Cross-country differences in household healthcare spending

Irene Papanicolas, Jonathan Cylus, Maecey Niksch and Luca Lorenzoni

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: Introduction Health systems face financial pressures as populations age and economic growth slows, with implications for who pays for health care and for what drives expenditure growth. Methods We examined changes in outpatient and pharmaceutical care financing across OECD countries from 2000 to 2023. Results While overall health spending growth slowed across countries after the Great Recession, household spending grew modestly everywhere, averaging about half a percentage point growth annually. The United States stood out for persistently high out-of-pocket financing burden—over twice that of most peer countries—and for price growth, rather than utilization, driving out-of-pocket spending for pharmaceutical care. Other countries saw out-of-pocket spending driven more by volume growth and slower price growth. Conclusion These patterns highlight potential affordability pressures from out-of-pocket healthcare payments, particularly in the U.S.. Policymakers should regularly monitor financial hardship from out-of-pocket payments and reconsider using cost-sharing to address health financing sustainability challenges.

Keywords: affordability; financial hardship; out-of-pocket healthcare payments; health financing (search for similar items in EconPapers)
JEL-codes: J1 (search for similar items in EconPapers)
Date: 2026-09-11
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Published in Health Affairs Scholar, 11, September, 2026, 4(9). ISSN: 2976-5390

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