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

Mapped: Geopolitical Risk by Economy

Prior to invading Ukraine, Russia had one of the highest levels of geopolitical risk. How does geopolitical uncertainty vary around the world?

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World map with countries coloured according to their level of geopolitical risk. Pakistan has the most geopolitical risk while New Zealand has the least.
The following content is sponsored by The Hinrich Foundation

Geopolitical Risk by Economy

The Russia-Ukraine war highlighted how geopolitical risk can up-end supply chains and weaponize trade. More precisely, the war led to trade sanctions, a food crisis, and energy shortages.

This graphic from The Hinrich Foundation, the third in a five-part series on the sustainability of trade, explores how geopolitical risk differs by economy. It pulls data from the 2022 Sustainable Trade Index, which The Hinrich Foundation produced in collaboration with the IMD World Competitiveness Center.

Breaking Down Geopolitical Risk

Geopolitical risk has a strong correlation with GDP per capita, meaning that developing economies typically have less stability.

The following table shows how geopolitical risk breaks down for select economies that are covered in the 2022 Sustainable Trade Index. A lower number indicates less stability, while a higher number indicates more stability.

EconomyGeopolitical Stability
Pakistan5.2
Myanmar9.9
Bangladesh16.0
India17.0
Mexico17.9
Philippines18.9
Papua New Guinea20.3
Russia20.8
Thailand24.5
Indonesia28.3
Ecuador34.4
China37.7
Peru38.7
Cambodia41.0
Vietnam44.8
Sri Lanka45.3
U.S.46.2
Chile49.1
Hong Kong50.0
Malaysia50.9
UK61.3
South Korea62.7
Laos69.3
Taiwan72.2
Australia73.1
Japan87.3
Canada90.1
Brunei90.6
Singapore97.2
New Zealand97.6

Source: World Bank, based on the latest available data from 2020. Values measure perceptions of political instability and violence, which are a proxy and precursor to geopolitical risk.

New Zealand has the highest level of stability, likely supported by the fact that it is a small nation with no direct neighbors. The country has taken steps to repair relationships with Indigenous peoples, through land and monetary settlements, though challenges remain. 

The U.S. has moderate stability. It has been impacted by increasing political polarization that has led to people having lower trust in institutions and more negative views of people from the opposing party. As the world’s largest economy, the U.S. also faces geopolitical risk such as escalating tariffs in the U.S.-China trade war. 

Want more insights into trade sustainability?

Sustainable Trade Index 2022 Report Cover

Download the 2022 Sustainable Trade Index for free.

Russia has one of the lowest levels of stability. The country’s invasion of Ukraine has led to war along with economic roadblocks that restrict normal trade activity. For instance, sanctions against Russia and blocked Ukrainian ports led to a food shortage. The two countries supply a third of the world’s wheat and 75% of the sunflower oil supply. 

The Impact of Geopolitical Uncertainty on Trade

Geopolitical risk can lead to civil unrest and war. It also has economic consequences including trade disruptions. As a result of the Russia-Ukraine war, the World Bank estimates that “world trade will drop by 1%, lowering global GDP by 0.7% and GDP of low-income economies by 1%.” A separate study found that Pakistan’s history of political instability has negatively affected trade in the country.

Of course, geopolitical risk is just one component of an economy’s trade sustainability. The Sustainable Trade Index uses a number of other metrics to measure economies’ ability to trade in a way that balances economic growth, societal development, and environmental protection. To learn more, visit the STI landing page where you can download the report for free.

The fourth piece in this series will explore air pollution by economy, and how it is influenced by economic activity such as trade.

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