1. Comparing US Health Care to OECD Countries: Costs and Access HCA 701 U.S. Health Care System

2. Factors contributing to Disproportionate Spending  Rising expectations about the value of health care services  Rapid development of technology expanding treatment of disease  Government financing of health care services  The nature of third-party reimbursement  Growth in the proportion of the elderly  Lack of competitive forces in the health care system to increase efficiency & productivity in delivery of services  The maldistribution of physicians and other health care providers.

3. Per-capita Spending on Health Care in OECD Countries

4. Health Care Spending as GDP

5. Physicians per 1,000 Population 1980199020002003 U.S.1.51.82.22.3 Austrl1.62.23.23.4 Canada1.82.1 German**2.83.33.5 France1.93.13.33.4 Japan1.31.71.92.0 Sweden2.22.93.13.3 Swis2.53.03.53.6 UK1.31.81.92.2

6. Nurses per 1,000 Population 1980199020002003 U.S.5.67.28.07.3 Austrl10.311.610.510.2 Canada9.611.110.19.8 German** 9.49.7 France4.75.66.77.3 Japan45.87.67.8 Sweden7.09.29.810.2 Swis** 10.7 UK**7.88.39.1

7. Acute Care Beds/1,000 Population 1980199020002003 U.S.4.43.72.92.8 Austrl6.44.83.83.6 Canada4.64.03.2 German**8.36.86.6 France**5.24.13.8 Japan**2.75.25.9 Sweden5.14.12.4 Swis7.26.54.13.9 UK** 3.7

8. MRI Units/1,000,000 Population 199020002003 U.S.3.78.18.6 Austrl0.63.53.7 Canada0.72.54.5 German1.14.96.2 France0.84.96.2 Japan6.123.235.3 Sweden1.57.9 Swis**12.414.2 UK**4.65.2

9. Life Expectancy 1980199020002003 U.S.73.775.376.777.2 Austrl72.67779.380.3 Canada75.377.679.379.7 German72.975.37878.1 France74.376.97979.4 Japan76.178.981.281.8 Sweden75.877.679.780.2 Swis76.277.479.880.4 UK73.275.777.978.5

10. Queuing for Health Care  More likely to have care on demand (queues a major concern in many OECD countries)  Australia, Canada and UK spending more to increase access to care  Health care spending in countries with waits averaged $2,366 per capita compared to $2,000 in countries with no waits, and $5,267 in U.S.

11. Malpractice Issues  U.S. had 50% more malpractice claims filed per 1,000 pop than UK and Australia; 350% more than Australia  2/3 of U.S. claims were dropped, dismissed or found in favor of defendant (same in Canada). UK has fewer cases dropped, dismissed or settled.  Judgments in U.S. were lower on average than those of Canada (14% ↓) or UK (36% ↓), but higher than Australia.  Spending per capita on malpractice U.S. = $16 UK = $12 Australia = $10 Canada = $4  U.S. spent significantly more on defending malpractice claims than other countries  Hard to estimate amount spent on “defensive medicine”

12. Other Fun Facts  U.S. per capita spending 53% higher than nearest comparison (Switzerland)  Americans have less access to physicians, nurses and acute care hospital beds  Access to care may be more efficient (Americans spend less time in hospitals)  Emergency room services for non-emergent health care significantly more in U.S. than other health care