Health Care's High Cost and Uncertain Outcomes

As I discuss in my column, Steven Brill's Time magazine cover story last week is an eye-opening expose of U.S. health care. He could also have mentioned that our system is the most expensive in the developed world and that the gap with other countries isn't narrowing.

In 2010, the last year for which data are available, according to the Organization for Economic Cooperation and Development, the U.S. spent 17.6 percent of its gross domestic product on health care. That's more than 50 percent more than Canada, the U.K. or Germany, all of which spend less than 12 percent of GDP on health care.

The most common contrasts are with neighboring Canada, which has a single-payer system and where the government picks up almost three-quarters of costs. Forty years ago, Canada and the U.S. spent the same amount per capita on health care -- about 7 percent of GDP. That began to climb in the 1980s, especially in the U.S., where it reached double digits in 1982.

There are many comparisons of outcomes. On the two most common, infant mortality rates and life expectancy, the Canadians comes out better, though experts note that there are variables -- drug use, cigarette smoking and gun violence -- that are higher in the U.S.

The research isn't clear cut. A few years ago, there was a survey of 38 comparative studies; 14 concluded that health-care outcomes were better in Canada, five found better results in the U.S. and 19 suggested mixed results.

What's clear is that more Canadians have access to health care, though they also sometimes have to wait longer for treatment.

(Albert R. Hunt is a Bloomberg View columnist. Follow him on Twitter.)