The United States spends more on healthcare than any other country in the world, and it isn’t close. In 2024, U.S. healthcare spending reached $5.3 trillion total, or roughly $14,775 per person. That’s about 50% more per capita than the next highest spender, Switzerland, at around $9,963 per person.
The Top Spenders Per Person
Using purchasing-power-adjusted dollars, which account for cost-of-living differences between countries, the 2024 rankings look like this:
- United States: $14,775 per person
- Switzerland: $9,963
- Germany: $9,365
- Netherlands: $8,436
- Austria: $8,401
The gap between the U.S. and every other wealthy nation is striking. Americans spend roughly 48% more per person than the Swiss and 58% more than the Germans. Norway, often cited among the top spenders, falls in the $9,300 to $10,000 range alongside Switzerland and Germany.
Healthcare as a Share of the Economy
Per-capita spending tells part of the story. The other part is how much of a country’s total economic output goes toward healthcare. The U.S. devoted 17.2% of its GDP to health in 2024. Germany, the second-highest by this measure, spent 12.3%. Most wealthy nations fall somewhere between 9% and 12%.
That 17.2% figure means that for roughly every six dollars generated in the American economy, one goes toward healthcare. The 7.2% annual growth rate in 2024 suggests this share is still climbing.
Why the U.S. Spends So Much More
The U.S. doesn’t have more doctors per person or more hospital beds than peer countries. The spending gap comes down to prices, administrative complexity, and compensation patterns. A Commonwealth Fund analysis broke down the “excess” U.S. spending, meaning the amount above what comparable countries spend, and identified where the extra money goes.
Administrative Costs
About 30% of excess U.S. spending ties back to administrative overhead, split evenly between insurers and healthcare providers. On the insurance side, the multi-payer system creates enormous costs around eligibility verification, claims coding, submission, and rework. On the provider side, hospitals and clinics spend heavily on general administration, human resources, and quality reporting. Countries with simpler insurance structures, whether single-payer or tightly regulated multi-payer systems, avoid much of this overhead.
Prescription Drug Prices
Americans spend more than twice as much per person on retail prescription drugs as the average across comparable wealthy nations: $1,126 versus $536 per person annually. The prices themselves are two to three times higher than in other countries, and the gap is especially large for brand-name drugs, which account for about 80% of U.S. prescription drug spending. Compared to specific countries, U.S. retail drug prices run about 2.4 times higher than Canada’s, 2.5 times higher than the United Kingdom’s, 2.9 times higher than Germany’s, and nearly 3.9 times higher than France’s. Higher drug spending accounts for roughly 10% of the excess.
Provider Salaries
U.S. physicians earn substantially more than their peers abroad. Primary care doctors make about 1.7 times the average in comparable countries, and specialists earn 2.6 times as much. Registered nurses in the U.S. earn about 1.5 times the average salary in peer nations. Combined, higher wages for doctors and nurses explain around 15% of the spending gap.
Medical Technology
The U.S. relies more heavily on expensive diagnostic imaging, surgical technology, and medical equipment than most countries. This adds to costs, though it represents a smaller slice of the excess, less than 5%.
Spending Doesn’t Match Outcomes
If higher spending bought better health, the U.S. would lead the world in life expectancy and health outcomes. It doesn’t. Americans have shorter life expectancies than people in most other wealthy nations, including every country in the top five spenders. Switzerland and Japan, which spend far less per person, consistently rank among the longest-lived populations on earth.
This disconnect is one of the most studied puzzles in health policy. The spending gap isn’t explained by Americans using more healthcare. Visit rates and hospital stays in the U.S. are comparable to or lower than in peer countries. The difference is that each visit, procedure, and prescription costs more. The system is expensive not because Americans consume more care, but because every unit of care carries a higher price tag.
How Other High Spenders Differ
Switzerland, Germany, and the Netherlands all spend heavily on healthcare, but they structure their systems differently from the U.S. All three use some form of regulated private insurance with universal coverage mandates. Insurers in these countries operate under strict rules about what they can charge and what they must cover, which limits administrative waste and price variation. Germany’s system, for instance, covers virtually all residents through competing nonprofit insurance funds with standardized benefits.
These countries get measurably more for their money: universal coverage, lower out-of-pocket costs for patients, and health outcomes that match or exceed American levels. Their spending is high by global standards but delivers broad access in a way the U.S. system does not, despite the U.S. spending 50% to 75% more per person.