Countries that spend the most and least on healthcare
Niamh Ollerton
10 February 2017
How much do countries pay towards healthcare?
The World Bank collects information about countries’ total expenditure on health as a percentage of their GDP. This is calculated by direct expenditure made within the health system and through tax spending. Let’s take a look at the countries that spend least and most on healthcare, starting with those who spend least.
Joint 14th: Eritrea 3.3% of GDP
As a whole, Eritrea has seen a steady decline in health expenditure. In 1995 4.5% of GDP was spent on health, in 2008 3.6%, and it has slowly made its way down to 3.3%. According to Trading Economics, health expenditure per person was measured at $16.51 (£13.34) in 2013.
Joint 14th: Angola 3.3% of GDP
Angola has almost halved its spending on health over the last two decades. In 2014, health expenditure came in at 3.3% of GDP, whereas back in 1995 6.5% of GDP was set aside for health. Although it may seem a substantial drop in expenditure, Angola’s average spending per person was measured at $267.20 (£216) in 2013, which is still much higher than many other African nations.
Joint 12th: Madagascar 3.0% of GDP
A scheme was introduced here in the 1980s to try and ensure good health for all by 2000. The general situation of health is getting better with life expectancies above 55 years and infant mortality decreasing. In 2006 the probability of dying in the first year of life was down to 58 deaths per 1,000 live births, compared with 98 in 1993 and 74 in 2003. Although health expenditure spending has decreased from 4.1% of GDP in 1995 to 3.0% in 2014, advances in healthcare are becoming more apparent.
Joint 12th: Kuwait 3.0% of GDP
Since 1995, when Kuwait’s contributions towards health expenditure was 3.7% of GDP, the country has seen erratic ups and downs. Kuwait’s highest-spending year was 1998, when the country spent 4.4% of GDP, but contributions steadily dwindled to 3.0% in 2014, causing some Kuwaitis to travel abroad for treatment. The government is now ramping up spending, although its growing budget deficit is a concern.
Joint 10th: Indonesia 2.8% of GDP
Indonesian healthcare has traditionally come from three areas: private insurance for those who could pay, basic state provisions for the poorest people, and NGOs in certain areas. In January 2014, Indonesia’s government launched a project to ensure a compulsory national health insurance system to establish healthcare for all by 2019. Although between 1995 and 2015 health expenditure remains the same at 2.8%, the figures will hopefully rise in the future.
Joint 10th: Bangladesh 2.8% of GDP
Although Bangladesh’s health expenditure contributions dropped from 3.2% of GDP in 1995 to 2.8% in 2014, it has seen a very steady increase since 1997 where it was at its lowest at 2.25%. Unfortunately, government health expenditure has dropped from 37.2% in 1995 of total healthcare spending to 27.9% in 2014, whereas in comparison its citizens’ spending has risen from 62.8% to 72.1%.
9th: South Sudan 2.7% of GDP
There aren’t many figures available to compare South Sudan’s health spending. From 2012 to 2013 health spending fell from 2.8% to 2.6% while it rose once more to 2.7% in 2014. The World Health Organization (WHO) recorded average spending on health per person in 2014 at $73 (£59). Unfortunately, life expectancy in the country is still low with men living to an average age of 56 and women 59.
Joint 6th: Pakistan 2.6% of GDP
Pakistan saw a spike in health spending in 2006 at 3.4% of GDP compared to 2.6% in 2004. But, as a whole, health expenditure between 1995 and 2014 has only risen to 2.6% in 2014 from 2.5% in 1995. In 2013, average health expenditure per person was measured at $36.88 (£30).
Joint 6th: Congo-Kinshasa 2.6% of GDP
Congo-Kinshasa’s health expenditure in 1995 was recorded at 3.2% of GDP, but had fallen to 2.6% by 2014. However, the government percentage of all spending on health within the country rose from 59.3% in 1995 to 81.8% in 2014.
Joint 6th: Brunei 2.6% of GDP
Brunei’s spending has changed over the years, with health spending at a peak of 4.5% of GDP in 1998. Unfortunately, this has fallen to 2.6% of GDP in 2013. A decline in oil revenues has been blamed for the cutback.
4th: Qatar 2.2% of GDP
Qatar’s health spending has significantly dropped between 1995 and 2014. The country spent 3.7% of GDP on healthcare in 1995, compared to 2.2% in 2014. This equalled an average of $3,071 (£2,482) per person in 2014. However, an ageing population means the government is likely to have to invest significantly more in the next few years.
3rd: Turkmenistan 2.1% of GDP
Average health expenditure per person in Turkmenistan was last measured at $157.54 in 2013, and has seen a steady increase since 2008, according to the World Bank. But, in comparison, the percentage of GDP spent on health has decreased from 3.1% in 1995 to 2.1% in 2014.
2nd: Laos 1.9% of GDP
Annual health spending halved in Laos between 1995 and 2014 from 3.8% to 1.9%, and in 2013, average public health expenditure came in at just $49.25 (£40) per person. And, unfortunately for the people of Laos, the number of doctors per 1,000 people has drastically decreased to a scarily low number of 0.18 in 2012.
1st: Timor-Leste 1.5% of GDP
According to the World Bank, health expenditure has continuously dropped in Timor-Leste and the last recorded measure was an average of just $4.71 (£3.81) per person in 2010. And only 1.5% of GDP was spent on health in 2014.
And the countries that spent the most on health
Now we take a look at the 15 countries that spend the most on healthcare...
15th: Canada 10.4% of GDP
In 2013, Canada had 2.5 doctors per 1,000 people, although this is below the OECD median of 3.2. As a country, Canada is spending more on health though. Between 1995 and 2014 health spending rose from 8.9% to 10.4% of GDP.
Joint 13th: Lesotho 10.6% of GDP
Average health expenditure per person in Lesotho was last measured at $123.42 (£99.73) in 2013, according to the World Bank. In comparison to other Africa countries, Lesotho has spent more on health expenditure between 1995 to 2014, up from 7.5% of GDP to 10.6%. Lesotho’s government continues to train more doctors, and the 2014/15 budget address reported that 39 nurses were sent for advanced midwifery training to address maternal mortality.
Joint 13th: Belgium 10.6% of GDP
Belgium seems to know the importance of public health spending as health expenditure has continuously risen from 1995 up to 10.6% of GDP in 2014. According to the WHO, 77.9% of total spending on health in 2014 was done by the government.
12th: Denmark 10.8% of GDP
In 2013, Denmark had 3.6 doctors per 1,000 people, putting it ahead of the OECD median of 3.2. Denmark’s average healthcare spending per person was $4,847 (£3,877) in 2013, which also puts Denmark ahead of the OECD median of $3,661 (£2,958). Healthcare spending from 1995 to 2014 has risen from 8.1% to 10.8% of GDP with an average life expectancy of 80.4 years in 2013, and mortality rates declining from 242 to 71 deaths per 100,000 people.
11th: Netherlands 10.9% of GDP
In 2013, the Netherlands spent 15% of GDP on social care and 12% on healthcare, showing that social care is also up there on its list of high priorities, with $5,131 (£4,146) spent on average per person. Similar to other advanced countries, the Netherlands spent 10.9% of GDP on health in 2014, compared to 7.4% of GDP in 1995.
10th: New Zealand 11.0% of GDP
The importance of health expenditure in New Zealand has obviously grown between 1995 and 2014 with a jump from 6.9% of GDP to 11%. Life expectancy has also risen from 79.5 years in 1995 to 83.5 years in 2014.
Joint 8th: Sierra Leone 11.1% of GDP
The average healthcare spending per person here was $96 (£78) in 2013. However, charity Save The Children cites Sierra Leone as one of the countries with the worst health indicators in the world. And healthcare spending has actually decreased from 11.4% of GDP in 1995 to 11.1%, despite major emergencies such as the Ebola outbreak in 2015.
Joint 8th: Cuba 11.1% of GDP
The average Cuban had $603.38 (£488) spent on their healthcare in 2013, which is a huge improvement on previous spending within the country. Health expenditure has more than doubled from 1995 to 2014 from 5.2% of GDP to 11.1% in 2014. And its medical professionals are renowned for their expertise, particularly in treating disease.
7th: Austria 11.2% of GDP
Life expectancy in Austria has improved continuously over the years, with a life expectancy of 84 in 2014 and more spending at 11.2% of GDP compared to 9.5% in 1995. Interestingly, total expenditure on health has risen over the 19-year period, and private expenditure on health has fallen from 25.2% to 22.1%, which indicates an improved national health system in Austria.
6th: Germany 11.3% of GDP
Germany’s average health spending per person in 2013 came in at $4,920 (£3,976). Between 2013 and 2014 this increased slightly to 11.3% of GDP, up from 9.4% in 1995. Government spending on health as a percentage of its expenditure has risen between 1995 and 2014 from 14.1% to 19.7%, showing the importance of government involvement in the healthcare system.
5th: France 11.5% of GDP
According to the OECD, life expectancy for French people has grown from 81.9 years in 1995 to 86 years in 2014, although annual health spending between 1995 and 2014 has only risen from 10.1% to 11.5%. However, more people are going private, according to the WHO, with an increase in people’s spending on private healthcare from 20.1% in 1995 to 21.8% in 2014.
4th: Switzerland 11.7% of GDP
In 2013, Switzerland was the second-highest-spending country, and spent on average $6,325 (£5,111) per person with an average life expectancy of 82.9 years. Between 1995 and 2014 Switzerland’s annual health spending has rocketed from just 5% to 11.7% of GDP. Government spending on health as a percentage of the country’s total health expenditure has risen from 53.6% in 1995 to 66% in 2014, with healthcare in Switzerland beating many other countries.
3rd: Sweden 11.9% of GDP
There were four doctors per 1,000 people in Sweden in 2013. There has been a jump in health spending from 8% of GDP in 1995 to 11.9% in 2014, which has contributed to a heightened life expectancy from 81.7 years in 1995 to 84.2 years in 2014. The government’s spending on health as a percentage of total healthcare expenditure has risen from 10.6% in 1995 to 19.03%, which indicates the government’s desire to keep pushing for better public healthcare.
2nd: Haiti 13.2% of GDP
The average expenditure on health per person in Haiti 2014 was $61.50 (£50) according to the World Bank, and life expectancy was 62 for men and 66 for women. On a positive note, the WHO noted health spending per year has more than doubled from 6.6% of GDP in 1995 to 13.2% in 2014. However, the government’s spending on health has halved from 40.9% in 1995 to 20.6%.
1st: United States 17.1% of GDP
When it comes to advanced countries’ annual spending on healthcare, none comes close to the US. In 2014, the US spent 17.1% of GDP, equivalent to an average of $9,086 (£7,342) per person. This is a major increase from 13.1% in 1995, and due to the so-called ‘Obamacare’ reforms.
What about the UK?
In 2014, the UK spent 9.1% of its GDP on healthcare, up from 6.7% in 1995. This puts it outside the global top 15 but still above the OECD average of 9%. However, a new survey by Sky News found two-thirds of people would be happy pay an extra 1p on their Income Tax to support the NHS, which is facing a huge funding crisis.
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