On Government Healthcare Spending — and Education

Last updated on: October 1, 2013 at 12:36 pm by Jane the Actuary

On Government Healthcare Spending — and Education 2013-10-01T12:36:00-06:00 Jane the Actuary

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This is a great article on government healthcare spending by Avik Roy at the National Review. Bottom line: even without regard to ObamaCare’s new subsidies, the federal government already spends more on healthcare than Germany, Canada, and the UK, on a per-capita and purchasing power parity basis.

This is stunning. Now, I don’t know if this is purely Medicare and Medicaid, or if it also includes community health clinics, the VA, or even spending for federal government employees in its role as employee benefits provider. Does it include funding for residencies, or loan forgiveness for doctors working in underserved areas? Of course, regardless of how comprehensive this number is, we’re up against systems that provide healthcare for their entire population (though individuals in Germany and the UK can opt out and elect private health insurance instead or in addition).

This is actually not dissimilar from a similar chart on education spending, which I couldn’t find just now but here’s the data I was looking for, anyway — from the OECD report, Education at a Glance, 2012. (The particular table below is at this URL.)

Germany’s government spends 1.1% of GDP on tertiary education. We spend 1.0% (public spending). But Germany provides virtually tuition-free universities, and our students have to pony up 2.6% of GDP more in private spending. Are we getting our money’s worth?

Table B2.3. Expenditure on educational institutions as a percentage of GDP, by source of fund and level of education (2009)
                         From public and private sources of funds       Pre-primary education Primary, secondary and
post-secondary non-tertiary education Tertiary education Total all levels of education Notes Public 1 Private 2 Total Public 1 Private 2 Total Public 1 Private 2 Total Public 1 Private 2 Total (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) OECD Australia 0.06   0.05   0.11   3.6   0.6   4.2   0.7   0.9   1.6   4.5   1.5   6.0   Austria 0.55   0.04   0.59   3.8   0.1   3.9   1.4   0.1   1.4   5.7   0.2   5.9   Belgium 0.60   0.02   0.62   4.3   0.2   4.4   1.4   0.1   1.5   6.4   0.3   6.7   Canada 3, 4 x(4)    x(5)    x(6)    3.2   0.4   3.6   1.5   0.9   2.5   4.8   1.3   6.1   Chile 5 0.60   0.14   0.74   2.9   0.8   3.6   0.8   1.6   2.5   4.3   2.6   6.8   Czech Republic 0.47   0.04   0.51   2.6   0.3   2.9   1.0   0.2   1.3   4.2   0.6   4.8   Denmark 4 0.91   0.13   1.04   4.7   0.1   4.8   1.8   0.1   1.9   7.5   0.3   7.9   Estonia 0.48   0.01   0.49   4.1   0.1   4.2   1.3   0.3   1.6   5.9   0.4   6.3   Finland 0.40   0.04   0.45   4.1   n    4.1   1.8   0.1   1.9   6.3   0.1   6.4   France 0.68   0.04   0.72   3.8   0.2   4.1   1.3   0.2   1.5   5.8   0.5   6.3   Germany 0.44   0.19   0.63   2.9   0.4   3.3   1.1   0.2   1.3   4.5   0.8   5.3   Greece m    m    m    m    m    m    m    m    m    m    m    m    Hungary 0.72   m    m    3.0   m    m    1.0   m    m    4.8   m    m    Iceland 0.79   0.23   1.02   5.0   0.2   5.2   1.2   0.1   1.3   7.3   0.7   8.1   Ireland n    n    n    4.6   0.1   4.7   1.4   0.3   1.6   6.0   0.4   6.3   Israel 0.68   0.18   0.87   3.8   0.2   4.0   1.0   0.6   1.6   5.8   1.3   7.2   Italy 0.46   0.04   0.51   3.3   0.1   3.4   0.8   0.2   1.0   4.5   0.4   4.9   Japan 4 0.10   0.12   0.22   2.7   0.3   3.0   0.5   1.0   1.6   3.6   1.7   5.2   Korea 0.11   0.15   0.26   3.6   1.1   4.7   0.7   1.9   2.6   4.9   3.1   8.0   Luxembourg 0.59   0.01   0.60   3.2   0.1   3.3   m    m    m    m    m    m    Mexico 0.53   0.12   0.65   3.3   0.7   4.0   1.0   0.4   1.4   5.0   1.2   6.2   Netherlands 0.41   n    0.41   3.7   0.4   4.1   1.2   0.5   1.7   5.3   0.9   6.2   New Zealand 0.48   0.10   0.58   4.5   0.7   5.2   1.1   0.5   1.6   6.1   1.3   7.4   Norway 0.35   0.06   0.41   4.2   m    m    1.3   0.1   1.4   6.1   m    m    Poland 0.52   0.12   0.64   3.5   0.2   3.6   1.1   0.5   1.5   5.0   0.8   5.8   Portugal 0.40   n    0.40   4.0   n    4.0   1.0   0.4   1.4   5.5   0.4   5.9   Slovak Republic 4 0.42   0.08   0.50   2.7   0.3   3.1   0.7   0.3   0.9   4.1   0.6   4.7   Slovenia 0.56   0.15   0.71   3.6   0.3   4.0   1.1   0.2   1.3   5.3   0.7   6.0   Spain 0.71   0.21   0.92   3.1   0.2   3.3   1.1   0.3   1.3   4.9   0.7   5.6   Sweden 0.73   n    0.73   4.2   n    4.2   1.6   0.2   1.8   6.6   0.2   6.7   Switzerland 0.21   m    m    3.8   0.6   4.4   1.4   m    m    5.5   m    m    Turkey m    m    m    m    m    m    m    m    m    m    m    m    United Kingdom 0.26   n    0.26   4.5   n    4.5   0.6   0.7   1.3   5.3   0.7   6.0   United States 0.34   0.08   0.43   3.9   0.3   4.3   1.0   1.6   2.6   5.3   2.1   7.3   OECD average 0.47   0.08   0.55   3.7   0.3   4.0   1.1   0.5   1.6   5.4   0.9   6.3   OECD total 0.37   0.09   0.47   3.6   0.3   3.9   1.0   1.0   1.9   5.0   1.4   6.4   EU21 average 0.52   0.06   0.56   3.7   0.2   3.9   1.2   0.3   1.5   5.5   0.5   6.0   Other G20 Argentina 0.46   0.21   0.66   4.4   0.5   4.9   1.1   0.3   1.4   6.0   1.0   7.0   Brazil 0.40   m    m    4.3   m    m    0.8   m    m    5.5   m    m    China m    m    m    m    m    m    m    m    m    m    m    m    India 0.04   m    m    2.2   m    m    1.3   m    m    3.5   m    m    Indonesia 5 0.02   0.02   0.04   2.0   0.4   2.5   0.5   0.2   0.7   3.0   0.6   3.6   Russian Federation 0.74   0.13   0.87   2.3   0.1   2.4   1.2   0.6   1.8   4.7   0.8   5.5   Saudi Arabia 5 m    m    m    m    m    m    2.3   m    m    m    m    m    South Africa 0.05   m    m    3.9   m    m    0.6   m    m    4.8   m    m    G20 average 0.35   m    m    3.0   m    m    0.9   m    m    4.4   m    m    1. Including public subsidies to households attributable for educational institutions, and direct expenditure on educational institutions from international sources.
2. Net of public subsidies attributable for educational institutions.
3. Year of reference 2008.
4. Some levels of education are included with others. Refer to “x” code in Table B1.1a for details.
5. Year of reference 2010.
Source*: OECD. Argentina, India, Indonesia: UNESCO Institute for Statistics (World Education Indicators programme). Saudi Arabia: Observatory on Higher Education. South Africa: UNESCO Institute for Statistics. See Annex 3 for notes (www.oecd.org/edu/eag2012).*
Please refer to the Reader’s Guide for information concerning the symbols replacing missing data.

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