In the United States, average employee premium contributions and deductibles as a percentage of median household income have risen in the past decade. In 2020, an employee’s total potential out-of-pocket medical costs (premium and deductible) amounted to 11.6 percent of median income. This included 6.9 percent in employee premium contributions and 4.7 percent in deductibles. However, states varied greatly in median income spent on premiums and deductibles, with workers in Mississippi having to spend on average 19 percent of their income on potential out-of-pocket medical costs.

Employer sponsored health insurance In 2020, over half of the U.S. population has some type of employment-based health insurance coverage. The Affordable Care Act penalizes large employers (with 50 or more full-time employees), if they do not provide health insurance to their employees. Nevertheless, of the uninsured aged under 65 years, the large majority worked either full or part-time (or someone in their household did).

Out-of-pocket medical costs Despite having insurance coverage, most plans have a deductible, the amount an insured must pay themselves that year before their insurance starts covering for them. The average annual deductible for single coverage amounted to roughly 1,700 U.S. dollars in 2021. Even after reaching their deductible, most insured have other forms of out-of-pocket health costs in the form of co-payments and co-insurance for health services or prescription drugs.

In 2020, an employee's premium contributions and deductibles were 10 percent or more of their state's median income in 37 states. Workers in Mississippi and New Mexico faced the highest total potential out-of-pocket medical costs relative to their income at 19 and 18.1 percent respectively. This statistic shows the percentage of state median income spent on premium contribution and deductible by U.S. employees in 2020, by state.

This statistic depicts the employees' health insurance contributions as a share of median income in the U.S. in 2021, by state. In that year, employees in Mississippi had to contribute 10.5 percent of the state's median income to health insurance. That was the highest shares employees in the U.S. had to spend.

The United States has the highest expenditure on health care per capita globally. However, the U.S. has an unique way of paying for their health care where a majority of the expenditure falls upon private insurances. In FY 2024, around one ***** of all health expenditure is paid by private insurance. Public insurance programs Medicare and Medicaid accounted for ** and ** percent, respectively, of health expenditure during that same year. U.S. health care system Globally health spending has been increasing among most countries. However, the U.S. has the highest public and private per capita health expenditure among all countries globally, followed by Switzerland. As of 2020, annual health care costs per capita in the United States totaled to over ** thousand U.S. dollars, a significant amount considering the average U.S. personal income is around ** thousand dollars. Out of pocket costs in the U.S. Aside from overall high health care costs for U.S. residents, the total out-of-pocket costs for health care have been on the rise. In recent years, the average per capita out-of-pocket health care payments have exceeded *** thousand dollars. Physician services, dental services and prescription drugs account for the largest proportion of out-of-pocket expenditures for U.S. residents.

In 2023, the South Korean government's public health insurance program National Health Insurance Service (NHIS) made up around **** percent of the total medical expenditure that year. The remaining **** percent of medical costs were taken on by private insurance companies. The NHIS has taken on a slowly increasing share of the total medical expenses. Medical expenditure in South Korea In 2023, South Korea’s total national medical expenditure amounted to about ***** trillion South Korean won. Both total and per capita spending have risen over the past decade, further leading to increases in premiums. The NHIS is a compulsory universal health insurance scheme run by the government and is financed by a payroll tax. It covers roughly ** percent of hospital inpatient costs. The role of private health insurance in South Korea With the NHIS only covering part of the insured’s medical costs, it is common in South Korea to pay for additional private health insurance. As this represents an additional cost on top of NHIS premiums, the share of households covered and the extent of personal health coverage varies by income. On average, privately insured households held **** private health insurance subscriptions. In comparison, low-income households only had **** subscriptions on average.

How much money does the Dutch government spend on healthcare? In 2021, the government expected to spend a total of 53.4 billion euros through the Zvw or the Health Insurance Act. This law covers the basic health insurance in the Netherlands that all residents and employees in the country are obliged to have. The numbers shown here indicate with which sources the government planned to afford this healthcare. The government expected that most money would go towards secondary care in 2019.

Health insurance in the Netherlands: two can play that game

The health system in the Netherlands has a hybrid character. The Dutch government, on the one hand, decides the contents of the mandatory basis health insurance on a yearly basis. Health insurance companies, on the other hand, have to offer this insurance as a product. They are not allowed to leave anybody out: any Dutch citizen, regardless of age or medical records, must be accepted in this insurance. The Netherlands had 11 health insurance concerns in 2019, which owned roughly 40 companies. Health insurance concern Achmea (formerly Zilveren Kruis) had a market share of approximately 30 percent, whereas the company Achmea Zorgverzekeringen N.V. had the most gross written premiums in this insurance segment.

How does the financing work exactly?

Dutch citizens have three ways to pay for the statutory health insurance, all three of which are mentioned in this statistic. First, the income related contribution (in Dutch: inkomens afhankelijke bijdrage) is a tax that is paid from one’s salary. The majority of the healthcare financing shown here was expected to come from this source: approximately 25 billion euros in 2019. Second, the nominal premium (in Dutch: nominale premie) is paid to health insurance companies and is a national average of the basic health insurance premium that the government expects these companies to use when they offer the product. The idea behind this is that free market competition forces companies to go below this average so as to curb increasing health costs (as the companies strive to make healthcare as affordable as possible in order to attract more customers). Third, the mandatory excess (in Dutch: verplichte eigen risico) is a fee the insured (18 years and older, younger ages are exempt from this) must have paid to healthcare during the year before the insurance starts to pay out. This serves the purpose of raising awareness on how expensive healthcare is.

Abstract

The main purpose of a Household Income and Expenditure Survey (HIES) was to present high quality and representative national household data on income and expenditure in order to update Consumer Price Index (CPI), improve statistics on National Accounts and measure poverty within the country.

The main objectives of this survey - update the weight of each expenditure item (from COICOP) and obtain weights for the revision of the Consumer Price Index (CPI) for Funafuti - provide data on the household sectors contribution to the National Accounts - design the structure of consumption for food secutiry - To provide information on the nature and distribution of household income, expenditure and food consumption patterns household living standard useful for planning purposes - To provide information on economic activity of men and women to study gender issues - To generate the income distribution for poverty analysis

The 2010 Household Income and Expenditure Survey (HIES) is the third HIES that was conducted by the Central Statistics Division since Tuvalu gained political independence in 1978.

This survey deals mostly with expenditure and income on the cash side and non cash side (gift, home production). Moreover, a lot of information are collected:

at a household level: - goods possession - description of the dwelling - water tank capacity - fruits and vegetables in the garden - livestock

at an individual level: - education level - employment - health

Geographic coverage

National Coverage: Funafuti and /Outer islands.

Analysis unit

• Household level
• Individual level

Universe

The scope of the 2010 Household Income and Expenditure Survey (HIES) was all occupied households in Tuvalu. Households are the sampling unit, defined as a group of people (related or not) who pool their money, and cook and eat together. It is not the physical structure (dwelling) in which people live. HIES covered all persons who were considered to be usual residents of private dwellings (must have been living in Tuvalu for a period of 12-months, or have intention to live in Tuvalu for a period of 12-months in order to be included in the survey). Usual residents who are temporary away are included as well (e.g., for work or a holiday).

All the private household are included in the sampling frame. In each household selected, the current resident are surveyed, and people who are usual resident but are currently away (work, health, holydays reasons, or border student for example. If the household had been residing in Tuvalu for less than one year: - but intend to reside more than 12 months => he is included - do not intend to reside more than 12 months => out of scope.

Kind of data

Sample survey data [ssd]

Sampling procedure

The Tuvalu 2010 Household Income and Expenditure Survey (HIES) outputs breakdowns at the domain level which is Funafuti and Outer Islands. To achieve this, and to match the budget constraint, a third of the households were selected in both domains. It was decided that 33% (one third) sample was sufficient to achieve suitable levels of accuracy for key estimates in the survey. So the sample selection was spread proportionally across all the islands except Niulakita as it was considered too small. The selection method used is the simple random survey, meaning that within each domain households were directly selected from the population frame (which was the updated 2009 household listing). All islands were included in the selection except Niulakita that was excluded due to its remoteness, and size.

For selection purposes, in the outer island domain, each island was treated as a separate strata and independent samples were selected from each (one third). The strategy used was to list each dwelling on the island by their geographical position and run a systematic skip through the list to achieve the 33% sample. This approach assured that the sample would be spread out across each island as much as possible and thus more representative.

Population and sample counts of dwellings by islands for 2010 HIES Islands: -Nanumea: Population: 123; sample: 41 -Nanumaga: Population: 117; sample: 39 -Niutao: Population: 138; sample: 46 -Nui: Population: 141; sample: 47 -Vaitupu: Population: 298; sample: 100 -Nukufetau: Population: 141; sample: 47 -Nukulaelae: Population: 78; sample: 26 -Funafuti: Population: 791; sample: 254 -TOTAL: Population: 1827; sample: 600.

Mode of data collection

Face-to-face [f2f]

Research instrument

3 forms were used. Each question is writen in English and translated in Tuvaluan on the same version of the questionnaire. The questionnaire was highly based on the previous one (2004 survey).

Household Schedule This questionnaire, to be completed by interviewers, is used to collect information about the household composition, living conditions and is also the main form for collecting expenditure on goods and services purchased infrequently.

• composition of the household and demographic profile of each members
• dwelling information
• dwelling expenditure
• transport expenditure
• education expenditure
• health expenditure
• land and property expenditure
• household furnishing
• home appliances
• cultural and social payments
• holydays/travel costs
• Loans and saving
• clothing
• other major expenditure items

Individual Schedule There will be two individual schedules: - health and education - labor force (individual aged 15 and above) - employment activity and income (individual aged 15 and above): wages and salaries working own business agriculture and livestock fishing income from handicraft income from gambling small scale activies jobs in the last 12 months other income childreen income tobacco and alcohol use other activities seafarer

Diary (one diary per week, on a 2 weeks period, 2 diaries per household were required) The diaries are used to record all household expenditure and consumption over the two week diary keeping period. The diaries are to be filled in by the household members, with the assistance from interviewers when necessary. - All kind of expenses - Home production - food and drink (eaten by the household, given away, sold) - Goods taken from own business (consumed, given away) - Monetary gift (given away, received, winning from gambling) - Non monetary gift (given away, received, winning from gambling).

Cleaning operations

Consistency of the data: - each questionnaire was checked by the supervisor during and after the collection - before data entry, all the questionnaire were coded - the CSPRo data entry system included inconsistency checks which allow the National Statistics Office staff to point some errors and to correct them with imputation estimation from their own knowledge (no time for double entry), 4 data entry operators. 1. presence of all the form for each household 2. consistency of data within the questionnaire

at this stage, all the errors were corrected on the questionnaire and on the data entry system in the meantime.

• after data entry, the extreme amount of each questionnaire where selected in order to check their consistency. at this stage, all the inconsistency were corrected by imputation on CSPRO editing.

Response rate

The final response rates for the survey was very pleasing with an average rate of 97 per cent across all islands selected. The response rates were derived by dividing the number of fully responding households by the number of selected households in scope of the survey which weren't vacant.

Response rates for Tuvalu 2010 Household Income and Expenditure Survey (HIES): - Nanumea 100% - Nanumaga 100% - Niutao 98% - Nui 100% - Vaitupu 99% - Nukufetau 89% - Nukulaelae 100% - Funafuti 96%

As can be seen in the table, four of the islands managed a 100 per cent response, whereas only Nukufetau had a response rate of less than 90 per cent.

Further explanation of response rates can be located in the external resource entitled Tuvalu 2010 HIES Report Table 1.2.

Sampling error estimates

The quality of the results can be found in the report provided in this documentation.

Per capita national health expenditures in the United States have increased significantly since 1960. In 2023, national health expenditures amounted to **** thousand U.S. dollars per capita. For comparison, in 1960, per capital expenditures for health stood at *** U.S. dollars. According to recent data, the U.S. has some of the highest health care costs in the world. Health care expenditures With increased per capita health expenditures, U.S. health care expenditures as a percentage of the gross domestic product (GDP) have also increased over the decades. Among developed countries, the U.S. has the highest health expenditure as a proportion of the GDP. The high level of health costs in the U.S. may be attributable to high costs for prescribed drugs and health services as well as high administrative costs. Cost areas A large proportion of all health care spending in the U.S. is attributable to hospital care and physician and clinical services. In recent years, many sectors have seen an increase in health care spending. However, data suggests that prescription drugs have seen some of the most dramatic increases in spending in recent years. The annual prescription drug expenditures in the U.S. reached an all-time high by the end of 2022.

In fiscal year 2023, the Children’s Health Insurance Program (CHIP) spent a total of about 23.2 billion U.S. dollars, of which 17.2 billion U.S. dollars were federal-funded and 5.9 billion U.S. dollars were state-funded. California had, as expected the highest spending and also the largest number of children enrolled in CHIP/Medicaid. The federal government matches spending for both Medicaid and CHIP, but has a higher match rate for CHIP than traditional Medicaid. The Federal Medical Assistance Percentage (FMAP) varies by state depending on the state's per capita income compared to the national average. This statistic illustrates CHIP spending in the United States in FY 2023, by state and state & federal share.

In 2023, U.S. national health expenditure as a share of its gross domestic product (GDP) reached 17.6 percent, this was an increase on the previous year. The United States has the highest health spending based on GDP share among developed countries. Both public and private health spending in the U.S. is much higher than other developed countries. Why the U.S. pays so much moreWhile private health spending in Canada stays at around three percent and in Germany under two percent of the gross domestic product, it is nearly nine percent in the United States. Another reason for high costs can be found in physicians’ salaries, which are much higher in the U.S. than in other wealthy countries. A general practitioner in the U.S. earns nearly twice as much as the average physician in other high-income countries. Additionally, medicine spending per capita is also significantly higher in the United States. Finally, inflated health care administration costs are another of the predominant factors which make health care spending in the U.S. out of proportion. It is important to state that Americans do not pay more because they have a higher health care utilization, but mainly because of higher prices. Expected developmentsBy 2031, it is expected that health care spending in the U.S. will reach nearly one fifth of the nation’s gross domestic product. Or in dollar-terms, health care expenditures will accumulate to about seven trillion U.S. dollars in total.

This statistic illustrates the health spending distribution of state and local government in the United States from 2013 to 2022. In 2022, 36 percent of state and local government health spending in the U.S. was spent on Medicaid. Health spending distributionHealth spending by the state and local government in the United States is divided among four major categories. As of 2021, 36 percent of spending was dedicated to Medicaid, 33 percent to private insurance premiums, 29 percent to other health programs, and three percent to Medicare payroll tax for state and local workers. In 1960, the majority of spending on prescription medications came from the consumer’s pocket, today out-of-pocket spending for prescriptions has decreased to about 13 percent. Among OECD countries, the United States spends the largest portion of its gross domestic product on health care expenditures, totaling nearly 17 percent in 2022. In comparison, the United Kingdom spent about 11.3 percent of the nation’s GDP on health care. High income countries spend over 6,100 U.S. dollars per capita compared to the world average of around 1,177 U.S. dollars per person. Health care spending in the United States has steadily risen over the last decades. In 1970, 355 U.S. dollars was expended on health care per capita in the United States; by 2021, this figure had risen to 12,591 U.S. dollars per capita. The increase in health care expenditure in the country may lie in parallel with the increase in premiums. Spending for hospitals, physicians, specialists, and dentists are significantly higher than other high income countries. Health care provider prices are especially high in the U.S. due to greater access to medical technologies as well as the obesity epidemic in the country.

In fiscal year 2021, the Children’s Health Insurance Program (CHIP) spent a total of about 20.9 billion U.S. dollars, of which 15.8 billion U.S. dollars were federal-funded and 5.1 billion U.S. dollars were state-funded. California had, as expected the highest spending and also the largest number of children enrolled in CHIP/Medicaid. The federal government matches spending for both Medicaid and CHIP, but has a higher match rate for CHIP than traditional Medicaid. The Federal Medical Assistance Percentage (FMAP) varies by state depending on the state's per capita income compared to the national average. This statistic illustrates CHIP spending in the United States in FY 2021, by state and state & federal share.

Among OECD member countries, the United States had the highest percentage of gross domestic product spent on health care as of 2023. The U.S. spent nearly ** percent of its GDP on health care services. Germany, France and Japan followed the U.S. with distinctly smaller percentages. The United States had both significantly higher private and public spending on health compared with other developed countries. Why compare OECD countries?OECD stands for Organization for Economic Co-operation and Development. It is an economic organization consisting of ** members, mostly high-income countries and committed to democratic principles and market economy. This makes OECD statistics more comparable than statistics of developed and undeveloped countries. Health economics is an important matter for the OECD, even more since increasing health costs and an aging population have become an issue for many developed countries. Health costs in the U.S.  A higher GDP share spent on health care does not automatically lead to a better functioning health system. In the case of the U.S., high spending is mainly because of higher costs and prices, not due to higher utilization. For example, physicians’ salaries are much higher in the U.S. than in other comparable countries. A doctor in the U.S. earns almost twice as much as the average physician in Germany. Pharmaceutical spending per capita is also distinctly higher in the United States. Furthermore, the U.S. also spends more on health administrative costs compare to other wealthy countries.

In 2019, Nigerian households spent on average 6.1 percent of their total annual expenditure on health. This share was lower in urban areas than in rural areas, where the expenditure peaked at 7.3 percent. Data on health insurance coverage show that only 1.4 percent of people living in rural areas had a health insurance. Overall, insurance coverage in Nigeria is very low. In particular, among individuals without education the coverage was below one percent.

In the fiscal year 2022, the national medical care expenses in Japan amounted to approximately **** trillion Japanese yen, an increase from around ** trillion Japanese yen in fiscal 2013. National medical care expenditure consists of the total public funding and medial expenditure paid by patients in Japan, as well as payments through the Japanese health insurance system. With over ** percent, the government provides a large share of expenses through the national treasury and municipality funds. Medical expenses per capita The national medical expenditure per capita has risen in the past decade, crossing the 300-thousand-yen mark in 2011. Several services are summarized under medical care expenses, among which are dental care, nursing care, as well as food and living expenses during hospitalization. Inpatient and outpatient services accounted for the highest per capita expenditure, with both amounting to over 100 thousand yen. Inpatient care describes the care of patients admitted to larger hospitals with beds. Outpatient services refer to treatments without overnight admissions conducted both at hospitals and small-scale medical clinics. Hospitals and medical clinics are the two main types of medical facilities in Japan, as opposed to general practitioners, private practices, or family doctors found in other countries. The prefecture with the highest individual expenditure Most recently, the Fukui prefecture was the Japanese region with the highest individual spending on health and fitness. Known for its large elderly population and the above-average longevity of its residents, thirty percent of surveyed Okinawans were willing to spend more money on health preservation.

California has more Medicaid and CHIP enrollees than any other state in the United States. As of April 2023, approximately 13 million Americans were enrolled in the Medicaid health insurance programs in California, which accounted for approximately 15 percent of the total number of Medicaid enrollees nationwide (94.4 million).

Blow to Medicaid expansion plans California is one of many states that has expanded its Medicaid program under the Affordable Care Act (ACA) to encourage more low-income adults to sign up for health coverage. One of the original aims of the ACA was to limit some of the variations in state Medicaid programs, but the Supreme Court ruled that the expansion should be optional. Governors of the states that did not expand said they were concerned about long-term costs. California is the leading state for Medicaid expenditure, spending approximately 97.8 billion U.S. dollars in FY2020.

Health coverage for children The Children’s Health Insurance Program (CHIP) was created as a complement to Medicaid, expanding the reach of government-funded health coverage to more children in low-income families. As of May 2021, over five million children were enrolled in Medicaid/CHIP programs in California, more than any other state. As of January 2021, the median Medicaid/CHIP eligibility level for children was 255 percent of the federal poverty level.

In September 2024, the disposable personal income in the United States increased by 0.3 percent from the previous month. The data are in current U.S. dollars, seasonally adjusted at annual rates. Disposable personal income in the United States According to the BEA, personal income is the income that is received by persons from all sources. It is calculated as the sum of wage and salary disbursements, supplements to wages and salaries, proprietors' income with inventory valuation and capital consumption adjustments, rental income of persons with capital consumption adjustment, personal dividend income, personal interest income, and personal current transfer receipts, minus contributions for government social insurance. In simple terms, disposable personal income is the total remaining income after taxes paid; it is the income available to persons for spending or saving. It is useful to economists because it measures the amount of money available for spending in a specific area. Disposable personal income is a significant indicator of an economy’s health. Personal income determines an individual’s ability to consume goods and services, i.e. personal consumption expenditure, and industries producing consumer goods and services contribute heavily to United States gross domestic product. The retail trade industry, for example, contributed 1.38 trillion chained U.S. dollars to the GDP of the United States in 2021. Total real GDP amounted to about 22.99 trillion U.S. dollars that year. The arts, entertainment, recreation, accommodation and food services industry contributed 839.6 billion U.S. dollars to the GDP in 2021. Personal income in the United States was 21.06 trillion U.S. dollars in 2021, the highest value in over ten years.

In 2023, the United States had the highest per capita health expenditure among OECD countries. At that time, per capita health expenditure in the U.S. amounted over ****** U.S. dollars, significantly higher than in Switzerland, the country with the second-highest per capita health expenditure. Norway, Germany and Austria are also within the top five countries with the highest per capita health expenditure. The United States also spent the highest share of it’s gross domestic product on health care, with **** percent of its GDP spent on health care services. Health Expenditure in the U.S. The United States is the highest spending country worldwide when it comes to health care. In 2022, total health expenditure in the U.S. exceeded **** trillion dollars. Expenditure as a percentage of GDP is projected to increase to approximately ** percent by the year 2031. Distribution of Health Expenditure in the U.S. Health expenditure in the United States is spread out across multiple categories such as nursing home facilities, home health care, and prescription drugs. As of 2022, the majority of health expenditure in the United States was spent on hospital care, accounting for a bit less than *** third of all health spending. Hospital care was followed by spending on physician and clinical services which accounted for ** percent of overall health expenditure.

In 2023, the gross median household income for Asian households in the United States stood at 112,800 U.S. dollars. Median household income in the United States, of all racial and ethnic groups, came out to 80,610 U.S. dollars in 2023. Asian and Caucasian (white not Hispanic) households had relatively high median incomes, while the median income of Hispanic, Black, American Indian, and Alaskan Native households all came in lower than the national median. A number of related statistics illustrate further the current state of racial inequality in the United States. Unemployment is highest among Black or African American individuals in the U.S. with 8.6 percent unemployed, according to the Bureau of Labor Statistics in 2021. Hispanic individuals (of any race) were most likely to go without health insurance as of 2021, with 22.8 percent uninsured.

In 2023, just four in ten Medicaid/CHIP enrollees were White, non-Hispanic. In comparison, roughly three-quarters of Medicare beneficiaries were White. The Affordable Care Act (ACA) Medicaid expansion in 2014, has helped reduce racial disparities in access to healthcare in the United States. Medicaid eligibility Medicaid provides health coverage to certain low-income individuals, families, children, pregnant women, the elderly, and persons with disabilities. Each state has its own Medicaid eligibility criteria in accordance with federal guidelines. As a result, Medicaid eligibility and benefits differ widely from state to state. Medicaid expansion provision under the Affordable Care Act (ACA) allows states to provide coverage for low-income adults by expanding eligibility for Medicaid to 138 percent of the federal poverty line (FPL). Medicaid coverage gap Uninsured individuals who live in states that have chosen not to expand Medicaid under the Affordable Care Act (ACA) are referred to as being in the Medicaid coverage gap. As of January 2021, 12 states have not adopted the Medicaid expansion provision under the Affordable Care Act (ACA). More than two million uninsured adults fall into this coverage gap, and among them, more than 60 percent are people of color.