The United States spent an estimated $14,775 per person on healthcare in 2024, more than any other country on earth and nearly $5,000 more than Switzerland, the next-highest spender. France, Germany, Canada, and the United Kingdom all spend roughly half as much per person. The returns on that spending do not match the price tag.
One in three U.S. adults currently has medical debt. According to a landmark investigation by KFF Health News and NPR, more than 100 million Americans (41% of all adults) are saddled with healthcare bills they cannot pay. Roughly 66.5% of personal bankruptcies in the United States are linked to medical expenses. In France, with its single-payer system, there were effectively zero medical bankruptcies in a comparable year. In the United Kingdom, Canada, and Germany, medical bills cause a fraction of the financial devastation they do here.
The Spending Paradox
The numbers warrant slowing down for a moment. The U.S. spends more than twice the OECD average on healthcare per capita, yet ranks dead last in life expectancy among G7 nations. Infant mortality is higher here than in comparable countries. Diabetes goes unmanaged at higher rates. Maternal mortality during childbirth is significantly worse. According to the Peterson-KFF Health System Tracker, healthcare spending has grown faster in the United States than in peer countries while life expectancy has grown slower.
The gap is not driven by Americans being sicker at baseline or having greater healthcare needs. Prices, according to multiple comparative analyses, are the primary driver. Americans pay more for the same drugs, the same procedures, the same hospital stays than patients in other rich democracies, largely because the United States has no structural mechanism to negotiate or cap those prices.
Roughly 66.5% of personal bankruptcies in the United States are linked to medical expenses. In France, with its single-payer system, there were effectively zero.
Half of U.S. adults report they cannot cover an unexpected $500 healthcare bill out of pocket. Approximately 31 million Americans borrowed $74 billion last year just to pay medical bills. Thirty-eight percent of adults skipped, delayed, or went without recommended care in the past 12 months because of cost.
What the "Big Beautiful Bill" Does to This Problem
Congress is currently moving in the opposite direction. The Congressional Budget Office estimated that the One Big Beautiful Bill Act would cut federal Medicaid spending by more than $900 billion over a decade. The same estimate projects 10.9 million Americans would lose health insurance coverage, with broader projections reaching 16 million when Affordable Care Act marketplace losses are included.
The bill pairs those Medicaid cuts with roughly $1 trillion in tax relief weighted toward the wealthiest households. The distribution is direct: people with the least capacity to absorb medical costs lose coverage, while those with the most capacity to pay retain their tax advantages.
Work reporting requirements, one of the bill's core mechanisms, are projected by CBO to push 4.8 million people off Medicaid by 2034. Most of those people are working. The requirement does not create jobs or improve health. It creates a paperwork compliance regime that generates coverage losses among people who meet the eligibility criteria but cannot navigate the bureaucratic process to prove it.
The Regulated Path Other Countries Already Took
Universal coverage has not required identical system design across the countries that have achieved it. Germany runs its healthcare through regulated, competing private insurers, with out-of-pocket costs capped based on income. The Netherlands uses a similar model. Switzerland has universal mandates with private insurers and income-linked subsidies. France operates a public system with private supplementary coverage. Each of these models preserves market dynamics where they add efficiency while eliminating the condition under which a medical emergency can produce financial ruin.
More than 30 OECD nations have built regulated frameworks, ranging from single-payer to regulated private insurers, that eliminate medical bankruptcy as a standard outcome. The United States has the revenue, the institutional infrastructure, and those working models available to study. In 2024, it spent $14,775 per person on a system that still sent 31 million people into debt just to cover their bills. The current legislative direction reduces coverage for the most financially exposed Americans while delivering tax cuts to the wealthiest.
Sources
- How Does Health Spending in the U.S. Compare to Other Countries? (Peterson-KFF Health System Tracker)
- 100 Million People in America Are Saddled With Health Care Debt (KFF Health News / NPR)
- Medical Bankruptcies by Country 2026 (World Population Review)
- The U.S. Spends More on Health Care Than Any Wealthy Nation, But American Lifespans Are Shorter (Fortune, 2025)
- $1 Trillion in Medicaid Cuts, $1 Trillion in Tax Giveaways for the Richest 1% (Center for American Progress)
- How Does the U.S. Healthcare System Compare to Other Countries? (Peter G. Peterson Foundation)
- Health Care Bankruptcies Drop in 2025, But That Doesn't Mean All Is Well for 2026 (Medical Economics)
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