due to nonprofit schemes, government transfers, and comprehensive social health insurance, this type of spending makes up two-thirds or more of all health spending in thirteen countries and territories.


Among this group are Turkmenistan, Armenia, Afghanistan and Nigeria, each exhibiting an out-of-pocket spending share of more than 75 percent. The United States, which is the only advanced economy with no robust universal health coverage, has a share of eleven percent. Looking at absolute instead of relative numbers, overall out-of-pocket spending grew to $471 billion or around $1,400 per capita according to the NHE fact sheet published by the Centers for Medicaid & Medicare Services. Private health insurance spending in the United States constituted 29 percent of national health expenditure, amounting to $1.3 trillion.


A comparison between the United States and other leading economies reveals that the U.S. has the same relative level of out-of-pocket spending as Germany and Japan as well as two percent less than the United Kingdom and two percent more than France. China, the second-biggest economy after the United States, exhibits an out-of-pocket spending share of 34 percent, despite almost universal healthcare coverage. This is likely due to a lower level of benefits, necessitating covering larger health expenses with personal money.


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