Cross-country differences in household healthcare spending

Health systems face financial pressures as populations age and economic growth slows, with implications for who pays for health care and for what drives expenditure growth.

We examined changes in outpatient and pharmaceutical care financing across OECD countries from 2000 to 2023.

While overall health spending growth slowed across countries after the Great Recession, household spending grew modestly everywhere, averaging about half a percentage point growth annually. The United States stood out for persistently high out-of-pocket financing burden-over twice that of most peer countries-and for price growth, rather than utilization, driving out-of-pocket spending for pharmaceutical care. Other countries saw out-of-pocket spending driven more by volume growth and slower price growth.

These patterns highlight potential affordability pressures from out-of-pocket healthcare payments, particularly in the US Policymakers should regularly monitor financial hardship from out-of-pocket payments and reconsider using cost-sharing to address health financing sustainability challenges.