Healthcare’s Unsolved Problems: Cost, Access and Quality

Healthcare in the US is Too Costly

The United States has the highest healthcare costs in the world. In 2020, the US spent $4 trillion on healthcare, or nearly $12,000 per person per year, more than double the average per capita spend of peer nations, Figure 1. Healthcare costs were 5 percent of GDP in 1960 and are forecast to climb to 20% of GDP by 2028, (Figure 2).


Figure 1 - Capita Healthcare Expenditures



Figure 2 - US Healthcare Spending as Percent of GDP


Figure 3 - Health Professional Shortage Areas



Figure 4 - Medically Underserved Areas (Yellow)

Many Americans Lack Access to Healthcare Services

Despite spending more on healthcare than all other countries, many Americans live in areas with limited access to needed healthcare services. The US has only 7.9 nurses and 2.6 physicians per 1,000 population, compared to 9.9 nurses and 3.2 physicians in peer countries.
Large portions of the United States have been designated as areas that are medically underserved or that lack access to primary care or other outpatient medical services, Figures 3-4.

US Lags Peer Nations in Key Healthcare Quality Metrics

The US healthcare system excels in the provision of many high-tech medical services such as cancer detection, medical imaging, development of new drugs and vaccines and joint replacement. The US also outperforms many peer nations in certain preventive services such as breast cancer screening and flu vaccinations for the elderly. However, the US lags many nations in providing its citizens with basic healthcare services, reflected by poor infant mortality and life expectancy rates compared to other nations, Figures 5-6.


Figure 5 - US infant Mortality Rate



Figure 6- US Life Expectancy at Birth