“One cent of money, one cent of goods” goes the Chinese idiom, which is the hope for all who
spend their money. However, in many aspects of life, it feels like there is an imbalance on the
scale of cents of money to goods. As detailed previously, in 2024 the U.S. spent $14,885 per
capita (17.2% of GDP) or $4,922 more per capita than Switzerland and 4.9% more of GDP than
Germany — the next nearest points of comparison. So, what are some demographic reasons
and health care system resource allocations that could be driving the relatively high cost of U.S.
health care.
Some might point to the relative wealth of the U.S. relative to other countries as a potential
reason for high expenditures — due to a higher standard of living which inflates the cost of
everything. Based on 2024 World Bank data, excepting Switzerland ($103K/capita), the U.S.
has higher GDP per capita ($84K) than the other nations (average of $44K/capita) used for
comparison in this and other articles. An aging population is also frequently cited as a reason for
high health care costs; however, the U.S. only has 18% of the population aged 65 or older, far
less than Japan at 30%, and less than all but New Zealand (17%). Perhaps the clearest
demographic driver of high health care costs in the U.S. is obesity, with Organisation for
Economic Co-operation and Development (OECD) statistics in 2023 recording 40.8% of the
population as obese — with New Zealand the closest at 32.7% and Japan the least at 4.6%.
While there may be some demographic reasons for higher health care costs, it is not readily
apparent that our health care system resources are driving these costs to meet the demand.
The OECD 2025 Health at a Glance report demonstrates that the U.S. is not an outlier in any
category. In terms of personnel, the U.S. is below OECD average in practicing physicians per
1,000 population at 2.7 — with Japan the lowest of compared nations at 2.6 and Germany the
highest at 4.7. The U.S. is above average in practicing nurses per 1,000 population at 12.4 —
with Spain the lowest at 5.9 and Switzerland the highest at 18.8. The U.S. is below average in
long-term care workers per 100 people aged 65 and over at 4.1 — with France the lowest at 2.8
and Switzerland the highest at 8.4. The U.S. is above average in practicing pharmacists per
100,000 population at 99 — with the Netherlands the lowest at 22 and Japan the highest at 203.
Likewise, in terms of physical resources, the U.S. is not an outlier in comparison to other
nations. In hospital beds per 1,000 population, the U.S. is below average at 2.8 — with the
Netherlands the lowest at 2.3 and Japan the highest at 12.5. The U.S. is well above average
with 86 CT, MRI, and PET scanners per 1 million population — well above the UK at 19 and
Canada at 26, but far below Japan at 184. Japan’s statistics are most noteworthy given that they
are the least expensive nation in terms of annual health care expenditures at $5,790 per capita
(or 2.57 times less than the U.S.).
While there may be demographic factors contributing to high health care costs in the U.S.,
health care resource statistics do not clearly demonstrate a higher allocation of resources than
other countries. This suggests that there are higher costs associated with medical personnel
and resources in the U.S. compared to other countries. This and further analysis of insurance
costs will follow in subsequent articles.
Aiken is the director of Reporting and Analytics at RW Supply & Design. He has been a West
Plains resident for the past 17 years after graduating from Grove City
College in Pennsylvania with a Bachelor of Arts in History. Prior to living in the U.S., he grew up
in Turkey and Germany.
