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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

How Much Do Countries Spend on Healthcare Compared to the Military?

Every year, governments spend trillions on healthcare and defense. But how much is spent per person, and how does this compare by country?

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Healthcare vs. Military Spending, by Country

Keeping citizens both healthy and secure are key priorities for many national governments around the world—but ultimately, decisions must be made on how tax dollars are spent to accomplish these objectives, and funding must fall into one bucket or another.

This infographic from PixlParade examines how much 46 different countries put towards healthcare and military spending in 2018, per capita.

Head to Head: Healthcare versus Military

Data for government and compulsory healthcare spending comes from the Organization for Economic Co-operation and Development (OECD). Note that these figures do not include spending through private insurance or out-of-pocket expenses.

Meanwhile, the data for military spending comes from the Stockholm International Peace Research Institute (SIPRI).

CountryHealth spending (Per capita, 2018 US$)Military spending (Per capita, 2018 US$)
U.S.$9,008.77$2,086.50
Norway$5,361.00$1,323.90
Germany$5,262.83$559.50
Switzerland$4,687.26$546.00
Sweden$4,623.68$574.90
Netherlands$4,461.30$651.50
Denmark$4,441.07$792.50
Luxembourg$4,385.66$650.80
France$4,310.55$791.00
Austria$4,137.25$381.00
Belgium$3,868.82$421.60
Japan$3,787.74$366.50
Canada$3,719.86$613.10
Ireland$3,629.43$229.80
UK$3,336.55$743.10
Finland$3,331.65$680.30
Australia$3,311.33$1,078.00
NZ$3,188.39$532.30
Czhechia$2,632.67$254.10
Italy$2,574.96$458.70
Malta$2,448.73$152.20
Spain$2,414.69$381.70
Slovenia$2,227.77$254.80
Portugal$1,906.23$431.00
South Korea$1,848.76$841.70
Israel$1,828.40$2,357.50
Estonia$1,744.57$458.60
Lithuania$1,599.15$377.10
Croatia$1,553.67$232.50
Poland$1,511.18$317.50
Hungary$1,493.01$184.60
Romania$1,344.34$223.50
Greece$1,331.19$547.10
Chile$1,282.59$296.10
Latvia$1,111.67$375.20
Cyprus$1,103.03$374.30
Bulgaria$1,042.85$136.30
Turkey$946.83$238.60
Russia$873.00$421.20
Colombia$864.16$204.10
Mexico$582.05$46.30
Brazil$388.98$134.50
South Africa$267.85$63.50
China$249.83$177.60
Indonesia$55.62$28.20
India$18.80$49.00
Source: OECDSource: SIPRI

Note: There are minor discrepancies in comparing table data to original sources due to recent estimate updates. Figures for Brazil, South Africa, China, Indonesia, and India come from the World Bank (2017).

The Top 10 Healthcare Spenders

The U.S. leads the world in government healthcare spending at $9,008 per capita – over 1.5 times that of Norway, the next-highest country examined.

CountryPer capita health spending% of GDP% of health spending
U.S.$9,008.7714.3%84.7%
Norway$5,361.008.6%85.3%
Germany$5,262.839.7%84.6%
Switzerland$4,687.267.6%64.4%
Sweden$4,623.689.3%85.1%
Netherlands$4,461.308.2%82.1%
Denmark$4,441.078.5%83.9%
Luxembourg$4,385.664.4%84.1%
France$4,310.559.4%83.6%
Austria$4,137.257.7%74.7%

While per-capita government spending on healthcare in the U.S. is the highest in the world, this has not necessarily brought about better outcomes (such as longer life expectancy) compared to other developed nations.

It’s also worth mentioning that the above figures do not cover all healthcare costs incurred by citizens, as they do not account for private insurance spending or out-of-pocket expenses. According to OECD data, these additional costs tend to be the highest in places like Switzerland and the United States.

The Top 10 Military Spenders

Israel has the highest rate of military spending per capita, and has the distinction of being the only country on this list to invest more in defense than in healthcare.

CountryPer capita military spending% of GDPTotal expenditure, US$M
Israel$2,357.505.3%$19,759M
U.S.$2,086.50 3.3%$682,491M
Norway$1,323.90 1.6%$7,067M
Australia$1,078.00 1.9%$26,840M
South Korea$841.70 2.5%$43,070M
Denmark$792.50 1.3%$4,559M
France$791.00 1.3%$51,410M
UK$743.101.8%$49,892M
Finland$680.30 1.4%$3,757M
Netherlands$651.501.2%$11,115M

Although the United States comes in second place here as well, in absolute terms, the U.S. puts more money into military expenditures than many other countries combined, at almost $700 billion per year.

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Politics

Political Longshots That Caught America by Surprise

Nothing is certain in politics until the results are in. Here’s a roundup of the most surprising longshot victories in American history.

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Millions of Americans rely on polls and the media to gauge the direction of political elections. Politics are sometimes unpredictable though, and on occasion, election outcomes can defy conventional wisdom.

These surprises, known as political longshots, are scattered throughout American political history. As time winds down to the 59th U.S. presidential election in November, today’s visual article from PredictIt goes back in time to showcase moments when polls, media outlets, and the American public were left stunned.

The Truman Show

PredictIt

What Happened?

As elections approached in 1948, incumbent Harry Truman led a struggling Democratic party.
Not only had they lost control of both chambers of Congress two years prior, they also faced internal divide over Truman’s civil rights initiatives. To make matters worse, Truman’s approval rating in June 1948 sat at just 39%.

Pollsters and the media were unanimous in declaring Republican Thomas Dewey the next president, but this didn’t discourage Truman from running a tactical campaign which featured:

  1. Clear demographic focus: Truman campaigned heavily in rural communities where working-class citizens felt neglected.
  2. Populist messaging: Truman often attacked Republicans, pinning them with the blame for a range of issues.

Despite being overlooked by many, Truman went on to claim a decisive victory. This caused one of the most famous media blunders in U.S. history—with high confidence in the polls, editors at the Chicago Daily Tribune prematurely reported Dewey as the winner of the election.

We stopped polling a few weeks too soon. We had been lulled into thinking that nothing much changes in the last few weeks of the campaign.

—George Gallup Jr.

Pollsters took a hit to their credibility, but used the opportunity to refine their methods. They extended the deadlines of polls and, over time, began using a methodology known as random sampling. This replaced quota sampling, a methodology prone to bias because it questioned a predetermined number of people from certain ethnic and age groups.

Murkowski’s Comeback

PredictIt

What Happened?

After losing the Republican primary to Joe Miller, incumbent senator Lisa Murkowski decided to run in 2010 as a write-in candidate. A somewhat unique aspect of American politics, a write-in candidate is one whose name does not appear on the ballot, and instead needs to be written in by the voter directly.

Miller, the Republican nominee, was supported by the Tea Party movement and former Alaskan governor Sarah Palin. All momentum seemed to be in his favor, according to polls conducted roughly a month ahead of election day:

PollDate AdministeredJoe Miller (R)Lisa Murkowski (R)Scott McAdams (D)
Raasmussen ReportsSept. 19, 201042%27%25%
Moore ResearchSept. 23-27, 201043%18%28%
CNN, Time, Opinion ResearchSept. 24-28, 201038%36%22%

Source: Rasmussen Reports, Moore Research, CNN/Time/Opinion Research

Despite Miller’s lead in the polls, Murkowski’s write-in campaign was able to capitalize on the state’s significant number of independent voters. On election day, Murkowski collected 101,091 write-in votes—a comfortable margin above Miller’s 90,839 votes.

[I]n our state, we have got over 54 percent of the electorate that chooses not to align themselves with any party at all, not Republican, not Democratic, not green, not anything.

—Lisa Murkowski

Miller challenged 8,000 write-in votes on the basis of name misspellings, but his claims were rejected by the Alaska Superior Court—perfect spelling on write-in ballots is not required if the voter’s intent is clear.

The Trump Train

PredictIt

What Happened?

Donald Trump’s 2016 victory will likely top the list as one of the most shocking political events of our time. As election day approached, many of America’s mainstream media outlets pointed to a decisive Clinton victory.

OutletClintonTrump
L.A. Times
by electoral count
352186
Fox News
by electoral count
274215
New York Times
by chance of winning
85%15%
CNN
by chance of winning
91%9%

Source: The Wrap, CNN

While Trump’s rhetoric was largely opposed in urban regions (which often lean Democrat), the media failed to recognize that his message was resonating in America’s industrial Midwest. One potential explanation for this is that the region’s manufacturing jobs had been drying up, causing workers to feel abandoned by the existing political establishment.

This led to a number of Democrat-controlled states flipping Republican, and was a critical force for propelling Trump to the White House.

PredictIt

In PredictIt’s market, Will Trump Win the 2016 Presidential Election, traders also underestimated Trump’s chances of winning. Throughout the entire campaign phase, Trump’s “yes” shares failed to break past the 50 cents marker.

Source: Predictit

Share prices climbed 64% after FBI Director James Comey released his letter regarding the Clinton email investigation, but these gains were erased in the days leading up to elections. It wasn’t until November 8th, election day, that the prediction market swung by an incredible 345% in favor of Trump.

The Rise of AOC

PredictIt

What Happened?

The biggest surprise from the 2018 midterm primaries was Alexandria Ocasio-Cortez’s (AOC) victory over incumbent Joseph Crowley in New York’s 14th Congressional District. That’s because the two candidates were nearly complete opposites of one another:

MetricAlexandria Ocasio-CortezJoseph Crowley
Age2856
Past Political ExperienceOrganizer for Bernie Sanders' 2016 presidential campaignU.S. Representative from New York's 14th congressional district (1999-2019)
Fundraising$300,000$3,354,370

Source: abc news

AOC led a grassroots campaign appealing to the district’s ethnically diverse population, which many believed Crowley could not relate with. Her platform included:

PredictIt

Also lending to the surprise factor was AOC’s relatively sparse media coverage. Because her campaign was largely operated through social media platforms such as Twitter and Instagram, it flew under the radar of traditional political media coverage.

The traditional media pay attention to one metric—money—but there should be other considerations: number of volunteers, social-media engagement, small-dollar donations.

—Dave Weigel, Washington Post

AOC would go on to win New York’s 14th Congressional District in the 2018 midterm election, defeating Republican Anthony Pappas with 110,318 votes to 19,202, to become the youngest woman to ever serve in the U.S. Congress. More recently, she secured her re-election in the 2020 Democratic primaries. This time, however, it comes as less of a surprise.

What’s Next?

The very definition of a longshot means that they are difficult to quantify and predict.

However, one potential longshot in the making may be 21-time Grammy Award winner Kanye West, who announced his intention to run for president on July 4th. While he hasn’t taken any official steps towards running as an independent candidate, he has garnered the support of notable figures like Tesla CEO Elon Musk. West first declared his interest in the presidency during an acceptance speech at the 2015 MTV Video Music Awards.

Looking further down the road, Democratic presidential nominee Joe Biden has still not declared his running mate. Much is at stake for Democrats hoping to deny Trump a second term, and the VP nominee will likely play a significant role in how the party performs. Biden has a long list of candidates that, for the first time in history, predominantly features women of color.

Speculation is ramping up as the 2020 presidential elections approach. While it’s difficult to say when politics will surprise us again, more longshots are sure to be in store.

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