Health Spending In OECD Countries In 2004: An Update, by Gerard Anderson, Bianca Frogner, and Uwe Reinhardt. "In 2004, the U.S. health care system continued to provide less access to health care resources than the health systems in many other [industrialized] countries; however, the United States continued to have the highest level of spending," Anderson and coauthors report.
As in prior years, higher U.S. spending stemmed primarily from its relatively high per capita gross domestic product (GDP) and "the much higher prices that Americans pay for health care services."
Per capita U.S. health spending was $6,102, about 2.5 times greater than median spending in 2004 -- the most recent year for which standardized international data is available -- for the countries in the Organization for Economic Cooperation and Development (OECD). The U.S. ranked first in outpatient expenditures at 3.6 times the median OECD country primarily because of higher spending on physician services. By contrast, the U.S. was essentially tied for fourth in inpatient spending at twice the median OECD country. Perhaps surprisingly, the U.S. spent the most per capita on public health and prevention, although the researchers caution that the high U.S. spending levels in this area could reflect higher prices in this country, rather than provision of more resources and use of more services.
The authors observe that chronic disease accounts for 80 percent of health care use in most OECD countries. Five of the most common chronic diseases account for half to two-thirds of all causes of mortality in high-income countries. The relatively high U.S. chronic disease prevalence and mortality "may be associated" with the high number of Americans who are overweight and obese, according to Anderson and his colleagues. U.S. tobacco and alcohol consumption per capita, also tied to chronic disease risk, was below the OECD medians in 2004. The authors note, however, that current rates of certain chronic diseases may be due to the long-term effects of previously higher smoking rates in the U.S. Moreover, OECD data do not track the best predictor of alcohol-related problems: the number of people who drink to excess.