Health of the Healthcare System: An overview
Peterson-Kaiser Health System Tracker
The U.S. has the lowest life expectancy at birth among
OECD comparable countries
Life expectancy at birth in years, 2011
Switzerland
83
Japan
France
Australia
Sweden
Comparable Country Average
82
Canada
Netherlands
Austria
United Kingdom
Germany
Belgium
United States
79
76
77
78
79
80
81
82
83
Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health
Statistics (database). doi: 10.1787/data-00349-en (Accessed on June 25, 2014).
Peterson-Kaiser Health System Tracker
84
On average, other wealthy countries spend about half as
much per person on health than the U.S. spends
Total health expenditures per capita, U.S. dollars, PPP adjusted, 2012
United States
$8,745
Switzerland
Netherlands
Austria
Germany
Canada
Comparable Country…
$4,460
Belgium
France
Sweden
Australia
Japan
OECD Average
$3,493
United Kingdom
$3,289
$-
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000 $10,000
Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health expenditure and financing: Health expenditure indicators",
OECD Health Statistics (database). doi: 10.1787/data-00349-en (Accessed on June 25, 2014). Notes: Because 2012 data was unavailable, 2011 were used
for Australia and the Netherlands. Data for Canada and Switzerland are estimated values.
Peterson-Kaiser Health System Tracker
Since 1980, the gap has widened between U.S. health
spending and that of other countries
Total health expenditures as percent of GDP, 1970 – 2012
18%
17% United States
16%
14%
12%
11%
10%
Comparable
country average
8%
6%
4%
2%
0%
1970
1976
1982
1988
1994
2000
2006
2012
Year
Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health expenditure and financing: Health expenditure indicators",
OECD Health Statistics (database). doi: 10.1787/data-00349-en (Accessed on June 25, 2014). Notes: Data unavailable for: the Netherlands in 1970, 1971,
and 2012; Australia in 1970 and 2012; Germany in 1991; and France from 1971 through 1974, 1976 through 1979; 1981 through 1984, and 1986 through 1989.
Break in series in 2003 for Belgium and France and in 2005 for the Netherlands. 2012 data for Canada and Switzerland are estimated values.
Peterson-Kaiser Health System Tracker
For most of the leading causes of death, mortality rates
are higher in the U.S. than in comparable countries
Age-adjusted major causes of mortality per 100,000 population, in years, 2010
Comparable Country Average
United States
300
261
250
243
212
200
199
150
100
80
63
60
43
50
47
29
29
40
23
33
0
Diseases of the
circulatory
system
Cancers
(Neoplasms)
Diseases of the
respiratory
system
External causes Diseases of the
of mortality
nervous system
Mental and
behavioral
disorders
Endocrine,
nutritional and
metabolic
diseases
Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health status: Health status indicators", OECD Health
Statistics (database). doi: 10.1787/data-00349-en (Accessed on November 6, 2014).
Peterson-Kaiser Health System Tracker
The U.S. has the highest rate of deaths amenable to
health care among comparable OECD countries
Amenable mortality per 100,000 population, in years, 2002 - 2003 and 2006 - 2007
2002-2003
2006-2007
120
110
103
100
90
82
80
71
56
57
France
Australia
61
84
82
71
65
60
96
61
83
76
66
81
70
67
40
20
0
Japan
Sweden
Netherlands
Austria
Germany
United
Kingdom
Comparable
United States
Country Average
Source: Nolte E, McKee C. Martin. Health Affairs “Measuring the Health of Nations: Updating an Earlier Analysis” Available at:
http://content.healthaffairs.org/content/27/1/58.long
Peterson-Kaiser Health System Tracker
About 1 in 10 adults report that they delayed or did not
get care because of its cost
Percent of adults who reported delaying or going without care due to costs, 2013
12%
10%
11%
9%
8%
7%
6%
4%
2%
0%
Delayed care
Did not get care
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Peterson-Kaiser Health System Tracker
Yes to either (delayed and/or did not get
care)
Uninsured adults are more likely to delay or go without
care due to cost
Percent of adults who reported delaying or going without care due to cost, 2013
Insured
Uninsured
35%
32%
30%
28%
24%
25%
20%
15%
10%
7%
6%
4%
5%
0%
Delayed care
Did not get care
Source: Kaiser Family Foundation analysis of National Health Interview Survey
Peterson-Kaiser Health System Tracker
Yes to either
Lower income adults report more cost-related access
problems than higher income adults
Percent of adults who report delaying and/or going without medical care due to costs, 1998 – 2013
All adults
200% FPL and above
Below 200% FPL
40%
35%
30%
25%
20%
17%
15%
14%
13%
10%
9%
5%
6%
5%
0%
1998
2003
2008
2013
Source: Kaiser Family Foundation analysis of National Health Interview Survey Note: Shading represents years when a recession took place in the U.S.
Peterson-Kaiser Health System Tracker
In 2013, the U.S. had the lowest insured rate of all
OECD countries
Percent of total population covered by private and/or public health insurance, in years, 2013
United Kingdom
100
Switzerland
100
Sweden
100
Japan
100
Canada
100
Australia
100
France
100
Comparable Country Average
100
Austria
100
Netherlands
100
Germany
100
Belgium
99
OECD Average
98
United States
86
75
80
85
90
95
Source: OECD (2013), “OECD Health Data: Health expenditure and financing: Health expenditure indicators”, OECD Health Statistics (database).
(Accessed on September 16, 2015).
Peterson-Kaiser Health System Tracker
100
The U.S. has fewer physician consultations per capita
than most comparable countries
Doctors Consultations, per capita, in all settings, 2010
14
13.1
12
9.9
10
8
6.6
6
4
6.6
6.7
6.9
France
Austria
7.4
7.7
8.1
5.0
4.0
4.0
Switzerland
United
States
2
0
United
Kingdom
Australia Netherlands
Belgium
Canada
Comparable Germany
Country
Average
Japan
Source: OECD (2013), "OECD Health Data: Health care utilisation", OECD Health Statistics (database). doi: 10.1787/health-data-en (Accessed on October
29, 2014). Notes: In cases where 2011 data were unavailable, data from the countries' last available year are shown.
Peterson-Kaiser Health System Tracker
Patients in the U.S. have much shorter average hospital
stays than patients in comparable countries
Average number of days in the hospital per visit (all causes) (2010)
Japan
18.2
Germany
9.5
Switzerland
9
Comparable Country Average
8.1
Austria
7.9
Canada
7.7
United Kingdom
7.4
Belgium
6.9
Sweden
6
France
5.7
Netherlands
5.6
Australia
5
United States
4.8
0
2
4
6
8
10
12
14
16
18
20
Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health care utilisation", OECD Health Statistics (database). doi:
10.1787/health-data-en (Accessed on September 10, 2014). Notes: In cases where 2010 data were unavailable, data from the countries' last available year
are shown.
Peterson-Kaiser Health System Tracker
The average price of an angioplasty or bypass in the
U.S. is higher than in other comparable countries
Average price of an Angioplasty (2013)
Average price of Coronary bypass surgery (2013)
$30,000
$27,907
$80,000
$75,345
$70,000
$25,000
$60,000
$20,000
$50,000
$42,130
$15,000
$40,000
$10,897
$10,000
$36,509
$30,000
$8,477
$20,000
$5,295
$15,742
$5,000
$10,000
$0
Netherlands
Australia
Switzerland
United States
$0
Netherlands
Switzerland
Australia
United States
Source: International Federation of Health Plans (2013), “2013 Comparative Price Report, Variation in Medical and Hospital Prices by Country”
Peterson-Kaiser Health System Tracker
The average price of a caesarean section in the U.S. is
more than the price of a normal delivery
Average price of a caesarean section (2013)
Average price of normal delivery (2013)
$18,000
$12,000
$16,000
$15,240
$10,002
$10,000
$14,000
$8,307
$12,000
$10,263
$10,681
$8,000
$6,623
$10,000
$6,000
$8,000
$6,000
$5,492
$4,000
$2,824
$4,000
$2,000
$2,000
$0
$0
Netherlands
Australia
Switzerland United States
Netherlands
Australia
Switzerland United States
Source: International Federation of Health Plans (2013), “2013 Comparative Price Report, Variation in Medical and Hospital Prices by Country”
Peterson-Kaiser Health System Tracker
The average price of an MRI in the U.S. is significantly
higher than in other comparable countries
Average price of an MRI (2013)
$1,400
$1,200
$1,145
$1,000
$800
$600
$461
$350
$400
$200
$138
$0
Switzerland
Australia
Netherlands
United States
Source: International Federation of Health Plans (2013), “2013 Comparative Price Report, Variation in Medical and Hospital Prices by Country”
Peterson-Kaiser Health System Tracker
Disease burden is higher in the U.S. than in comparable
countries
Age standardized disability adjusted life year (DALY) rate per 100,000 population, 2010
United States
21,956
United Kingdom
20,384
Belgium
20,314
France
19,860
Austria
19,782
Germany
19,527
Netherlands
19,480
Canada
19,392
Comparable Country Average
19,071
Australia
18,701
Sweden
18,546
Switzerland
17,877
Japan
15,922
-
5,000
10,000
15,000
20,000
Source: Institute for Health Metrics and Evaluation. Global Burden of Disease Study 2010 (GBD 2010) Data Downloads, available here:
http://ghdx.healthdata.org/global-burden-disease-study-2010-gbd-2010-data-downloads
Peterson-Kaiser Health System Tracker
25,000
U.S. health care spending per capita has risen at
historically low rates recently, but is expected to pick up
Average annual growth rate of health spending per capita for 1970’s – 1990’s;
Annual change in actual health spending per capita 2000 – 2014 and projected health spending per capita (2015 – 2024)
Actual
Projected
14%
12.1%
12%
9.9%
10%
8.6%
8%
7.6%
7.5%
6.3%
6.1%
6%
5.5%
5.8%
6.3%
5.5% 5.5%
4.5%
4.0%
3.7%
4%
4.5% 4.6%
5.2% 5.3% 5.3% 5.3% 5.2% 5.1%
3.0% 3.1% 3.1% 3.0%
2.1%
2%
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the
Actuary, National Health Statistics Group Note: 2014 to 2015 percent changes are calculated using 2014 actual and 2015 projected amounts.
Peterson-Kaiser Health System Tracker
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1990s
1980s
1970s
0%
U.S. health care spending per capita has risen at
historically low rates recently, but is expected to pick up
Average annual growth rate of health spending per capita for 1970’s – 1990’s;
Annual change in actual health spending per capita 2000 – 2014 and projected health spending per capita (2015 – 2024)
Actual
Projected
14%
12.1%
12%
9.9%
10%
8.6%
8%
7.6%
7.5%
6.3%
6.1%
6%
5.5%
5.8%
6.3%
5.5% 5.5%
4.5%
4.0%
3.7%
4%
4.5% 4.6%
5.2% 5.3% 5.3% 5.3% 5.2% 5.1%
3.0% 3.1% 3.1% 3.0%
2.1%
2%
Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the
Actuary, National Health Statistics Group Note: 2014 to 2015 percent changes are calculated using 2014 actual and 2015 projected amounts.
Peterson-Kaiser Health System Tracker
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1990s
1980s
1970s
0%
Foot and leg amputations due to diabetes are
decreasing in the U.S. and comparable countries
Age standardized diabetes lower extremity amputation rate per 100,000 population, ages 15 and older, in years 2006, 2008, and 2010
United States
40
Comparable Country Average
37.5
34.5
35
30
25
20
17.1
14.7
15
8.5
10
7.4
5
0
2006
2008
Source: OECD (2013), "OECD Health Data: Health status: Health quality indicators", OECD Health Statistics (database).
doi: 10.1787/data-00349-en (Accessed on March 2, 2015). Notes: Data for 2006 Comparable Country Average are from 2007.
Peterson-Kaiser Health System Tracker
2010
The U.S. has higher rates of medical, medication, and
lab errors than comparable countries
Medical, medication, or lab errors or delays in past two years, 2011
United States
22%
Canada
21%
Netherlands
20%
Sweden
20%
Australia
19%
Comparable Country Average
16%
Germany
16%
France
13%
Switzerland
9%
United Kingdom
8%
0%
5%
10%
15%
20%
25%
Note: Experienced medical mistake, given wrong medication or dose, lab test error, or delay receiving abnormal test results. Source: 2011 Commonwealth
Fund International Health Policy Survey in Eleven Countries, available here: http://www.commonwealthfund.org/interactives-and-data/internationalsurvey-data
Peterson-Kaiser Health System Tracker
Five-year survival rates for certain cancers are higher in
the U.S. than in comparable countries
Percentage of age-adjusted five-year relative survival for breast, colorectal, and cervical cancer, ages 15-99, in years 2004-2009
United States
Comparable Country Average
100
90
88.7
84.2
80
70
64.7
61.6
62.2
64.8
60
50
40
30
20
10
0
Breast Cancer
Colorectal Cancer
Cervical Cancer
Source: OECD (2013), "OECD Health Data: Health status: Health quality indicators", OECD Health Statistics (database).
doi: 10.1787/data-00349-en (Accessed on March 2, 2015). Notes: Data for breast and cervical cancers are for females.
Peterson-Kaiser Health System Tracker
Mortality rates for breast and colorectal cancer in the
U.S. are lower than in comparable countries
Age-standardized mortality rate per 100,000 population for breast, colorectal, and cervical cancer, in years, (2010)
United States
Comparable Country Average
30
26.1
25
24.5
22.7
20
17.6
15
10
5
2.4
2.4
0
Breast Cancer
Colorectal Cancer
Source : OECD (2013), "OECD Health Data: Health status: Health status indicators", OECD Health Statistics (database).
doi: 10.1787/data-00349-en (Accessed on May 5, 2015). Notes: Data for breast and cervical cancers are for females.
Peterson-Kaiser Health System Tracker
Cervical Cancer
Circulatory and ill-defined conditions, such as checkups, are the largest category of spending
Total expenditures in $ billions by disease category, 2012
Ill-defined conditions
$247
Circulatory
$241
Musculoskeletal
$186
Respiratory
$157
Endocrine
$138
Nervous system
$133
Cancers and tumors
$124
Injury and poisoning
$118
Genitourinary
$113
Digestive
$107
Other
$93
Mental illness
$80
Infectious diseases
$67
Dermatological
$44
Pregnancy and childbirth
$39
$-
$50
$100
$150
$200
$250
$300
Source: Bureau of Economic Analysis Health Care Satellite Account (Blended Account). Accessed January 25, 2016. Note: Expenditures on nursing home
and dental care are not included in health services spending by disease.
Peterson-Kaiser Health System Tracker
The average price of Celebrex in the U.S. is about 63%
higher than in Switzerland
Average Price, 2013
$250
$225
$200
$150
$138
$112
$112
Netherlands
England
$100
$50
$51
$0
Canada
Switzerland
United States
Source: International Federation of Health Plans Notes: U.S. average prices are calculated using commercial claims data from Truven MarketScan
Research databases. Methods and sources for comparable countries can be found here: http://www.ifhp.com/1404121
Peterson-Kaiser Health System Tracker
The average price of Nexium in the U.S. is almost 3
times more than the average price in Switzerland
Average Price, 2013
$250
$215
$200
$150
$100
$60
$42
$50
$23
$0
Netherlands
England
Switzerland
United States
Source: International Federation of Health Plans Notes: U.S. average prices are calculated using commercial claims data from Truven MarketScan
Research databases. Methods and sources for comparable countries can be found here: http://www.ifhp.com/1404121
Peterson-Kaiser Health System Tracker
The average price of Cymbalta in the U.S. is 76% more
than the average price in Canada
Average Price, 2013
$250
$194
$200
$150
$110
$100
$76
$50
$52
$46
$0
England
Netherlands
Switzerland
Canada
United States
Source: International Federation of Health Plans Notes: U.S. average prices are calculated using commercial claims data from Truven MarketScan
Research databases. Methods and sources for comparable countries can be found here: http://www.ifhp.com/1404121
Peterson-Kaiser Health System Tracker