Many European countries saw further reductions in health spending in 2013, according to OECD Health Statistics 2015. Health spending continued to shrink in Greece, Italy and Portugal in 2013. Most countries in the European Union reported real per capita health spending below the levels of 2009. Outside of Europe, health spending has been growing at around 2.5% per year since 2010.
Health spending growth has generally in line with economic growth, so health expenditure as a share of GDP remained stable relative to 2012. This is in contrast to the years leading up to the economic crisis, when health spending strongly outpaced the rest of the economy. In 2013, health spending excluding investment as a share of GDP was 8.9%, ranking from 5.1% in Turkey to 16.4% in the United States.
Outside of the European Union, average real growth in health spending was around 2.6% in 2013, bolstered by strong growth in Asia and South America. In Chile and Korea, health spending growth was above 5% in 2013; the level of per capita spending has increased in both by close to 25% in real terms since 2009.
Figures for Canada show a continuing trend of health spending growth below that of economic growth. In the United States, health spending grew by 1.5% in 2013, less than half the average annual growth rate in the United States prior to 2009. The latest available forecasts show faster growth in 2014 as more Americans get health insurance.
Preliminary growth figures for a dozen OECD countries suggest a similar modest increase in spending overall in 2014, but with growth remaining well below the pre-crisis levels.
Three-quarters of health spending continues to come from public sources across OECD countries, but cost-containment measures in some countries have led to an increase in the private share – either through private health insurance or direct payments by households. Greece and Portugal have seen the private share of health spending increase by around 4 percentage points since 2009, the largest increases in the OECD, resulting in a third of all health spending coming from private sources in 2013 in both countries.
For medical tourism the positive news is that everywhere is increasingly dependent on private healthcare.