1、 Why U.S. health care expenditure and ranking on health care indicators are so different from Canadas A. H. G. M. Spithoven Abstract Compared to other industrialized countries, the U.S. spends most of all on health care. Nonetheless, the U.S. ranks relatively low on health care indicators. This para
2、dox has been already known for decades. For example, the turning point comparing the U.S. and Canada was in 1972. Health expenditure as a percentage of GDP was higher in Canada than in the USA from 1960 until 1972. Since 1972 expenditure on health care has been higher in the U.S. than in Canada (OEC
3、D 2005a, Health data 2005, fourteenth OECD electronic database on health systems, date of release June 2005, last update 04/26/2005). The present study integrates the dispersed literature on spending and health care rankings and adds some statistical analysis to these studies. The evaluation of diff
4、erent factors influencing health care expenditure in the U.S. relative to other countries is restricted to a comparison with Canada. The U.S. and Canada are two countries that are sufficiently similar to make comparisons useful. The comparison of factors influencing health care expenditure in the U.
5、S. and Canada in 2002 reveals that health care expenditure in the U.S. is higher than in Canada mainly due to administration costs, Baumols cost disease and pharmaceutical prices. It is not primarily inefficiency in health care production but the dominant prevalence for free choice and own responsib
6、ility that explains the paradox of high expenditure on health care and low ranking on health care indicators. Keywords Health care expenditure United States Canada Introduction Health care outlays in the U.S. were equal to 14.6% of Gross Domestic Product (GDP) in 2002 (OECD 2005a). Compared to other industrialized countries, the U.S. had the highest spending on health care, even though 14% of the population is uninsured in 2002 (NCHS 2004), whereas other industrialized nations have c
