International Comparisons of Public Health Expenditures


Winter (2013) starts by arguing that the United States become the country that has the highest spending on healthcare. This is in comparison to other nations in the OECD (Organization for Economic Cooperation and Development). Notably, the United States is considered the most developed country. However, the reasons for the higher spending on health care in the United States have been controversial. The country’s budget show high spending on health services to its citizens, however, this spending is not reflected in the hospitals.

Relationship between public health expenditures and desired public health outcomes

Public health expenditures may not correlate with desired public health results. Bradley (2015) argues that higher spending in healthcare does not necessarily mean that there would be improved health care services. Taking the United States as an example, the country uses many funds in health care. However, the provision of health services in the country is distorted (Rothgang, 2010). In addition, the United States has hospitals with few hospital beds and fewer discharges per capita than in the OECD. Furthermore, health care insurance premiums have been rising recently. Therefore, the cost of health care in the United States is very high. Brannon (2010) attests that many workers in the country do not have admission to paid sick leaves despite the fact that the government is spending many funds on healthcare. Statistics give that the United States has poor population health. Giaimo (2002) admits that the United States has worse health outcomes than the other international countries. Observably, Walshe (2003) confirms the people in the United States have the lowest life expectancy rates on top of the highest infant mortality rates.

Comparison of healthcare spending between the United States, United Kingdom, and Germany

The United States spends 17.1% of its GDP (gross domestic product) on healthcare. This figure is two times that of the United Kingdom, which uses 8.8% of its GDP. The United Kingdom uses $3,480 per year on healthcare (Johnson, 2010). On the other hand, the United States government uses $8,362 per individual per annum on healthcare. Germany uses $4,920 on total health per capita (Greenwald, 2010). Germany and the United States differ in the effectiveness of health insurance (Shi, 2012). Recognizably, the typical per-capita healthcare expenditures for Germany’s system are less than half of the expenses in the United States. The United Kingdom defeats the United States on the number of nurses in the healthcare facilities. However, Germany defeats both the United Kingdom and the United States on the number of nurses.


The reason behind the poor health services in the United States, despite the high spending, can be said to emanate from the method used by the government to fund healthcare (Johnson, 2010). The United States uses Medicare while Germany relies on private and non-profit insurers, which are tightly controlled to function towards communally desired accomplishments.


It can be drawn from the discussion that several recommendations have to be enacted to ensure that higher spending on healthcare by the United States brings the intended medical outcomes. The country should adopt the policy executed by Germany to add more contributors to the healthcare provider. This is apparent because there are still observable shortages of hospital beds and practitioners in the face of the high spending.


Bradley, E. (2015). American Health Care Paradox: Why Spending More is Getting Us Less. New York: Public Affairs.

Brannon, L (2010). Health Psychology: An Introduction to Behavior and Health. Australia: Cengage Learning.

Giaimo, S. (2002). Markets and Medicine: The Politics of Health Care Reform in Britain, Germany, and the United States.Ann Arbor: University of Michigan Press.

Greenwald, H. (2010). Health Care in the United States: Organization, Management, and Policy. San Francisco: Jossey-Bass.

Johnson, J. (2010). Comparative Health Systems: Global Perspectives.Sudbury: Jones and Bartlett Publishers.

Rothgang, H. (2010). The State and Healthcare: Comparing OECD Countries. Hampshire: Palgrave Macmillan.

Shi, L. (2012). Delivering Health Care in America: A Systems Approach.Sudbury: Jones & Bartlett Learning.

Walshe, K. (2003). Regulating Healthcare: A Prescription for Improvement?. Maidenhead: Open University Press.

Winter, R. (2013). Unraveling the U.S. Health Care: A Personal Guide.Lanham: Rowman& Littlefield.

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