US ranks low in share of total health spending paid out-of-pocket by patients

See A Headline You Probably Won’t Hear from the Left by Andrew Biggs of AEI. Here it is, but he also has a great graph.

"I recently wrote about comparisons of Social Security’s generosity relative to pension plans in other countries (with follow-up here). Left-leaning think tanks often compare the average benefit offered by Social Security to that of other OECD countries, finding that we’re ranked near the bottom. I countered that, when compared to other Anglo countries that share our values regarding the role of government versus the private sector, we’re right in the middle: slightly more generous than some countries like the U.K., but slightly less generous than others like Canada.

But here’s another ranking relative to OECD countries that I’m betting you won’t find liberal think tanks citing: it’s the share of total health spending paid out-of-pocket by patients. This share is important, as it gives patients some “skin in the game,” generating incentives to monitor quality and trade health spending against other goods and services we value. Health savings accounts, premium support, and other market-oriented health proposals are designed to improve these incentives. So where does the United States rank in out-of-pocket shares compared to 30 other developed countries? We’re 26th, with 12 percent of health costs paid out of pocket. This is almost identical to the U.K., which may be the most socialized health program in the world.

In fact, the U.S. out-of-pocket share is one-third below the OECD average of 19 percent and the only countries where patient payments make up significantly less of health costs are France and the Netherlands. Compared to our Anglo brethren we’re also on the low end: in Australia patients pay 18 percent of costs; in Ireland 14 percent; in Canada 15 percent; and in New Zealand 14 percent.

I hereby join hands in solidarity with my left-leaning think tank brothers in asking—no, demanding!—that the patient contributions to U.S. healthcare costs be made compatible with the standards of the civilized world."