Healthcare spending in all 31 Organisation for Economic Cooperation and Development (OECD) member nations is rising faster than their economic growth, pushing the average ratio of health spending to Gross Domestic Product (GDP) from 7.8% in 2000 to 9.0% in 2008, the Organisation reported yesterday.

The recent economic downturn, with GDP falling and healthcare costs rising, has led to some sharp increases in the ratio; in Ireland, for example, the percentage of GDP devoted to health increased from 7.5% in 2007 to 8.7% in 2008, while in Spain it rose from 8.4% to 9.0%, says the OECD. Factors pushing health spending up - technological change and population expectations and ageing - will continue to drive cost higher in the future, it adds.

The US spent $7,538 per person on health in 2008, well over double the $3,000 average of all OECD countries, while the next biggest spenders, Norway and Switzerland, spent much less than the US per capita but still some 50% more than the OECD average, the report notes.

Governments of most OECD countries shoulder the lion’s share of healthcare costs, and this percentage has risen from an average of 12% in 1990 to an all-time high of 16% in 2008. Given the urgent need to reduce their budget deficits, many OECD governments will have to make difficult choices to sustain their healthcare systems, ie curbing the growth of public spending on health, reducing spending in other areas or raising taxes, the Organisation warns.

New diagnostic technologies such as magnetic resonance imaging (MRI) units and computed tomography (CT) scanners are a major driver of spending growth. The number of MRI units more than doubled on average across OECD countries between 2000 and 2008, reaching 13 machines per million population in 2008, up from six in 2000, while 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 US, Italy and Greece than in other countries. These countries, along with Australia and Korea, also have more CT scanners, but there are big differences in their use per capita - far more in the US than in Canada, France or the Netherlands, notes the report, which examines health and health systems across the 31 OECD countries (including Chile, a new member this year) and three prospective members (Estonia, Israel and Slovenia).

Meantime, another new report shows that while the US health system is the world’s most expensive, it ranks last or next-to-last compared to Australia, Canada, Germany, the Netherlands, New Zealand and the UK on five dimensions of performance - quality, access, efficiency, equity and healthy lives – and in last place overall.

Most troubling is the fact that the US is failing to achieve better health outcomes than the other countries, and is last in terms of dimensions of access, patient safety, coordination, efficiency and equity, says the study, which is produced by the US Commonwealth Fund. The Netherlands ranks first in the comparison, followed closely by the UK and Australia, it says.