US Health Care Costs 2024: $15,474 Per Person, 18% of GDP

Key Takeaways

• $15,474 per person in 2024 — total US health spending reached $5.3 trillion (18.0% of GDP), per CMS National Health Expenditure Accounts. On the basis used for international comparison, the US spent $14,775 per person — about 1.9× the $7,860 average of comparable wealthy countries (Peterson-KFF).
• Worst outcomes among peers. The Commonwealth Fund's 2024 Mirror Mirror report ranks the US health system 10th of 10 high-income countries overall, and last on access to care and health outcomes; the US scores well only on care process (2nd). US life expectancy was 79.0 years in 2024 (CDC), versus 84.1 in Japan (OECD, 2023).
• Seven structural drivers explain the gap — not one of them is "individual choice." Layered middlemen, admin overhead, brand drug pricing, hospital consolidation, defensive medicine, price opacity, and employer-tied insurance compound into a system that bills more for less.
• Millions without financial protection. 26.7 million under-65s were uninsured in 2024 (KFF), and 23% of all working-age adults had coverage all year yet were underinsured (Commonwealth Fund, 2024).
• Reform is moving, slowly. Medicare Drug Negotiation (IRA 2022, effective 2026), the Hospital Price Transparency Rule, and the No Surprises Act target specific layers — but the paradox persists: highest spending, worst peer outcomes.

How Much Does the US Spend on Health Care? (2024 Figures)

The United States spent $5.3 trillion on health care in 2024 — $15,474 per person, equal to 18.0% of gross domestic product — and total spending grew 7.2% over 2023 (CMS National Health Expenditure Accounts).

Three per-person figures circulate, and each measures something different. $15,474 is total national health expenditure, including investment in research, structures and equipment. $14,775 is health consumption expenditure (CMS Table 1), the figure the Peterson-KFF Health System Tracker uses in the country table below. $14,885 is the OECD's purchasing-power-adjusted estimate of current health spending, published in November 2025 as a provisional figure. The share of GDP differs for the same reason: 18.0% (CMS, total) versus 17.2% (OECD, current health spending).

On the OECD's figures, the US spent about 2.5 times the OECD average per person in 2024: $14,885 versus $5,967. The OECD average share of GDP spent on health was 9.3%; the US spent 17.2%, "well above Germany, the next highest spender (at 12.3%)". Per person, Germany spent $9,365, France $7,367 and the United Kingdom $6,747 (OECD, Health at a Glance 2025, provisional 2024 data).

Seven Structural Drivers

The cost gap is not explained by individual consumer behavior, technological innovation, or sicker patients. It is the cumulative result of seven documented structural drivers, each anchored to peer-reviewed or regulatory sources.

1. ①

   Layered Middlemen

   The top 3 PBMs control 79% of US prescription claims (FTC Interim Staff Report, July 2024). Each layer — insurer, PBM, group purchasing organization, third-party administrator — extracts margin without delivering care.

2. ②

   Administrative Overhead

   In 2017, administration consumed 34.2% of US health spending ($2,497 per person) versus 17.0% in Canada ($551) (Himmelstein & Woolhandler, Annals of Internal Medicine, 2020).

3. ③

   Brand Drug Prices

   In 2022, US drug prices were 2.78× those in 33 other OECD countries across all drugs, and 4.22× for brand-name drugs before rebates (RAND, 2024). For insulin, the average US manufacturer price per standard unit was $98.70 versus $12.00 in Canada (RAND for HHS ASPE, 2018 data).

4. ④

   Hospital Consolidation

   In 2016, 90% of US metropolitan areas had highly concentrated hospital markets (Fulton, Health Affairs 2017). Prices at monopoly hospitals are 12% higher than in markets with four or more rivals (Cooper, Craig, Gaynor, Van Reenen — QJE 2019).

5. ⑤

   Defensive Medicine

   Defensive medicine was estimated at $45.6 billion in 2008, within $55.6 billion in total medical-liability costs — about 2.4% of US health spending (Mello, Chandra, Gawande, Studdert — Health Affairs 2010). The cost is embedded in every facility fee.

6. ⑥

   Price Opacity

   In a November 2024 review of 2,000 US hospitals, the advocacy group PatientRightsAdvocate.org found only 21.1% fully compliant with the federal Hospital Price Transparency Rule (34.5% in its February 2024 review). Without usable prices, patients cannot shop on cost.

7. ⑦

   Employer-Tied Insurance

   49% of Americans get coverage through employers; family premiums averaged $28,303 in 2026 (KFF Employer Health Benefits Survey). The tax exclusion subsidizes the system that drives admin overhead and ties coverage to jobs ('job lock').

What Uninsured and Underinsured Americans Live With

System-level statistics translate into household-level exposure. 26.7 million Americans under 65 were uninsured in 2024 (9.8%, KFF analysis of Census data). 23% of working-age adults (19–64) were underinsured in 2024 — insured all year, but with out-of-pocket costs (excluding premiums) or deductibles that were high relative to income (Commonwealth Fund 2024 Biennial Health Insurance Survey).

In a 2013–2016 survey of bankruptcy filers, 66.5% cited medical bills or illness-related income loss as a contributing factor (Himmelstein et al., AJPH 2019); other researchers using hospitalization data estimate a much smaller direct causal share (Dobkin et al., American Economic Review 2018). Surprise out-of-network bills were common before the No Surprises Act took effect in 2022, and "job lock" — staying in a job to keep employer coverage — remains a documented effect of tying insurance to employment.

These are not edge cases. They are predictable downstream effects of the seven drivers above — features of the system, not bugs.

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