A Snapshot of Health Care in America

A comparison of U.S. spending on Health Care with Cuba, France and the U.K. i i

hide captionThe United States spends more of its gross domestic product on heath care than any other country. The WHO came up with these estimates in 1997, showing that the U.S. spends more than twice as much of its GDP on health care compared with the United Kingdom, with Cuba and France in the middle. Most of the medical costs in the U.K, Cuba and France are paid by the government, respectively 97 percent, 87 percent, and 77 percent. In the U.S., government spending accounts for 44 percent of the nation's health care bill, with most of that going to Medicare and Medicaid.

Lindsay Mangum, NPR
A comparison of U.S. spending on Health Care with Cuba, France and the U.K.

The United States spends more of its gross domestic product on heath care than any other country. The WHO came up with these estimates in 1997, showing that the U.S. spends more than twice as much of its GDP on health care compared with the United Kingdom, with Cuba and France in the middle. Most of the medical costs in the U.K, Cuba and France are paid by the government, respectively 97 percent, 87 percent, and 77 percent. In the U.S., government spending accounts for 44 percent of the nation's health care bill, with most of that going to Medicare and Medicaid.

Lindsay Mangum, NPR
WHO Rankings of Countries by Health Care System Performance

hide captionA WHO survey ranked the health care systems of 191 countries, based on factors such as the health of the general population, patient satisfaction and equality of access. France ranked first overall, the United States placed 37th, and Nigeria was near the end of the list at 187.

Lindsay Mangum, NPR

Michael Moore's new movie Sicko details problems in the U.S. health care system. (Hear NPR's Joanne Silberner and Bob Mondello discuss the film.) At one point, Moore asks, plaintively, "Who are we?" He's asking how is it that Americans, as a people, are supporting the current system.

Here, some statistics on who we are:

Snapshot of America's Uninsured

Moore starts the movie with the stories of two people who don't have health insurance. They're not alone:

— Nearly 47 million Americans, or 16 percent of the population, were without health insurance at some point in 2005.

— The number of uninsured rose 1.3 million between 2004 and 2005 and has increased by almost 7 million people since 2000.

— In 2005, nearly 15 percent of employees had no employer-sponsored health coverage available to them, either through their own job or through a family member.

— Young adults (18 to 24 years old) remained the least likely of any age group to have health insurance in 2005 – 30.6 percent of this group did not have health insurance.

— Nearly 40 percent of the uninsured population reside in households that earn $50,000 or more. A growing number of middle-income families cannot afford health insurance payments even when coverage is offered by their employers.

Source: National Coalition Health Care

Snapshot of America's Insured

Sicko focuses on people who do have insurance, but insurance that doesn't serve them well. Statistics show that health insurance is becoming more expensive and fewer insurers are offering it.

— Fewer employers are offering coverage to workers, down from 69 percent of employers in 2000 to 60 percent in 2005. The drop stems almost entirely from fewer small businesses offering health benefits.

— Insurance premiums increased an average of 9.2 percent in 2005.

— Annual premiums for family coverage reached $10,880 in 2005, eclipsing the gross earnings for a full-time minimum-wage worker ($10,712).

— 61 percent of all employees with health coverage in 2005 were enrolled in a PPO (up from 55 percent in 2004). Enrollment in HMOs, which generally cost less than PPOs, fell to 21 percent of people with insurance in 2005.

Source: 2006 Kaiser Family Foundation Survey of Employer Health Benefits

Where the U.S. Ranks in the World

After painting a bleak picture of American health care, Moore looks at the health care systems of the United Kingdom, France and Cuba. The World Health Organization did an international survey back in 2000, with some surprising results.

The survey looked at the health care systems of 191 countries based on factors such as the general level of population health, patient satisfaction, equality of access, and health care financing.

And while the U.S. health system spends a higher portion of its gross domestic product than any other country, it ranked 37. The United Kingdom, which spends just 6 percent of GDP on health services, ranked 18. France ranked first. And Cuba, which Moore describes as a great place to get health care, ranked 39.

Other findings:

— A key recommendation from the report is for countries to extend health insurance to as large a percentage of the population as possible, whether in the form of insurance or taxes.

— The United States ranked highest on patient satisfaction, followed by Switzerland, Luxembourg, Denmark, Germany, Japan, Canada, Norway, Netherlands and Sweden.

— On the consumer affordability of health care, Colombia ranked No. 1, followed by Luxembourg, Belgium, Djibouti, Denmark, Ireland, Germany, Norway, Japan and Finland. The United States ranked 54.

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