Health: who gets the most for their money?
The United States spends nearly twice as much per person on health as France, with worse results. Asia gets a lot for little. And is the French model, whose national insurance pushes prices down, as efficient as it is said to be? What OECD and WHO figures show.
Scope: OECD countries plus China, India, Brazil, Indonesia, South Africa, Russia, Saudi Arabia, Argentina and Singapore; OECD health accounts, WHO health expenditure database (via the World Bank), latest year published for each country.
Key points
- The United States spends the most, for worse results. In 2022, an American costs $13,062 of care, 1.9 times a French person ($6,761). Yet deaths that effective care should have avoided are twice as frequent there (95 per 100,000 per 100,000 people, against 48 per 100,000), and life expectancy (78.4 years) is close to China’s (78.0 years).
- The American extra cost comes mostly from prices and administration (evidence level C). Americans spend 2.1 times more than the French on drugs and 2.9 times more on running insurance per person, while comparative studies find they do not use more care.
- France is efficient compared with the United States, less so compared with Asia and southern Europe. Its treatable mortality (48 per 100,000) is among the lowest, but South Korea does at least as well spending 30% less per person. Japan, Spain and Italy have longer life expectancy for lower spending.
- The French model protects the patient. Only 9.3% of health spending is paid directly by households, against 31.8% in Korea and 32.2% in China. Complementary insurers take over from national insurance: the public share (67.7%) is lower than in Germany (79.1%) or Japan (84.8%).
How to read these figures
Spending is in purchasing-power-parity dollars per person: this corrects differences in the general price level between countries, not differences in health prices. That is precisely what shows care is more expensive in the United States. The outcome used by the OECD is treatable mortality: deaths before 75 that timely, high-quality care should have avoided, per 100,000 people, at the same age structure. Life expectancy, a broader measure, also depends heavily on lifestyle and income.
The efficiency frontier links the countries no other country beats on both spending and outcome. A country far from the frontier is not “bad”: it gets a result another country reaches while spending less. The low end of the frontier groups countries that spend little, with average outcomes, simply because none spends less. Above all, this chart is a correlation: diet, tobacco, accidents and income matter too. It raises questions; it does not point to a model to copy.
1. What each country spends
The United States devotes an unmatched share of its wealth to health: 16.7% of GDP of GDP in 2023, against 11.5% of GDP in France. The gap has widened since 2000 (12.5% of GDP against 9.6% of GDP): at constant prices, spending per person grew 99% in the United States and 44% in France.
Current health expenditure, % of GDP
All spending on care and medical goods, public and private, excluding investment (WHO health expenditure database).
- China
- South Korea
- Japan
- United Kingdom
- Germany
- France
- United States
Source:World Bank / WHO
Show the chart data
| Period | United States | France | Germany | United Kingdom | Japan | South Korea | China |
|---|---|---|---|---|---|---|---|
| 2000 | 12.5% of GDP | 9.6% of GDP | 9.8% of GDP | 7.1% of GDP | 7.0% of GDP | 3.7% of GDP | 4.5% of GDP |
| 2001 | 13.2% of GDP | 9.8% of GDP | 9.8% of GDP | 7.4% of GDP | 7.2% of GDP | 4.2% of GDP | 4.2% of GDP |
| 2002 | 14.0% of GDP | 10.1% of GDP | 10.0% of GDP | 7.9% of GDP | 7.4% of GDP | 3.9% of GDP | 4.3% of GDP |
| 2003 | 14.5% of GDP | 10.1% of GDP | 10.2% of GDP | 8.1% of GDP | 7.5% of GDP | 4.5% of GDP | 4.4% of GDP |
| 2004 | 14.6% of GDP | 10.2% of GDP | 10.0% of GDP | 8.3% of GDP | 7.5% of GDP | 4.4% of GDP | 4.2% of GDP |
| 2005 | 14.6% of GDP | 10.2% of GDP | 10.1% of GDP | 8.4% of GDP | 7.7% of GDP | 4.7% of GDP | 4.1% of GDP |
| 2006 | 14.7% of GDP | 10.4% of GDP | 10.0% of GDP | 8.5% of GDP | 7.7% of GDP | 5.0% of GDP | 3.9% of GDP |
| 2007 | 14.9% of GDP | 10.3% of GDP | 9.8% of GDP | 8.8% of GDP | 7.8% of GDP | 5.0% of GDP | 3.6% of GDP |
| 2008 | 15.2% of GDP | 10.5% of GDP | 10.0% of GDP | 9.0% of GDP | 8.1% of GDP | 5.2% of GDP | 3.8% of GDP |
| 2009 | 16.2% of GDP | 11.3% of GDP | 11.0% of GDP | 9.8% of GDP | 9.0% of GDP | 5.7% of GDP | 4.3% of GDP |
| 2010 | 16.2% of GDP | 11.2% of GDP | 10.8% of GDP | 9.8% of GDP | 9.1% of GDP | 5.8% of GDP | 4.2% of GDP |
| 2011 | 16.1% of GDP | 11.2% of GDP | 10.5% of GDP | 9.8% of GDP | 10.5% of GDP | 5.9% of GDP | 4.3% of GDP |
| 2012 | 16.1% of GDP | 11.3% of GDP | 10.6% of GDP | 9.9% of GDP | 10.7% of GDP | 6.0% of GDP | 4.5% of GDP |
| 2013 | 16.0% of GDP | 11.4% of GDP | 10.7% of GDP | 10.0% of GDP | 10.7% of GDP | 6.1% of GDP | 4.6% of GDP |
| 2014 | 16.1% of GDP | 11.6% of GDP | 10.8% of GDP | 10.0% of GDP | 10.7% of GDP | 6.2% of GDP | 4.7% of GDP |
| 2015 | 16.4% of GDP | 11.5% of GDP | 10.9% of GDP | 9.9% of GDP | 10.7% of GDP | 6.5% of GDP | 4.9% of GDP |
| 2016 | 16.7% of GDP | 11.6% of GDP | 11.0% of GDP | 9.9% of GDP | 10.7% of GDP | 6.6% of GDP | 4.9% of GDP |
| 2017 | 16.6% of GDP | 11.4% of GDP | 11.1% of GDP | 9.7% of GDP | 10.7% of GDP | 6.8% of GDP | 5.0% of GDP |
| 2018 | 16.5% of GDP | 11.3% of GDP | 11.2% of GDP | 9.8% of GDP | 10.7% of GDP | 7.1% of GDP | 5.1% of GDP |
| 2019 | 16.5% of GDP | 11.2% of GDP | 11.4% of GDP | 10.0% of GDP | 11.0% of GDP | 7.7% of GDP | 5.3% of GDP |
| 2020 | 18.5% of GDP | 12.1% of GDP | 12.5% of GDP | 12.1% of GDP | 11.4% of GDP | 8.0% of GDP | 5.5% of GDP |
| 2021 | 17.4% of GDP | 12.2% of GDP | 12.7% of GDP | 12.1% of GDP | 12.1% of GDP | 8.3% of GDP | 5.3% of GDP |
| 2022 | 16.5% of GDP | 11.8% of GDP | 12.4% of GDP | 11.1% of GDP | 12.3% of GDP | 8.9% of GDP | 5.9% of GDP |
| 2023 | 16.7% of GDP | 11.5% of GDP | 11.7% of GDP | 11.0% of GDP | 10.7% of GDP | 8.6% of GDP | 5.9% of GDP |
| 2024 | – | 11.5% of GDP | 12.3% of GDP | 11.1% of GDP | – | 8.7% of GDP | – |
Health spending per person, constant prices
2020 purchasing-power-parity dollars, OECD health accounts. The last year may be a provisional estimate.
- Switzerland
- South Korea
- Japan
- United Kingdom
- Germany
- France
- United States
Source:OECD
Show the chart data
| Period | United States | France | Germany | United Kingdom | Japan | South Korea | Switzerland |
|---|---|---|---|---|---|---|---|
| 2000 | $6,542 | $4,252 | $4,806 | $2,837 | $2,792 | $971 | $5,035 |
| 2001 | $6,901 | $4,364 | $4,859 | $3,035 | $2,877 | $1,114 | $5,278 |
| 2002 | $7,404 | $4,547 | $4,964 | $3,269 | $2,919 | $1,115 | $5,473 |
| 2003 | $7,802 | $4,578 | $5,024 | $3,442 | $2,999 | $1,305 | $5,573 |
| 2004 | $8,057 | $4,692 | $4,971 | $3,633 | $3,068 | $1,351 | $5,712 |
| 2005 | $8,286 | $4,759 | $5,057 | $3,749 | $3,159 | $1,456 | $5,733 |
| 2006 | $8,517 | $4,927 | $5,148 | $3,855 | $3,189 | $1,598 | $5,688 |
| 2007 | $8,727 | $5,016 | $5,247 | $4,045 | $3,261 | $1,692 | $5,798 |
| 2008 | $8,722 | $5,077 | $5,375 | $4,083 | $3,300 | $1,798 | $5,926 |
| 2009 | $9,056 | $5,329 | $5,662 | $4,226 | $3,500 | $1,972 | $6,133 |
| 2010 | $9,154 | $5,280 | $5,783 | $4,304 | $3,662 | $2,153 | $6,165 |
| 2011 | $9,149 | $5,324 | $5,794 | $4,256 | $4,196 | $2,204 | $6,298 |
| 2012 | $9,281 | $5,372 | $5,847 | $4,374 | $4,327 | $2,251 | $6,502 |
| 2013 | $9,333 | $5,465 | $5,942 | $4,414 | $4,412 | $2,355 | $6,729 |
| 2014 | $9,647 | $5,542 | $6,094 | $4,529 | $4,448 | $2,479 | $6,818 |
| 2015 | $10,099 | $5,602 | $6,296 | $4,631 | $4,606 | $2,684 | $7,053 |
| 2016 | $10,399 | $5,691 | $6,453 | $4,691 | $4,635 | $2,850 | $7,229 |
| 2017 | $10,549 | $5,725 | $6,627 | $4,734 | $4,695 | $3,009 | $7,295 |
| 2018 | $10,774 | $5,704 | $6,764 | $4,806 | $4,741 | $3,214 | $7,285 |
| 2019 | $11,067 | $5,755 | $6,987 | $4,950 | $4,826 | $3,478 | $7,481 |
| 2020 | $12,077 | $5,770 | $7,363 | $5,409 | $4,859 | $3,618 | $7,621 |
| 2021 | $12,007 | $6,237 | $7,762 | $5,837 | $5,264 | $3,958 | $8,026 |
| 2022 | $11,754 | $6,125 | $7,675 | $5,453 | $5,244 | $4,220 | $8,015 |
| 2023 | $12,099 | $5,937 | $7,231 | $5,313 | $4,960 | $4,044 | $7,919 |
| 2024 | $12,551 | $5,995 | $7,569 | $5,496 | $4,877 | $4,218 | $8,037 |
| 2025 | $13,049 | $6,123 | $7,907 | $5,683 | $4,868 | $4,259 | $8,229 |
2. What each country gets
Each dot is a country: on the left those that spend little, at the bottom those where care prevents the most deaths. Of 36 OECD countries, 9 form the frontier. The United States sits alone, far to the right and high up.
Health spending per person and deaths avoidable through care, OECD countries
Spending: purchasing-power-parity dollars, current prices. Outcome: deaths before 75 avoidable through care, per 100,000 people, age-standardised (lower = better). Each country at its latest year published for both series (2020 – 2023). The dotted line is the efficiency frontier.
Source:OECD
Show the chart data
| Country | Spending per person (PPP $) | Avoidable deaths per 100,000 | Period | On the frontier |
|---|---|---|---|---|
| Mexico | $1,377 | 175 per 100,000 | 2022 | yes |
| Colombia | $1,635 | 115 per 100,000 | 2021 | yes |
| Costa Rica | $1,759 | 94 per 100,000 | 2022 | yes |
| Türkiye | $2,103 | 119 per 100,000 | 2023 | |
| Chile | $3,130 | 78 per 100,000 | 2022 | yes |
| Hungary | $3,162 | 141 per 100,000 | 2023 | |
| Estonia | $3,182 | 101 per 100,000 | 2022 | |
| Greece | $3,240 | 72 per 100,000 | 2022 | yes |
| Latvia | $3,247 | 154 per 100,000 | 2023 | |
| Poland | $3,263 | 114 per 100,000 | 2022 | |
| Slovakia | $3,484 | 130 per 100,000 | 2023 | |
| Israel | $3,836 | 56 per 100,000 | 2022 | yes |
| Lithuania | $3,952 | 134 per 100,000 | 2023 | |
| Portugal | $4,690 | 63 per 100,000 | 2022 | |
| South Korea | $4,715 | 45 per 100,000 | 2022 | yes |
| Italy | $4,865 | 52 per 100,000 | 2022 | |
| Czechia | $4,921 | 87 per 100,000 | 2023 | |
| Slovenia | $5,202 | 53 per 100,000 | 2023 | |
| Spain | $5,251 | 50 per 100,000 | 2023 | |
| Japan | $5,465 | 49 per 100,000 | 2021 | |
| United Kingdom | $5,824 | 71 per 100,000 | 2021 | |
| Finland | $5,834 | 57 per 100,000 | 2022 | |
| Iceland | $6,138 | 49 per 100,000 | 2022 | |
| Belgium | $6,549 | 50 per 100,000 | 2021 | |
| France | $6,761 | 48 per 100,000 | 2022 | |
| Ireland | $6,864 | 57 per 100,000 | 2022 | |
| Denmark | $6,888 | 55 per 100,000 | 2022 | |
| Canada | $6,910 | 58 per 100,000 | 2022 | |
| Germany | $7,363 | 66 per 100,000 | 2020 | |
| Australia | $7,574 | 47 per 100,000 | 2023 | |
| Sweden | $7,655 | 47 per 100,000 | 2023 | |
| Luxembourg | $7,736 | 39 per 100,000 | 2023 | yes |
| Netherlands | $8,151 | 49 per 100,000 | 2023 | |
| Austria | $8,278 | 54 per 100,000 | 2023 | |
| Switzerland | $9,246 | 34 per 100,000 | 2023 | yes |
| United States | $13,062 | 95 per 100,000 | 2022 |
Health spending per person and life expectancy, OECD and large emerging countries
Spending: purchasing-power-parity international dollars (WHO, via the World Bank). Outcome: life expectancy at birth (higher = better), which also depends on lifestyle and income. 47 countries, latest year published (2023 – 2024).
Source:World Bank / WHOWorld Bank
Show the chart data
| Country | Spending per person (PPP $) | Life expectancy (years) | Period | On the frontier |
|---|---|---|---|---|
| India | $346 | 72.0 years | 2023 | yes |
| Indonesia | $417 | 71.1 years | 2023 | |
| South Africa | $1,354 | 66.1 years | 2023 | |
| Mexico | $1,368 | 75.1 years | 2023 | yes |
| China | $1,487 | 78.0 years | 2023 | yes |
| Colombia | $1,758 | 77.9 years | 2024 | |
| Türkiye | $1,769 | 77.2 years | 2023 | |
| Costa Rica | $1,928 | 80.8 years | 2023 | yes |
| Brazil | $2,070 | 75.8 years | 2023 | |
| Hungary | $2,875 | 76.6 years | 2023 | |
| Latvia | $3,034 | 75.4 years | 2023 | |
| Argentina | $3,089 | 77.4 years | 2023 | |
| Russia | $3,204 | 73.3 years | 2023 | |
| Slovakia | $3,230 | 78.1 years | 2023 | |
| Greece | $3,454 | 81.7 years | 2023 | yes |
| Saudi Arabia | $3,475 | 78.7 years | 2023 | |
| Chile | $3,612 | 81.4 years | 2024 | |
| Estonia | $3,741 | 79.3 years | 2024 | |
| Poland | $3,939 | 78.4 years | 2024 | |
| Israel | $4,033 | 83.2 years | 2023 | yes |
| Lithuania | $4,127 | 77.2 years | 2024 | |
| Czechia | $4,674 | 80.0 years | 2024 | |
| Portugal | $4,928 | 82.4 years | 2024 | |
| Spain | $4,935 | 83.9 years | 2023 | yes |
| Italy | $4,993 | 84.0 years | 2024 | yes |
| South Korea | $5,081 | 83.6 years | 2024 | |
| Japan | $5,365 | 84.0 years | 2023 | yes |
| Slovenia | $5,425 | 82.3 years | 2024 | |
| New Zealand | $5,576 | 82.0 years | 2024 | |
| Finland | $6,433 | 81.6 years | 2023 | |
| Singapore | $6,551 | 83.1 years | 2023 | |
| United Kingdom | $6,606 | 81.4 years | 2024 | |
| France | $6,868 | 83.0 years | 2024 | |
| Iceland | $6,927 | 82.8 years | 2024 | |
| Denmark | $7,262 | 82.3 years | 2024 | |
| Belgium | $7,489 | 82.4 years | 2023 | |
| Canada | $7,646 | 82.1 years | 2024 | |
| Australia | $7,691 | 83.1 years | 2023 | |
| Sweden | $7,770 | 84.1 years | 2024 | yes |
| Netherlands | $8,195 | 82.0 years | 2024 | |
| Austria | $8,250 | 82.0 years | 2024 | |
| Ireland | $8,772 | 83.0 years | 2024 | |
| Luxembourg | $8,808 | 83.2 years | 2024 | |
| Germany | $8,826 | 80.8 years | 2024 | |
| Norway | $9,523 | 83.0 years | 2023 | |
| Switzerland | $10,602 | 84.2 years | 2023 | yes |
| United States | $13,473 | 78.4 years | 2023 |
3. Why the United States spends so much
Health accounts track two items where the price argument is most often made: medicines, and running health insurance (costs of public and private insurers, administration of the system).
Spending on medicines and other non-durable medical goods, per person
Purchasing-power-parity dollars, current prices (health accounts item HC51).
- Switzerland
- South Korea
- Japan
- United Kingdom
- Germany
- France
- United States
Source:OECD
Show the chart data
| Period | United States | France | Germany | United Kingdom | Japan | South Korea | Switzerland |
|---|---|---|---|---|---|---|---|
| 2010 | $986 | $614 | $663 | – | $649 | $462 | $605 |
| 2011 | $1,004 | $617 | $652 | – | $707 | $473 | $613 |
| 2012 | $1,013 | $620 | $671 | – | $750 | $478 | $642 |
| 2013 | $1,020 | $637 | $694 | $436 | $812 | $466 | $675 |
| 2014 | $1,118 | $641 | $740 | $448 | $814 | $471 | $688 |
| 2015 | $1,189 | $631 | $761 | $451 | $891 | $509 | $712 |
| 2016 | $1,193 | $656 | $819 | $468 | $797 | $545 | $755 |
| 2017 | $1,202 | $658 | $850 | $473 | $805 | $565 | $770 |
| 2018 | $1,224 | $653 | $892 | $463 | $809 | $607 | $794 |
| 2019 | $1,268 | $682 | $937 | $489 | $835 | $651 | $863 |
| 2020 | $1,328 | $697 | $1,017 | $553 | $848 | $724 | $896 |
| 2021 | $1,422 | $716 | $1,144 | $545 | $887 | $752 | $963 |
| 2022 | $1,515 | $786 | $1,188 | $615 | $932 | $864 | $1,085 |
| 2023 | $1,652 | $812 | $1,227 | $629 | $1,026 | $925 | $1,067 |
| 2024 | $1,752 | $851 | $1,338 | $635 | $1,029 | $1,000 | $1,193 |
| 2025 | – | $854 | – | – | – | $1,004 | – |
Cost of governing and financing the health system, per person
Purchasing-power-parity dollars, current prices (item HC7). Countries do not all classify the same spending under this item: gaps between European countries call for caution.
- Switzerland
- South Korea
- Japan
- United Kingdom
- Germany
- France
- United States
Source:OECD
Show the chart data
| Period | United States | France | Germany | United Kingdom | Japan | South Korea | Switzerland |
|---|---|---|---|---|---|---|---|
| 2010 | $585 | $245 | $237 | – | $50 | $53 | $249 |
| 2011 | $607 | $253 | $241 | – | $64 | $55 | $253 |
| 2012 | $626 | $260 | $244 | – | $65 | $61 | $246 |
| 2013 | $653 | $278 | $248 | $86 | $69 | $59 | $248 |
| 2014 | $733 | $279 | $247 | $84 | $57 | $66 | $253 |
| 2015 | $761 | $277 | $254 | $79 | $74 | $69 | $261 |
| 2016 | $797 | $289 | $271 | $74 | $71 | $74 | $280 |
| 2017 | $817 | $292 | $278 | $79 | $76 | $80 | $276 |
| 2018 | $922 | $295 | $293 | $82 | $79 | $87 | $280 |
| 2019 | $887 | $308 | $300 | $91 | $83 | $100 | $303 |
| 2020 | $1,071 | $316 | $326 | $113 | $70 | $123 | $315 |
| 2021 | $974 | $320 | $342 | $104 | $74 | $143 | $337 |
| 2022 | $1,041 | $343 | $377 | $115 | $86 | $141 | $373 |
| 2023 | $1,102 | $360 | $394 | $110 | $80 | $138 | $412 |
| 2024 | $1,094 | $378 | $400 | $114 | $79 | $147 | $433 |
| 2025 | – | $388 | – | – | – | $173 | – |
Why the United States spends so much: what the research says
Several comparative studies agree: Americans do not use more care than Europeans, they pay more for it, and their system costs more to administer. These are comparisons of data, not experiments: the finding is solid, while the causal link with a given rule (price negotiation, single payer) remains to be established.
- CAnderson, Reinhardt, Hussey and Petrosyan (2003), Health Affairs, “It’s The Prices, Stupid”Method: comparison of spending and use of care across OECD countries
The US spending gap is caused mostly by higher prices for health care goods and services, not by greater use of care.
- CAnderson, Hussey and Petrosyan (2019), Health Affairs, “It’s Still The Prices, Stupid”Method: update of the same comparison on more recent data
Fifteen years later the chief reason is the same: not greater use of care, but higher prices.
- CPapanicolas, Woskie and Jha (2018), JAMAMethod: comparison of the United States with ten other high-income countries on about a hundred spending, utilisation and price indicators
Americans have fewer physician visits and fewer hospital days; the extra cost comes from administrative complexity and high prices across a wide range of care, including drugs and health workers’ pay.
The scale
- A: causal effect shown by several studies with a rigorous design (experiment, reform compared with a control group), in several countries.
- B: causal effect shown by at least one rigorous study, or several quasi-experimental studies that agree.
- C: strong correlations and a plausible mechanism, no causal proof.
- D: descriptive observation or expert opinion only.
4. Who pays: the patient, insurance or taxes
The French model combines compulsory national insurance and complementary insurance, so patients pay very little out of pocket. In Asia, South Korea and China leave a much larger share to households.
Share of health spending paid directly by households
Out-of-pocket payments after reimbursement, % of current health expenditure.
- China
- South Korea
- Japan
- United Kingdom
- Germany
- France
- United States
Source:World Bank / WHO
Show the chart data
| Period | United States | France | Germany | United Kingdom | Japan | South Korea | China |
|---|---|---|---|---|---|---|---|
| 2000 | 15.1% | 7.3% | 11.8% | 18.2% | 15.9% | 43.3% | 60.1% |
| 2001 | 14.4% | 7.3% | 11.8% | 18.0% | 15.8% | 41.3% | 64.2% |
| 2002 | 14.3% | 7.1% | 12.0% | 17.4% | 16.0% | 40.8% | 62.9% |
| 2003 | 14.2% | 7.4% | 12.3% | 16.2% | 16.9% | 45.2% | 60.7% |
| 2004 | 14.0% | 7.2% | 13.5% | 14.7% | 16.6% | 44.8% | 58.8% |
| 2005 | 13.9% | 7.4% | 13.6% | 13.4% | 15.7% | 44.4% | 57.7% |
| 2006 | 13.7% | 9.4% | 13.9% | 12.4% | 16.4% | 42.5% | 56.0% |
| 2007 | 13.6% | 9.5% | 13.8% | 14.4% | 15.5% | 40.6% | 51.3% |
| 2008 | 13.4% | 10.0% | 13.5% | 13.5% | 15.2% | 41.6% | 47.4% |
| 2009 | 12.6% | 10.2% | 13.3% | 12.4% | 15.2% | 39.2% | 43.5% |
| 2010 | 12.4% | 11.4% | 13.3% | 13.2% | 14.6% | 38.8% | 40.8% |
| 2011 | 12.3% | 11.5% | 13.3% | 13.3% | 13.1% | 39.0% | 40.3% |
| 2012 | 12.3% | 11.3% | 13.5% | 14.2% | 13.0% | 38.7% | 39.2% |
| 2013 | 12.3% | 10.2% | 12.7% | 15.8% | 12.7% | 38.3% | 38.2% |
| 2014 | 12.0% | 11.1% | 12.4% | 15.7% | 12.9% | 37.6% | 36.6% |
| 2015 | 11.8% | 11.0% | 12.4% | 15.9% | 12.9% | 37.7% | 35.1% |
| 2016 | 11.6% | 10.7% | 12.2% | 15.7% | 12.9% | 36.5% | 35.9% |
| 2017 | 11.3% | 10.6% | 12.0% | 15.8% | 12.7% | 35.8% | 36.1% |
| 2018 | 11.3% | 10.4% | 12.2% | 16.2% | 13.0% | 34.7% | 35.8% |
| 2019 | 11.3% | 10.3% | 12.4% | 16.0% | 12.9% | 32.8% | 35.2% |
| 2020 | 10.1% | 9.4% | 11.3% | 12.4% | 11.6% | 31.8% | 34.8% |
| 2021 | 10.7% | 9.2% | 11.4% | 13.0% | 10.8% | 29.7% | 34.4% |
| 2022 | 11.0% | 9.2% | 10.4% | 14.4% | 11.1% | 29.3% | 31.6% |
| 2023 | 10.9% | 9.3% | 11.1% | 14.6% | 12.2% | 31.8% | 32.2% |
| 2024 | – | 9.2% | 10.7% | 14.6% | – | 33.7% | – |
Share of health spending financed by government
Central and local government and social security, % of current health expenditure. In France, complementary insurers (mutual funds, insurance companies) are not counted here.
- China
- South Korea
- Japan
- United Kingdom
- Germany
- France
- United States
Source:World Bank / WHO
Show the chart data
| Period | United States | France | Germany | United Kingdom | Japan | South Korea | China |
|---|---|---|---|---|---|---|---|
| 2000 | 44.4% | 72.7% | 78.5% | 75.8% | 80.4% | 50.6% | 22.0% |
| 2001 | 45.3% | 72.8% | 78.5% | 75.9% | 81.0% | 54.2% | 22.9% |
| 2002 | 45.2% | 73.0% | 78.1% | 76.8% | 80.8% | 54.8% | 25.4% |
| 2003 | 45.0% | 72.6% | 77.8% | 78.3% | 80.0% | 50.3% | 28.4% |
| 2004 | 45.4% | 72.6% | 76.2% | 80.2% | 80.3% | 50.8% | 30.2% |
| 2005 | 45.5% | 72.5% | 76.0% | 81.3% | 81.2% | 51.2% | 32.8% |
| 2006 | 46.3% | 71.3% | 75.6% | 82.4% | 80.3% | 53.1% | 35.1% |
| 2007 | 46.3% | 71.1% | 75.6% | 80.4% | 81.2% | 54.9% | 39.0% |
| 2008 | 47.5% | 70.6% | 75.7% | 81.3% | 81.2% | 53.4% | 44.5% |
| 2009 | 48.6% | 70.7% | 76.0% | 82.7% | 81.3% | 55.0% | 49.4% |
| 2010 | 49.0% | 69.6% | 76.1% | 82.0% | 81.9% | 55.3% | 51.9% |
| 2011 | 49.1% | 69.5% | 75.8% | 81.8% | 83.7% | 54.5% | 53.7% |
| 2012 | 48.8% | 69.6% | 75.8% | 81.0% | 83.9% | 54.3% | 55.7% |
| 2013 | 49.5% | 70.2% | 76.8% | 79.5% | 84.3% | 54.7% | 57.1% |
| 2014 | 50.8% | 69.8% | 77.4% | 79.6% | 84.1% | 54.5% | 58.4% |
| 2015 | 51.4% | 71.6% | 77.4% | 79.5% | 84.1% | 54.3% | 60.2% |
| 2016 | 51.3% | 74.4% | 77.8% | 80.1% | 84.0% | 55.0% | 58.1% |
| 2017 | 51.3% | 75.2% | 78.1% | 79.7% | 84.2% | 55.7% | 56.7% |
| 2018 | 51.6% | 75.2% | 77.9% | 79.4% | 83.8% | 56.5% | 56.4% |
| 2019 | 52.0% | 74.6% | 77.9% | 79.7% | 84.0% | 57.6% | 56.0% |
| 2020 | 56.9% | 76.3% | 79.2% | 84.1% | 85.4% | 58.2% | 54.7% |
| 2021 | 55.5% | 75.5% | 79.6% | 83.7% | 86.3% | 60.8% | 54.1% |
| 2022 | 55.2% | 75.3% | 80.5% | 82.1% | 86.0% | 62.3% | 57.7% |
| 2023 | 54.0% | 67.7% | 79.1% | 81.8% | 84.8% | 58.6% | 57.1% |
| 2024 | – | 68.4% | – | – | – | 56.6% | – |
5. Is the French model efficient?
Compared with the United States, without a doubt: France spends half as much per person, with treatable mortality half as high and one of the lowest out-of-pocket shares in the world. Compared with Germany, it gets better results (66 per 100,000 avoidable deaths per 100,000 in 2020) for slightly lower spending ($7,363).
But it is not on the frontier. South Korea, Japan, Spain and Italy get comparable results for less; with the broader measure of life expectancy, an outcome at least as good is observed elsewhere for 41% less spending. And administration is not its strength: it costs $378 per person in France, as in Germany ($400), against $79 in Japan, which partly reflects the coexistence of national and complementary insurance.
That social security’s pressure on prices explains this position remains a plausible hypothesis, not an established fact: the data show lower prices than in the United States, they do not allow attributing them to a specific rule (evidence level D for this claim).
What we know, what we don’t
What the figures establish
- The United States spends by far the most per person, for worse outcomes than most rich countries.
- Its extra cost comes mostly from prices and administration, not from using more care (comparative studies agree).
- France strongly protects patients: its out-of-pocket share is among the lowest.
What they don’t tell
- How much of the outcome gaps comes from the health system rather than lifestyle, income or diet.
- Whether price regulation by national insurance causes France’s relative efficiency.
- Whether low-spending Asian countries can keep it up as their populations age fast.
Sources
Series downloaded from their producers on Nov 14, 2026, the snapshot date. Only published periods are used: no projection.
- OECD Health expenditure and financing (System of Health Accounts), DSD_SHA@DF_SHA
- OECD Avoidable mortality (treatable and preventable), DSD_HEALTH_STAT@DF_AM
- World Bank Life expectancy at birth, total (years), SP.DYN.LE00.IN
- World Bank / WHO Current health expenditure per capita, PPP (current international $), SH.XPD.CHEX.PP.CD
- World Bank / WHO Current health expenditure (% of GDP), SH.XPD.CHEX.GD.ZS
- World Bank / WHO Out-of-pocket expenditure (% of current health expenditure), SH.XPD.OOPC.CH.ZS
- World Bank / WHO Domestic general government health expenditure (% of current health expenditure), SH.XPD.GHED.CH.ZS