Countries Spending the Most on Healthcare (2025)

No international ranking generates more policy argument than health spending. The United States spends far more on health than any other large economy: 16.7% of its gross domestic product in 2023, or about $13,473 per person, according to the WHO Global Health Expenditure Database as republished by the World Bank. The US government's own national accounts, which use a slightly broader definition, put 2024 spending at $5.3 trillion, 18.0% of GDP and $15,474 per person. Yet American life expectancy at birth, 78.9 years in 2024 by World Bank figures, sits below that of almost every other wealthy country in this ranking.

Understanding why requires looking past the headline totals. Two different measures, share of GDP and spending per person, rank countries differently. Data sources disagree by a point or two. And the link between money and health outcomes turns out to run through prices, coverage, demographics and things outside the health system entirely. This article walks through each of those layers, using official data with the year attached to every figure.

Key takeaways

• The United States spent 16.7% of GDP and about $13,473 per person on health in 2023 (WHO/World Bank), the highest of any large economy on both measures.
• Switzerland ($11,784 per person, 2023) and Norway ($8,296, 2023) are the next-highest per-capita spenders among large economies; Germany (12.3% of GDP, 2024) has the highest share of GDP in Europe.
• Share of GDP and per-capita spending tell different stories: Afghanistan spent 15.0% of GDP on health in 2023 but only about $59 per person.
• Japan spent 10.7% of GDP ($3,638 per person, 2023) and reached a life expectancy of 84.0 years (2024), about five years above the US figure.
• How health spending is financed varies widely: governments paid 86% of the bill in Norway and Sweden (2023) but 54% in the United States and 33% in Switzerland, where mandatory private insurance carries much of the load.

Top Healthcare Spenders: Large and High-Income Economies

The table below covers the countries that usually appear in rich-country comparisons, sorted by per-capita spending. Every figure is the most recent year available in the World Bank's World Development Indicators, which republish the WHO Global Health Expenditure Database (GHED). "Current health expenditure" covers spending on health goods and services from all sources (government, compulsory insurance, voluntary insurance and out-of-pocket payments), but excludes capital investment such as building new hospitals.

Rank (per capita)	Country	Health spending per person (US$)	Year	% of GDP	Year	Government share of spending	Life expectancy at birth (2024)
1	United States	$13,473	2023	16.7%	2023	54.0% (2023)	78.9
2	Switzerland	$11,784	2023	11.7%	2023	33.1% (2023)	84.4
3	Norway	$8,296	2023	9.4%	2023	86.1% (2023)	83.2
4	Luxembourg	$8,170	2024	5.9%	2024	86.9% (2024)	83.2
5	Iceland	$7,642	2024	9.0%	2024	83.6% (2023)	82.8
6	Ireland	$7,395	2024	6.9%	2024	76.6% (2023)	83.0
7	Australia	$6,980	2023	10.4%	2023	73.7% (2023)	83.1
8	Germany	$6,849	2024	12.3%	2024	79.1% (2023)	80.8
9	Netherlands	$6,845	2024	10.0%	2024	68.4% (2023)	82.0
10	Denmark	$6,745	2024	9.4%	2024	83.4% (2024)	82.3
11	Austria	$6,739	2024	11.8%	2024	76.5% (2023)	82.0
12	Sweden	$6,485	2024	11.2%	2024	86.1% (2023)	84.1
13	Canada	$6,378	2024	11.3%	2024	70.2% (2024)	82.1
14	Belgium	$5,931	2023	10.8%	2023	73.7% (2023)	82.3
15	United Kingdom	$5,860	2024	11.1%	2024	81.8% (2023)	81.4
16	Finland	$5,515	2023	10.5%	2023	81.1% (2023)	82.3
17	France	$5,327	2024	11.5%	2024	68.4% (2024)	83.0
18	New Zealand	$5,022	2024	10.1%	2024	77.7% (2023)	82.0
19	Israel	$3,928	2023	7.1%	2023	65.2% (2023)	83.2
20	Japan	$3,638	2023	10.7%	2023	84.8% (2023)	84.0
21	Italy	$3,398	2024	8.4%	2024	73.1% (2023)	84.0
22	South Korea	$3,137	2024	8.7%	2024	56.6% (2024)	83.6
23	Spain	$3,107	2023	9.2%	2023	73.2% (2023)	83.9

Sources: World Bank World Development Indicators, series SH.XPD.CHEX.PC.CD (current health expenditure per capita, current US$), SH.XPD.CHEX.GD.ZS (current health expenditure, % of GDP) and SH.XPD.GHED.CH.ZS (domestic general government health expenditure, % of current health expenditure), all sourced from the WHO Global Health Expenditure Database; life expectancy from series SP.DYN.LE00.IN. Retrieved October 2026.

Per-capita figures are in current US dollars at market exchange rates, not adjusted for purchasing power. That choice flatters countries with strong currencies (Switzerland, Norway) and penalises countries whose currencies were weak in the reporting year (Japan's yen fell sharply against the dollar in 2022–2023, which helps explain its low dollar figure). OECD comparisons usually use purchasing-power parities instead, so OECD per-capita numbers will not match this table exactly.

The Other Ranking: Share of GDP

Sort the same database by share of GDP instead, and the top of the list looks completely different. In the World Bank's 2023 data, the highest shares belong to Tuvalu (27.1%), Nauru (18.2%) and the United States (16.7%), followed by Afghanistan (15.0%), the Marshall Islands (13.4%), Liberia (13.0%) and Micronesia (12.9%).

Country	% of GDP	Year	Per person (US$)
Tuvalu	27.1%	2023	$1,724
Nauru	18.2%	2023	$2,292
United States	16.7%	2023	$13,473
Afghanistan	15.0%	2023	$59
Marshall Islands	13.4%	2023	$894
Liberia	13.0%	2023	$104
Micronesia	12.9%	2023	$508
Lesotho	12.6%	2023	$123
Germany	12.3%	2024	$6,849
Austria	11.8%	2024	$6,739

Source: World Bank WDI series SH.XPD.CHEX.GD.ZS and SH.XPD.CHEX.PC.CD (WHO GHED), retrieved October 2026.

This is why a ranking by share of GDP alone can mislead. The ratio has two parts, and a high number can come from a large numerator (lots of health spending) or a small denominator (a small economy). Afghanistan's 15% share sits on spending of about $59 per person. Small Pacific island states have tiny economies and must fly patients abroad for specialist treatment, which pushes their ratios up. In low-income countries, donor funding can also make health spending look large relative to domestic output. A share of GDP is best read as a measure of how much of a nation's economic activity is devoted to health, not how much care each person receives. Our explainer on what GDP measures and why it matters covers the denominator side of this in more detail.

Where this data comes from

Three bodies publish the health-spending numbers that most rankings use, and they do not always agree.

WHO Global Health Expenditure Database (GHED). The WHO compiles spending data for more than 190 countries using the System of Health Accounts (SHA 2011), a common accounting framework developed jointly by the WHO, OECD and Eurostat. The World Bank republishes these figures in its World Development Indicators, which is where the tables above come from. Coverage is global, but the most recent year is often two years behind.

OECD Health Statistics. The OECD collects the same SHA-based accounts from its 38 members, publishes preliminary estimates for the latest year and adjusts per-capita figures for purchasing power. In its Health at a Glance 2025 report, the OECD estimated that its members spent an average of 9.3% of GDP on health in 2024, up from 8.8% in 2019, with the United States at 17.2% and Germany next at 12.3%.

National accounts. Countries also publish their own figures. The US Centers for Medicare & Medicaid Services (CMS) runs the National Health Expenditure Accounts, which reported $5.3 trillion in 2024 spending, growth of 7.2% over the year, $15,474 per person and 18.0% of GDP. The CMS figure is higher than the WHO one partly because it includes items, such as investment in structures and research, that the SHA "current expenditure" measure excludes.

The practical lesson is to compare like with like. A US figure from CMS should not be set against a German figure from the WHO. Each row in the tables above uses one source and one definition, with the year shown, and readers should expect other publications to differ by one or two percentage points.

The Global Picture

Health is one of the largest sectors of the world economy. The WHO's report Global spending on health: Emerging from the pandemic, published in December 2024, put world health spending at $9.8 trillion in 2022, or 9.9% of global GDP. That was down from 10.3% of GDP in 2021, the first real-terms decline since 2000 as pandemic emergency spending unwound, though still above the 2019 level.

The distribution is extremely unequal. High-income countries account for most of the money, while the WHO notes that in low-income countries external aid makes up about 31% of health spending, more than domestic government spending (22%), and out-of-pocket payments exceed 40%. World Bank data show average health spending of about $1,317 per person worldwide in 2023, compared with $67 in Nigeria, $85 in India and $763 in China. Out-of-pocket payments made up 71.9% of Nigeria's health spending and 43.9% of India's in 2023, against 10.9% in the United States and 9.2% in France.

These shares matter because out-of-pocket spending is the part of the bill that falls on households at the moment of illness. The WHO treats high out-of-pocket shares as a warning sign for financial hardship, and reducing them is a core target of universal health coverage.

The American Paradox: Most Expensive, Not Healthiest

The United States spends more per person than any other large country, about $13,473 in 2023 against $6,849 in Germany (2024) and $5,860 in the United Kingdom (2024), yet its life expectancy at birth (78.9 years in 2024) is lower than every other country in the main table. The question of why has been studied intensively.

The most cited modern comparison is a 2018 study in JAMA by Irene Papanicolas, Liana Woskie and Ashish Jha, which compared the United States with ten other high-income countries using mostly 2013–2016 data. In 2016 the US spent 17.8% of GDP on health, against a range of 9.6% (Australia) to 12.4% (Switzerland) in the comparison group. The authors found that Americans did not use dramatically more health care. Rates of doctor visits and hospital stays were broadly similar. The difference came mainly from prices: of labour, of goods including pharmaceuticals, and of administration. The finding echoed a 2003 Health Affairs paper by Gerard Anderson and colleagues whose title summarised it bluntly: "It's the prices, stupid."

Several structural features push US prices up:

• Fragmented purchasing. Hundreds of private insurers, plus Medicare, Medicaid and other public programmes, each negotiate separately with hospitals and drug makers. Single-payer or tightly regulated systems negotiate as one buyer or set national fee schedules.
• Administrative complexity. Multiple payers with different rules require billing staff on both the provider and insurer side. The JAMA study identified administration as one of the main drivers of the gap.
• Coverage gaps. Unlike every other country in the main table, the United States does not have universal coverage. Uninsured people tend to delay care, which can mean more expensive treatment later.

Life expectancy is shaped by much more than health care. Higher US rates of obesity, drug overdose, road deaths and firearm deaths all reduce American life expectancy, and none of them is mainly a health-system failure. Comparisons of obesity rates by country and life expectancy by country show how much of the gap sits outside the hospital. So the paradox is real but has two halves: the US pays more for each unit of care, and it also faces population health problems that care alone cannot fix.

How the Money Is Raised: Four Models

Countries with similar spending can finance it in very different ways. Health economists usually group systems into four broad models, though most real systems mix them.

Model	How it is funded	Examples	Government share of spending
Tax-funded national health service	General taxation; government owns many providers	UK (NHS, 1948), Sweden, Norway, Denmark, Italy, Spain	73–86% (2023/2024)
Social health insurance	Mandatory payroll contributions to sickness funds	Germany (from 1883), France, Japan, Belgium, Netherlands	68–85% (2023/2024)
Single-payer national insurance	Public insurer pays private providers	Canada, South Korea, Australia (Medicare)	57–74% (2023/2024)
Mixed / market-based	Employer private insurance plus targeted public programmes	United States; Switzerland's mandated private insurance is a regulated variant	33–54% (2023)

Source for government shares: World Bank WDI series SH.XPD.GHED.CH.ZS (WHO GHED). System classifications follow standard health-policy usage; dates of founding are historical.

The "government share" column is revealing. In Switzerland only 33.1% of spending is government money, because the law requires every resident to buy basic insurance from private, non-profit insurers; the premium is compulsory but not a tax. Switzerland also has one of the highest out-of-pocket shares in the rich world (22.0% in 2023), driven by deductibles and co-payments. Italy (22.3%, 2024) and South Korea (33.7%, 2024) also ask households to pay a large share directly. A system can be universal and still leave patients paying a lot at the point of use.

Switzerland: Expensive and Regulated

Switzerland is the world's second-highest per-capita spender among large economies ($11,784 in 2023) and devotes 11.7% of GDP to health, but it also records one of the world's highest life expectancies (84.4 years in 2024).

Since 1996, when the federal health insurance law came into force, every resident has been required to buy basic coverage from an approved insurer. Insurers cannot refuse applicants or vary basic premiums by health status, and they must cover a standard benefits package. Cantons subsidise premiums for lower-income households. Hospitals and doctors are paid under negotiated tariffs rather than free-market prices.

Part of Switzerland's high dollar spending reflects high wages throughout the economy and a strong franc: nurses, doctors and pharmacists earn Swiss salaries. In purchasing-power terms the gap with neighbours such as Germany and Austria narrows, though Switzerland remains among the most expensive systems in Europe.

Germany: The Social Insurance Archetype

Germany's statutory health insurance dates back to Chancellor Otto von Bismarck's Health Insurance Act of 1883, making it the oldest national social insurance scheme still operating. Employees and employers share mandatory contributions to competing non-profit sickness funds (Krankenkassen), which operate within a tightly regulated framework. Higher earners may opt out into private insurance.

At 12.3% of GDP in 2024, Germany has the highest health spending share in Europe in the World Bank data. Government and compulsory schemes covered 79.1% of spending in 2023. Germany has a dense hospital network and a high number of physicians, a topic covered in our ranking of countries with the most doctors per capita. Its life expectancy (80.8 years in 2024), however, is below most Western European peers, a reminder that spending and longevity do not move in lockstep.

Japan: Low Dollars, Long Lives

Japan spent 10.7% of GDP on health in 2023, about $3,638 per person in current dollars, and its life expectancy at birth was 84.0 years in 2024. Universal coverage was achieved in 1961. Everyone joins an employment-based or residence-based insurance scheme, and a single national fee schedule sets the price of every covered service and drug. The government revises it every two years, which gives it a strong lever on costs.

Japan's dollar spending is flattered by the weak yen, and its share of GDP has risen steadily: from 7.0% in 2000 to 9.1% in 2010 and 10.7% in 2023, per World Bank data. The driver is age. In 2025, 30.0% of Japan's population was 65 or older, the highest share of any major country and nearly three times the world average of 10.4%. Older people use far more care, so ageing pushes spending up even when prices are held down. The biology of why that happens is the subject of our piece on why we age.

South Korea shows the same trend at an earlier stage: health spending rose from 3.7% of GDP in 2000 to 5.8% in 2010 and 8.7% in 2024, while the share of Koreans aged 65 and over reached 20.3% in 2025.

Does More Spending Buy Better Health?

Across the world as a whole, the answer is clearly yes up to a point. Moving from $60 to $1,000 per person pays for vaccination, skilled birth attendance, clean blood supplies and antibiotics, which produce large gains in life expectancy. Nigeria, with health spending of about $67 per person in 2023, had a life expectancy of 54.6 years in 2024; China, at about $763 per person, reached 78.0 years.

Among rich countries the relationship flattens sharply. Spain ($3,107 per person, 2023) and Italy ($3,398, 2024) both recorded life expectancies of around 84 years in 2024, higher than Germany at twice the spending and five years above the United States at four times the spending. Once the basics are universally available, the extra money increasingly pays for higher prices, more advanced (and sometimes marginal) treatments, and care for chronic conditions in the last years of life.

There are good reasons not to read this as proof that spending is wasted. Life expectancy is a population average that is heavily shaped by diet, smoking history, inequality, violence and road safety. A health system can deliver excellent cancer survival rates or short waiting times without moving national life expectancy much. Differences in income inequality by country are another candidate explanation that researchers continue to debate. And a high-spending system may offer things patients value, such as choice of doctor or rapid access to new drugs, that do not show up in mortality statistics.

Why Spending Keeps Rising

Health spending has grown faster than the overall economy in most rich countries for decades. US health spending rose from 12.5% of GDP in 2000 to 16.7% in 2023 in the WHO series, with a spike to 18.5% in 2020 when the pandemic shrank GDP and added emergency spending. Economists usually point to four drivers:

1. Technology. New treatments, such as biologic drugs, minimally invasive surgery and advanced imaging, often add cost even when they improve results. Developments such as AI-assisted diagnosis and treatment are promoted as cost-saving, but their net effect on spending is not yet established.
2. Ageing. Older populations need more chronic care, as Japan and Korea illustrate.
3. Rising incomes. As countries get richer, people choose to spend a larger share of income on health. This is sometimes described as health being a "luxury good" at the national level.
4. Labour costs. Health care remains labour-intensive, so wages rise with the rest of the economy even when productivity gains are slow. Economists call this Baumol's cost disease.

The pandemic years distort recent trends. Spending ratios jumped in 2020–2021 as GDP fell and governments funded testing, vaccines and hospital surge capacity, then fell back in 2022 as GDP recovered. When comparing countries, it is safer to look at the years either side of the pandemic than at 2020 or 2021.

Common Misconceptions

"The country with the highest share of GDP has the best-funded health system." Not necessarily. The share-of-GDP leaders in 2023 included Tuvalu, Nauru and Afghanistan, where spending per person is a small fraction of rich-country levels.

"Universal systems are all government-run." Switzerland and the Netherlands achieve universal coverage through compulsory private insurance, and Germany through non-profit sickness funds. Only some universal systems, such as the UK's NHS, own most of their hospitals.

"Americans pay less tax for health care." US government health spending is large in absolute terms. Public sources paid 54.0% of US health spending in 2023, which in dollar terms is more public money per person than many countries with fully public systems spend in total.

"Out-of-pocket costs are always lowest in public systems." France (9.2%, 2024) and the US (10.9%, 2023) actually have low out-of-pocket shares, while Switzerland (22.0%) and South Korea (33.7%) are much higher, despite universal coverage.

"More money will close the life expectancy gap." The evidence from high life expectancy countries suggests the factors behind long lives sit as much in diet, safety and equality as in health budgets.

Limitations of This Ranking

• Lags. The latest WHO data are usually two years old, and some countries in the table report 2023 figures while others report 2024. Rows with different years should be compared with care.
• Exchange rates. Dollar figures move with currencies. A strong year for the dollar makes every other country look cheaper.
• Definitions. "Current health expenditure" excludes capital investment. Long-term care for older people is counted inconsistently across countries, which matters for countries with large nursing-home sectors.
• Revisions. WHO, OECD and national agencies revise past years when better data arrive, so figures quoted in older reports (including earlier versions of this page) may not match today's database.

Frequently asked questions

Q: Which country spends the most on healthcare? A: Among large economies, the United States spends the most on both measures: 16.7% of GDP and about $13,473 per person in 2023, by WHO data published through the World Bank. US national accounts put 2024 spending at 18.0% of GDP. By share of GDP alone, the tiny Pacific state of Tuvalu ranked higher at 27.1% in 2023, but on a far smaller economy.

Q: What is the difference between health spending as a share of GDP and per capita? A: Share of GDP shows how much of a country's economic output goes to health, while per-capita spending shows how much money is spent per resident. A poor country can have a high share with very little money per person, as Afghanistan did in 2023 (15.0% of GDP, about $59 per person).

Q: Does higher healthcare spending mean longer life expectancy? A: Only up to a point. Between poor and middle-income countries the link is strong, but among rich countries it weakens. Spain and Italy spent roughly a quarter of the US amount per person and recorded life expectancies around 84 years in 2024, versus 78.9 for the United States.

Q: Why does the United States spend so much on health care? A: The best-known comparative research, including a 2018 JAMA study by Papanicolas, Woskie and Jha, found that Americans use roughly similar amounts of care to people in other rich countries but pay higher prices for labour, drugs and administration. A fragmented system of many payers and incomplete coverage both contribute.

Q: Why are OECD, WHO and US government figures different? A: They use different definitions and update schedules. The OECD estimated US spending at 17.2% of GDP in 2024, WHO data show 16.7% for 2023, and US national accounts report 18.0% for 2024 because they include some investment spending. Compare figures only within a single source.

Q: Which wealthy country gets the most life expectancy per dollar? A: On this table's data, Spain, Italy and Japan stand out, each combining life expectancy of about 84 years (2024) with spending of roughly $3,100 to $3,650 per person. Exchange rates and demographic differences mean such comparisons are indicative rather than precise.

The bottom line

Health spending rankings tell a story about system design, prices and population ageing as much as about generosity. The United States stands apart, spending roughly twice as much per person as most other rich countries without matching their life expectancy, largely because it pays higher prices and lacks universal coverage. Elsewhere, countries reach universal coverage through very different routes, from Britain's tax-funded NHS to Switzerland's compulsory private insurance and Japan's national fee schedule. The most reliable conclusion from the data is a modest one: beyond a basic level, how money is spent, and what happens outside the health system, matters as much as how much is spent.

Sources

• World Bank, World Development Indicators: Current health expenditure (% of GDP), per capita (current US$), life expectancy at birth, sourced from the WHO Global Health Expenditure Database.
• WHO, Global spending on health: Emerging from the pandemic (December 2024).
• US Centers for Medicare & Medicaid Services, National Health Expenditure Data: Historical.
• Papanicolas I, Woskie LR, Jha AK. "Health care spending in the United States and other high-income countries." JAMA 2018;319(10):1024–1039. LSE Research Online record.

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