Rise in US spending on healthcare in 2009 was twice that in UK.

Higher prices, more readily accessible technology, and greater levels of obesity are probably the main reasons why the United States spends far more on healthcare than do other developed countries. The analysis was contained in a briefing paper prepared by the charity the Commonwealth Fund. The higher rate of spending cannot be attributed to higher income, an older population, or a greater supply and use of hospitals and doctors, wrote David Squires, the paper’s author. His analysis drew on data from the Organisation for Economic Co-operation and Development (OECD) and from Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the US for the period 1980 to 2009. The median gross domestic product (GDP) per head was $33 434 (£20 650; €25 600) in OECD countries, of which 9.5%was devoted to healthcare. Total per capita spending on healthcare over that period rose nearly eightfold in the US, from about $1000 to $7960 per person. Spending as a percentage of GDP nearly doubled, from about 9% to 17.4%. That contrasts sharply with Japan, the country with the longest life expectancy, which spent less per capita ($2325) and as a percentage of GDP (8.5%) than any of the other countries studied. This was due largely to controlling costs through aggressive price regulation. The UK was in the middle of the pack, spending $3487 per capita or 9.8% of GDP on healthcare. Healthcare expenditure has risen significantly as the population ages, a trend seen in all countries. Japan has the oldest population, with 23% of people older than 65, while the US has one of the youngest (13%). The OECD median was 15.8% in 2009. But obesity is much more prevalent in the US than in Japan. A third of US people but only 4% of Japanese are obese (body mass index ≥30). The UK hit the OECDmedian of 15.8% of the population older than 65 years, but obesity was more common (23%) than in its continental neighbours of France (11.2%), the Netherlands (11.8%), and Germany (14.7%). The US fell below the OECD median on quantitative use of healthcare, with fewer doctors per 100 000 population (2.4 versus 3.0), fewer doctor consultations per capita (3.9 versus 6.3); fewer acute care hospital beds per 1000 population (2.7 versus 3.2); a shorter average length of stay for acute care (5.4 versus 5.9 days); and fewer hospital discharges per 1000 population (131 versus 160). The greater healthcare expenditure in the US is explained in part by the intensity of interventions once a patient is in the healthcare system.More expensive diagnostics and interventions are used in the US than in other countries. US doctors are paid much more than their overseas colleagues. But they pay for a significant part of their education and often begin practice with a substantial debt incurred from medical school. Although brand name prescription drugs often cost a lot more in the US, generic drugs are often cheaper and are more likely to be used in the US than in other countries. Pharmaceuticals constitute about 10% of total healthcare expenditure in the US.