How Canada Compares Internationally International Chartbook How Canada Compares Internationally A Health Spending Perspective, 2017

The following slides are provided for reuse in your own presentations. Please cite as follows: Canadian Institute for Health Information. How Canada Compares Internationally: A Health Spending Perspective — International Chartbook, 2017. Ottawa, ON: CIHI; 2017. Additional resources The following companion products are available on CIHI’s website: Report Data tables Methodology notes Infographics Briefing deck Provincial/territorial chartbook media@cihi.ca For data-specific information: oecdcs@cihi.ca cihi.ca

Canada’s health spending as share of GDP and life expectancy higher than OECD average In 2015, total health spending as percentage of GDP was 10.4% in Canada and 8.9% in 35 selected OECD countries (average). Life expectancy at birth was 81.7 years for Canada (2013 data) and 80.6 years for the 35 OECD countries (average). Here is the data for all 35 countries in order of highest total health spending as percentage of GDP to lowest, followed by life expectancy at birth: United States: 16.9%; 78.8 years Switzerland: 12.1%; 83 years Germany: 11.2%; 80.7 years France: 11.1%; 82.4 years Sweden: 11.0%; 82.3 years Japan (provisional total health spending per person): 10.9%; 83.9 years Netherlands: 10.7%; 81.6 years Belgium: 10.5%; 81.1 years Canada (provisional total health spending per person, 2013 life expectancy data): 10.4%; 81.7 years Denmark: 10.3%; 80.8 years Austria: 10.3%; 81.3 years Norway: 10.0%; 82.4 years United Kingdom: 9.9%; 81 years Finland: 9.4%; 81.6 years Australia (difference in methodology, and estimated total health spending per person): 9.4%; 82.5 years New Zealand (estimated total health spending per person): 9.3%; 81.7 years Spain: 9.2%; 83 years Italy: 9.0%; 82.6 years Portugal: 9.0%; 81.2 years Iceland (difference in methodology for total health spending per person): 8.6%; 82.5 years Slovenia: 8.5%; 80.9 years Greece: 8.4%; 81.1 years Chile: 8.1%; 79.1 years Ireland: 7.8%; 81.5 years Israel (difference in methodology, and provisional total health spending per person): 7.4%; 82.1 years Korea: 7.4%; 82.1 years Hungary: 7.2%; 75.7 years Czech Republic: 7.2%; 78.7 years Slovak Republic: 6.9%; 76.7 years Estonia: 6.5%; 77.7 years Poland: 6.3%; 77.6 years Luxembourg (provisional total health spending per person): 6.0%; 82.4 years Mexico: 5.9%; 75 years Latvia: 5.8%; 74.6 years Turkey: 4.1%; 78 years © Canadian Institute for Health Information, 2017 Notes * Canada 2013 data for life expectancy at birth. Total health spending as a percentage of gross domestic product (GDP): † Provisional (Japan, Canada, Israel, Luxembourg); ‡ Difference in methodology (Australia, Iceland, Israel); § Estimated (Australia, New Zealand). Total current expenditure (capital excluded). Source Organisation for Economic Co-operation and Development. OECD Health Statistics 2017. 2017.

Some OECD countries spend less on health and have higher life expectancy than Canada In 2015, 8 of 35 selected OECD countries had lower health spending per person and higher life expectancy at birth than Canada: France, Australia, Japan, Iceland, Italy, Spain, Israel and Korea.   In 2015, total health spending per person (in Canadian dollars) was $5,782 in Canada and $4,826 in the 35 OECD countries (average). Life expectancy at birth was 81.7 years for Canada (2013 data) and 80.6 years for the 35 OECD countries (average). Here is the data for all 35 countries in order of highest health spending per person to lowest, followed by life expectancy at birth: United States: $11,916; 78.8 years Switzerland: $9,445; 83 years Luxembourg (provisional total health spending per person): $8,545; 82.4 years Norway: $7,759; 82.4 years Germany: $6,709; 80.7 years Netherlands: $6,639; 81.6 years Ireland: $6,612; 81.5 years Sweden: $6,601; 82.3 years Austria: $6,392; 81.3 years Denmark: $6,339; 80.8 years Belgium: $5,989; 81.1 years Canada (provisional total health spending per person): $5,782; 81.7 years France: $5,677; 82.4 years Australia (difference in methodology, and estimated total health spending per person): $5,631; 82.5 years Japan (provisional total health spending per person): $5,559; 83.9 years United Kingdom; $5,170; 81 years Iceland (difference in methodology for total health spending per person): $5,146; 82.5 years Finland: $5,005; 81.6 years New Zealand (estimated total health spending per person): $4,443; 81.7 years Italy: $4,201; 82.6 years Spain: $3,986; 83 years Slovenia: $3,423; 80.9 years Israel (difference in methodology, and provisional total health spending per person): $3,400; 82.1 years Portugal: $3,339; 81.2 years Korea: $3,177; 82.1 years Czech Republic: $3,051; 78.7 years Greece: $2,770; 81.1 years Slovak Republic: $2,581; 76.7 years Hungary: $2,398; 75.7 years Estonia: $2,363; 77.7 years Chile: $2,353; 79.1 years Poland: $2,135; 77.6 years Latvia: $1,798; 74.6 years Mexico: $1,322; 75 years Turkey: $1,249; 78 years © Canadian Institute for Health Information, 2017 Notes * Canada 2013 data for life expectancy at birth. $CA PPP: Purchasing power parity in Canadian currency. Total health spending per person: † Provisional (Luxembourg, Canada, Japan, Israel); ‡ Difference in methodology (Australia, Iceland, Israel); § Estimated (Australia, New Zealand). 8 countries spent less but had higher life expectancy at birth than Canada: France, Australia, Japan, Iceland, Italy, Spain, Israel, Korea. Total current expenditure (capital excluded). Source Organisation for Economic Co-operation and Development. OECD Health Statistics 2017. 2017.

Some OECD countries such as France and Japan spend less on health and have a larger share of seniors than Canada In 2015, total health spending per person (in Canadian dollars) was $5,782 in Canada and $4,826 in the 35 selected OECD countries (average).   The population age 65 and older accounted for 16.1% of Canada’s population and 16.6% of the average OECD population (35 selected countries). Here is the data for all 35 countries in order of highest health spending per person to lowest, followed by the percentage of seniors in the total population: United States: $11,916; 14.9% Switzerland: $9,445; 17.7%: Luxembourg (provisional total health spending per person): $8,545; 14.0% Norway: $7,759; 16.1% Germany: $6,709; 20.9% Netherlands: $6,639; 17.8% Ireland: $6,612; 12.8% Sweden: $6,601; 19.5% Austria: $6,392; 18.3% Denmark: $6,339; 18.5% Belgium: $5,989; 18.0% Canada (provisional total health spending per person): $5,782; 16.1% France: $5,677; 18.4% Australia (difference in methodology, and estimated total health spending per person): $5,631; 15.0% Japan (provisional total health spending per person): $5,559; 26.6% United Kingdom: $5,170; 17.7% Iceland (difference in methodology for total health spending per person): $5,146; 13.5% Finland: $5,005; 19.9% New Zealand (estimated total health spending per person): $4,443; 14.7% Italy: $4,201; 21.8% Spain: $3,986; 18.5% Slovenia: $3,423; 17.9% Israel (difference in methodology, and provisional total health spending per person): $3,400; 11.0% Portugal: $3,339; 20.3% Korea: $3,177; 12.8% Czech Republic: $3,051; 17.8% Greece: $2,770; 21.0% Slovak Republic: $2,581; 14.0% Hungary: $2,398; 17.9% Estonia: $2,363; 18.8% Chile: $2,353; 10.3% Poland: $2,135; 15.4% Latvia: $1,798; 19.5% Mexico: $1,322; 6.8% Turkey: $1,249; 7.9% © Canadian Institute for Health Information, 2017 Notes $CA PPP: Purchasing power parity in Canadian currency. Total health spending per person: † Provisional (Luxembourg, Canada, Japan, Israel); ‡ Difference in methodology (Australia, Iceland, Israel); § Estimated (Australia, New Zealand). Total current expenditure (capital excluded). Source Organisation for Economic Co-operation and Development. OECD Health Statistics 2017. 2017.

Canada spends more on health and has a lower publicly funded share than the OECD average In 2015, total health spending per person (in Canadian dollars) was $5,782 in Canada and $4,826 in the 35 selected OECD countries (average).   The public sector accounted for 70.4% of total health spending in Canada and 72.5% in the OECD (average). Here is the data for all 35 countries in order of highest health spending per person to lowest, followed by the public sector’s share of total health spending: United States: $11,916; 49.4% Switzerland: $9,445; 64.0% Luxembourg (provisional total health spending per person): $8,545; 82.0% Norway: $7,759; 85.4% Germany: $6,709; 84.5% Netherlands: $6,639; 80.7% Ireland: $6,612; 70.0% Sweden: $6,601; 83.7% Austria: $6,392; 75.6% Denmark: $6,339; 84.1% Belgium: $5,989; 77.5% Canada (provisional total health spending per person): $5,782; 70.4% France: $5,677; 78.9% Australia (difference in methodology, and estimated total health spending per person): $5,631; 67.3% Japan (provisional total health spending per person): $5,559; 84.0% United Kingdom: $5,170; 79.7% Iceland (difference in methodology for total health spending per person): $5,146; 81.5% Finland: $5,005; 74.4% New Zealand (estimated total health spending per person): $4,443; 80.3% Italy: $4,201; 74.9% Spain: $3,986; 71.0% Slovenia: $3,423; 71.7% Israel (difference in methodology, and provisional total health spending per person): $3,400; 60.7% Portugal: $3,339; 66.2% Korea: $3,177; 56.4% Czech Republic: $3,051; 83.5% Greece: $2,770; 59.1% Slovak Republic: $2,581; 79.7% Hungary: $2,398; 66.7% Estonia: $2,363; 75.7% Chile: $2,353; 60.8% Poland: $2,135; 70.0% Latvia: $1,798; 57.5% Mexico: $1,322; 52.2% Turkey: $1,249; 78.1% © Canadian Institute for Health Information, 2017 Notes $CA PPP: Purchasing power parity in Canadian currency. Total health spending per person: † Provisional (Luxembourg, Canada, Japan, Israel); ‡ Difference in methodology (Australia, Iceland, Israel); § Estimated (Australia, New Zealand). Total current expenditure (capital excluded). Source Organisation for Economic Co-operation and Development. OECD Health Statistics 2017. 2017.

How does Canada compare internationally? Canada is among the highest spenders on health care in the Organisation for Economic Co-operation and Development (OECD), at $5,782 per person in 2015. That year, among 35 selected OECD countries, spending per person remained the highest in the United States, at $11,916. Although Canada was above the OECD average in terms of per-person spending on health care, our public-sector share of total health expenditure (70%) was below the OECD average (72%). Here are the numbers for 2015 per-person spending in Canadian dollars, health spending as a percentage of gross domestic product (GDP) and the public/private split for the OECD as a whole and 9 selected OECD countries, including Canada: OECD: $4,826 per person; 8.9% of GDP; 72% public/28% private Canada: $5,782 per person; 10.4% of GDP; 70% public/30% private United States: $11,916 per person; 16.9% of GDP; 49% public/51% private France: $5,677 per person; 11.1% of GDP; 79% public/21% private Germany: $6,709 per person; 11.2% of GDP; 84% public/16% private Sweden: $6,601 per person; 11.0% of GDP; 84% public/16% private Netherlands: $6,639 per person; 10.7% of GDP; 81% public/19% private Australia: $5,631 per person; 9.4% of GDP; 67% public/33% private New Zealand: $4,443 per person; 9.3% of GDP; 80% public/20% private United Kingdom: $5,170 per person; 9.9% of GDP; 80% public/20% private Note that these numbers reflect total current expenditure, excluding capital. Spending data is based on the System of Health Accounts. © Canadian Institute for Health Information, 2017 Notes $CA PPP: Purchasing power parity in Canadian currency. Total current expenditure (capital excluded). Source Organisation for Economic Co-operation and Development. OECD Health Statistics 2017. 2017.

Lower growth seen in health spending and GDP since global economic recession in 2008 For both Canada and the OECD on average, annual growth in current health spending per person and GDP trended downward from 2001 to 2016. Growth rates since 2008, when the global economic recession began, have been generally lower than in previous decades. Nominal growth in GDP was negative for both Canada and the OECD on average in 2009, and for Canada only in 2015. Here is the data for all 35 countries from 2001 to 2016, in order of growth in OECD average GDP per person. Data includes growth in OECD average GDP per person, growth in Canada GDP per person, growth in OECD average total health spending per person and growth in Canada total health spending per person: 2001: OECD average GDP per person, 6.8%; Canada GDP per person, 2.3%; OECD average total health spending per person, 10.7%; Canada total health spending per person, 7.0% 2002: OECD average GDP per person, 6.1%; Canada GDP per person, 3.2%; OECD average total health spending per person, 9.4%; Canada total health spending per person, 5.9% 2003: OECD average GDP per person, 5.4%; Canada GDP per person, 4.2%; OECD average total health spending per person, 8.9%; Canada total health spending per person, 6.0% 2004: OECD average GDP per person, 7.1%; Canada GDP per person, 5.5%; OECD average total health spending per person, 8.2%; Canada total health spending per person, 6.1% 2005: OECD average GDP per person, 6.4%; Canada GDP per person, 5.4%; OECD average total health spending per person, 7.1%; Canada total health spending per person, 5.1% 2006: OECD average GDP per person, 7.9%; Canada GDP per person, 4.2%; OECD average total health spending per person, 7.0%; Canada total health spending per person, 5.9% 2007: OECD average GDP per person, 7.5%; Canada GDP per person, 4.4%; OECD average total health spending per person, 7.4%; Canada total health spending per person, 5.5% 2008: OECD average GDP per person, 3.7%; Canada GDP per person, 3.9%; OECD average total health spending per person, 7.3%; Canada total health spending per person, 5.8% 2009: OECD average GDP per person, -3.6%; Canada GDP per person, -6.3%; OECD average total health spending per person, 4.1%; Canada total health spending per person, 4.7% 2010: OECD average GDP per person, 3.8%; Canada GDP per person, 4.9%; OECD average total health spending per person, 2.6%; Canada total health spending per person, 4.8% 2011: OECD average GDP per person, 4.3%; Canada GDP per person, 5.4%; OECD average total health spending per person, 3.2%; Canada total health spending per person, 2.0% 2012: OECD average GDP per person, 1.9%; Canada GDP per person, 1.8%; OECD average total health spending per person, 3.0%; Canada total health spending per person, 1.8% 2013: OECD average GDP per person, 2.5%; Canada GDP per person, 2.9%; OECD average total health spending per person, 3.6%; Canada total health spending per person, 1.8% 2014: OECD average GDP per person, 3.2%; Canada GDP per person, 3.4%; OECD average total health spending per person, 3.2%; Canada total health spending per person, 2.1% 2015: OECD average GDP per person, 3.9%; Canada GDP per person, -0.7%; OECD average total health spending per person, 4.2%; Canada total health spending per person, 3.8% 2016: OECD average GDP per person, 3.0%; Canada GDP per person, 0.8%; OECD average total health spending per person, 3.8%; Canada total health spending per person, 2.3% © Canadian Institute for Health Information, 2017 Notes Current price used in the calculation of growth rates of GDP and health spending per person. Total current expenditure (capital excluded). Source Organisation for Economic Co-operation and Development. OECD Health Statistics 2017. 2017.