The United States spends far more than other wealthy industrial countries but has poorer outcomes. Spending per person is more than double the spending per person in Canada, France, and the United Kingdom (see exhibit 1.1). Differences this large should be reflected in the outcomes of care.

However, of the six countries listed in exhibit 1.2, the United States has the shortest life expectancy at birth. In part, this difference is because the United States invests relatively little in improving the social determinants of health and reducing inequality. Adler, Glymour, and Fielding (2016) note that the life expectancy of 40-year-old men at the bottom of the income distribution is 14.6 years shorter than for men in the top of the income distribution. Greater spending should not produce these results.

Discussion Questions

• Why is spending so much more than other countries a problem?

• What can Americans not buy because of high spending on healthcare?

• What factors other than healthcare affect population health?

• Does this evidence suggest that the American healthcare system is not efficient?

• What are the most important social determinants of health?

Transcribed Image Text:

Country Canada France Germany Switzerland United Kingdom United States 2011 $4,248 $4,031 $4,588 $6,048 $3,084 $8,145 2016 $4,644 $4,600 $5,501 $7,919 $4,193 $9,892