How much countries spend on health and the rate at which such expenditure grows from one year to the next reflects a wide array of economic and social factors, as well as countries’ diverse financing and organisational structures of their health systems.
In 2022, the United States continued to outspend all other OECD countries by a wide margin, with the equivalent of USD 12 555 per person spent on health (Figure 7.7). This level of health spending is two‑and-a-half times the OECD average (USD 5 000) and 55% higher than Switzerland, the next biggest spending country. Around three‑quarters of countries fall within a per capita spending range of USD 3 000‑8 000. Countries spending below USD 3 000 include several Central European and Latin American members of the OECD, together with Türkiye. The lowest per capita spender on health was Mexico with USD 1 200 per person (24% of OECD average). Among the key emerging economies, in 2022, China, Indonesia and India spent 20%, 8% and 4% of the OECD average on health, respectively, in per capita terms.
Figure 7.7 also shows the split of health spending based on the type of financing scheme. On average across OECD countries, about three‑quarters of all health spending comes either from government schemes (Denmark, Iceland, Norway, Sweden, and the United Kingdom) or from some form of compulsory insurance (Germany, France, Japan and Luxembourg). On average, health spending through voluntary arrangements, such as private voluntary health insurance or household out-of-pocket payments, represents 22% of total spending. Trends in per capita health spending and GDP over the last 15 years reflect two shocks: the economic and financial crisis in 2008 and the COVID‑19 pandemic in 2020 (Figure 7.8). While OECD economies sharply contracted in 2008 and 2009, health spending growth was maintained in the short term before hovering just above zero, as a range of different policy measures to reduce public spending on health were put in place between 2010 and 2012. This was followed by a return to somewhat stronger growth, both in health spending and GDP up until the pandemic. In 2020, widespread lockdowns and other public health measures that severely restricted economic activity and consumer spending sent many OECD economies into freefall. There was a rebound in 2021 with per capita GDP increasing by 5.8% on average. At the same time, real per capita spending on health accelerated from just over 4% in 2020 to 8% in 2021 as countries allocated additional funding to tackle the pandemic. With countries emerging from the acute stage of the pandemic, on average health spending per capita is likely to have fallen by close to 1.5% in real terms in 2022.
In the years preceding the COVID‑19 pandemic, annual average per capita spending on healthcare grew by an average of 2.6% across OECD countries (Figure 7.9). The emergence of COVID‑19 in 2020 led to sharp increases in health spending, particularly from governments as they mobilised funds to slow down and tackle the effects of the pandemic. Between 2019 and 2022, average per capita spending growth in the OECD accelerated to 3.3% per year. However, diverging trends in the pattern of health spending growth across countries during the pandemic could be observed due to the severity of the various waves across different regions, and the extent and duration of containment policies. Around two‑thirds of OECD countries saw higher spending growth during the pandemic than in the years immediately beforehand; only Mexico experienced reduced growth over the most recent three‑year period.
