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U.S. Healthcare is a Global Outlier, and Not in a Good Way

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Historically, the United States has spent more money than any other country on healthcare.

In the late 1990s, for example, the U.S. spent roughly 13% of GDP on healthcare, compared to about a 9.5% average for all high income countries.

However, in recent years, the difference has become more stark. Last year, as Obamacare continued to roll out, costs in the U.S. reached an all-time high of 17.5% of GDP. That’s over $3 trillion spent on healthcare annually, and the rate of spending is expected accelerate over the next decade.

High Costs, High Benefit?

With all that money being poured into healthcare, surely the U.S. must be getting better care in contrast to other high income countries.

At least, that’s what one would think.

Today’s chart comes to us from economist Max Roser (h/t @NinjaEconomics) and it shows the extreme divergence of the U.S. healthcare system using two simple stats: life expectancy vs. health expenditures per capita.

U.S. Healthcare is a Global Outlier, and Not in a Good Way

The Divergence of U.S. Healthcare

As you can see, Americans are spending more money – but they are not receiving results using the most basic metric of life expectancy. The divergence starts just before 1980, and it widens all the way to 2014.

It’s worth noting that the 2015 statistics are not plotted on this chart. However, given that healthcare spend was 17.5% of GDP in 2015, the divergence is likely to continue to widen. U.S. spending is now closing in on $10,000 per person.

Perhaps the most concerning revelation from this data?

Not only is U.S. healthcare spending wildly inefficient, but it’s also relatively ineffective. It would be one thing to spend more money and get the same results, but according to the above data that is not true. In fact, Americans on average will have shorter lives people in other high income countries.

Life expectancy in the U.S. has nearly flatlined, and it hasn’t yet crossed the 80 year threshold. Meanwhile, Chileans, Greeks, and Israelis are all outliving their American counterparts for a fraction of the associated costs.

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Politics

Charted: The Number of Democracies Globally

How many democracies does the world have? This visual shows the change since 1945 and the top nations becoming more (and less) democratic.

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Charted: The Number of Democracies Globally

The end of World War II in 1945 was a turning point for democracies around the world.

Before this critical turning point in geopolitics, democracies made up only a small number of the world’s countries, both legally and in practice. However, over the course of the next six decades, the number of democratic nations would more than quadruple.

Interestingly, studies have found that this trend has recently reversed as of the 2010s, with democracies and non-democracies now in a deadlock.

In this visualization, Staffan Landin uses data from V-DEM’s Electoral Democratic Index (EDI) to highlight the changing face of global politics over the past two decades and the nations that contributed the most to this change.

The Methodology

V-DEM’s EDI attempts to measure democratic development in a comprehensive way, through the contributions of 3,700 experts from countries around the world.

Instead of relying on each nation’s legally recognized system of government, the EDI analyzes the level of electoral democracy in countries on a range of indicators, including:

  • Free and fair elections
  • Rule of law
  • Alternative sources of information and association
  • Freedom of expression

Countries are assigned a score on a scale from 0 to 1, with higher scores indicating a higher level of democracy. Each is also categorized into four types of functional government, from liberal and electoral democracies to electoral and closed autocracies.

Which Countries Have Declined the Most?

The EDI found that numerous countries around the world saw declines in democracy over the past two decades. Here are the 10 countries that saw the steepest decline in EDI score since 2010:

CountryDemocracy Index (2010)Democracy Index (2022)Points Lost
🇭🇺 Hungary0.800.46-34
🇵🇱 Poland0.890.59-30
🇷🇸 Serbia0.610.34-27
🇹🇷 Turkey0.550.28-27
🇮🇳 India0.710.44-27
🇲🇱 Mali0.510.25-26
🇹🇭 Thailand0.440.20-24
🇦🇫 Afghanistan0.380.16-22
🇧🇷 Brazil0.880.66-22
🇧🇯 Benin0.640.42-22

Central and Eastern Europe was home to three of the countries seeing the largest declines in democracy. Hungary, Poland, and Serbia lead the table, with Hungary and Serbia in particular dropping below scores of 0.5.

Some of the world’s largest countries by population also decreased significantly, including India and Brazil. Across most of the top 10, the “freedom of expression” indicator was hit particularly hard, with notable increases in media censorship to be found in Afghanistan and Brazil.

Countries Becoming More Democratic

Here are the 10 countries that saw the largest increase in EDI score since 2010:

CountryDemocracy Index (2010)Democracy Index (2022)Points Gained
🇦🇲 Armenia0.340.74+40
🇫🇯 Fiji0.140.40+26
🇬🇲 The Gambia0.250.50+25
🇸🇨 Seychelles0.450.67+22
🇲🇬 Madagascar0.280.48+20
🇹🇳 Tunisia0.400.56+16
🇱🇰 Sri Lanka0.420.57+15
🇬🇼 Guinea-Bissau0.410.56+15
🇲🇩 Moldova0.590.74+15
🇳🇵 Nepal0.460.59+13

Armenia, Fiji, and Seychelles saw significant improvement in the autonomy of their electoral management bodies in the last 10 years. Partially as a result, both Armenia and Seychelles have seen their scores rise above 0.5.

The Gambia also saw great improvement across many election indicators, including the quality of voter registries, vote buying, and election violence. It was one of five African countries to make the top 10 most improved democracies.

With the total number of democracies and non-democracies almost tied over the past four years, it is hard to predict the political atmosphere in the future.

Want to know more about democracy in today’s world? Check out our global breakdown of each country’s democratic score in Mapped: The State of Global Democracy in 2022.
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