The OECD says the share of public spending on health increased in most
countries, rising from an average of 12% in 1990 to an all-time high of 16% in
In all OECD countries total spending on healthcare is rising faster than
economic growth, pushing the average ratio of health spending to GDP from 7.8%
in 2000 to 9.0% in 2008. Factors pushing health spending up - - technological
change, population expectations and population ageing - - will continue to
drive cost higher in the future.
In some countries the recent economic downturn, with GDP falling and healthcare
costs rising, led to a sharp increase in the ratio of health spending to
GDP. In Ireland, the percentage of GDP devoted to health increased from 7.5% in
2007 to 8.7% in 2008. In Spain, it rose from 8.4% to 9.0%. The United States spent $7,538 per person on health in
2008, well over double the $3,000 average of all OECD countries. The
next biggest spenders, Norway and Switzerland, spent much less than the US
per capita but still some 50% more than the OECD average.
Governments of most OECD countries shoulder the lion’s share
of healthcare costs. The share of government expenditure devoted to health
increased in most countries, rising from an average of 12% in 1990 to an
all-time high of 16% in 2008. The OECD says given the urgent need to reduce their budget
deficits, many OECD governments will have to make difficult choices to
sustain their healthcare systems: curb the growth of public spending on
health, cut spending in other areas, or raise taxes.
November 2009 OECD report on Ireland said the Government should
introduce greater competition in the provision of healthcare.
Seán Byrne, lecturer in economics at the Dublin Institute of
Technology, wrote in the Irish Times last month:
"The very high incomes earned by GPs in Ireland is partly due to
the fact that the number of them per 1,000 population in Ireland
is only 60% of that in most other European countries.
While the demand for GP services is rising due to an increasing
population and larger numbers of older people, the supply is not
increasing in line with this.
The supply is further
constrained by the fact that in order to set up as a GP, a
doctor must undertake four years of postgraduate training, but
the number of training places is not adequate to meet the demand
for them. The first two years of this training is hospital based
and must be undertaken even if the doctor has previous hospital
Seán Byrne referred to a survey published
recently by the National Consumer Agency, which showed that 70% of dentists and half of doctors do not display their
A GP in Dublin 4 charged €70 per visit, twice
the fee charged by a GP in Kerry. The charge for a tooth
extraction varied from €40 to €150 depending on where the
dentist was located.
Byrne said only 30% of the population
hold medical cards and the determination of GPs to protect their
excessive earnings is shown by the fact that the IMO (Irish
Medical Organisation) has demanded that if the proportion of the
population with medical cards were to rise to 40%, the
GP contract must be renegotiated.
Medical technologies are driving up spending
New medical technologies are improving diagnosis and treatment but they also
increase health spending.
OECD Health Data 2010
shows that there has been rapid growth in the supply and use of computed
tomography (CT) scanners and magnetic resonance imaging (MRI) units used for
diagnostic purposes. MRI units per capita more than doubled on average
across OECD countries between 2000 and 2008, reaching 13 machines per
million population in 2008, up from 6 in 2000. The number of CT scanners
rose to 24 per million population, up from 19 in 2000. The number of MRI
units per capita is much greater in Japan, the United States, Italy and
Greece than in other countries. These countries, along with Australia and
Korea, also have more CT scanners.
MRI and CT scanners are expensive to buy and to operate. There are big
differences in their use per capita - - far more in the United States than in
Canada, France or the Netherlands. The rapid growth in these diagnostic
procedures over the past decade in the United States has raised concerns
that some imaging may not be useful. To reduce unnecessary procedures and
cut costs, many OECD countries are trying to promote rational use of costly
These are some of the findings from
OECD Health Data 2010,
the most comprehensive source of comparable statistics on health and health
systems across the 31 OECD countries (including Chile as a new member this
year) and 3 prospective members (Estonia, Israel and Slovenia). Covering
the period 1960 to 2008, this interactive database can be used for
comparative analyses on:
Risk factors to health (including trends in smoking and obesity)
Health care resources and utilisation
Long-term care resources and utilisation
Health expenditure and financing
Social protection (including public health coverage and private
Paris- -based OECD think thank for governments has 31 mainly developed country
members: Australia, Austria, Belgium, Canada, Chile, the Czech Republic,
Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy,
Japan, Korea, Luxembourg, Mexico, the Netherlands, New Zealand, Norway, Poland,
Portugal, the Slovak Republic, Spain, Sweden, Switzerland, Turkey, the United
Kingdom and the United States.