Kenneth E. Thorpe, Mike Ciarametaro, and Robert W. Dubois
The U.S. spends twice as much per capita on health care compared to other wealthy developed countries. Many studies have focused on how the high prices of health care in the U.S. compared to other countries contributes to this disparity. However, many other factors play a role in the higher per capita health care spending in the U.S. This study sought to determine the impact of chronic disease prevalence on per capita health care spending in the U.S. and Europe.
The study compares data on the prevalence of the most common and expensive chronic conditions –including cancer, diabetes, and heart disease – in the U.S. and nine European countries. The researchers calculated U.S. health care spending per person for adults aged 50 and older for each chronic condition included in the analysis. Then, the researchers estimated how much the U.S. would spend on health care if it had chronic disease prevalence levels as low as Europe.
The U.S. had substantially higher chronic disease prevalence in adults 50 and older for all eight of the chronic conditions examined. For example, arthritis was 25.5% higher, cardiovascular disease was 10.7% higher, and cancer was 9.4% higher. Applying the lower European rates of chronic diseases, U.S. health care spending for those 50 and older would drop 17% (from $10,698 to $8,841 per capita), or about $220 billion per year. If the U.S. had the same rates of chronic disease as Switzerland, the healthiest of the European countries studied, U.S. health care spending would have dropped 28% (from $10,698 to $7,705 per capita).
The study shows that the higher prevalence of chronic disease in the U.S. is a significant contributing factor to high U.S. health care spending. These findings point to the need to more fully understand the drivers of health care spending beyond prices to adequately address the growth of health care spending in the U.S.