The resources that a country allocates to healthcare compared to the size of the overall economy vary over time due to differences in both the growth of health spending and overall economic growth. During the 1990s and 2000s, OECD countries generally saw health spending outpace the rest of the economy, leading to an almost continual rise in the health expenditure‑to-gross domestic product (GDP) ratio. After the volatility of the 2008 economic and financial crisis, this share remained relatively stable, as growth in health spending broadly matched overall economic performance across the OECD. In recent years, the COVID‑19 pandemic and the cost-of-living and energy crisis led to further adjustments in this ratio.
In 2024, OECD countries are estimated to have allocated around 9.3% of their GDP to health on average (Figure 7.1). This was above the ratio seen in 2023 but remained somewhat below the peak of 2020 and 2021, when the share jumped to 9.6%. However, the 2024 ratio was still significantly above the pre‑pandemic level of 2019, when OECD countries were dedicating around 8.8% of their GDP to health – a figure that had remained relatively stable since 2013. In 2024, the United States spent by far the most on health, equivalent to 17.2% of its GDP – and well above Germany, the next highest spender (at 12.3%). These are followed by a group of around 15 countries that all allocated 10‑12% of their GDP to healthcare. In many of the Central and Eastern European OECD countries, as well as in the newer OECD Member countries in Latin America, spending on health represented between 6‑9% of their GDP. Finally, Mexico and Türkiye spent less than 6% of their GDP on health.
An analysis of trends in per capita health spending and GDP over the past 20 years highlights two major shocks: the 2008 economic and financial crisis and the impact of COVID‑19 in 2020 (Figure 7.2). While OECD economies sharply contracted in 2009, health spending growth was briefly maintained before slowing to near zero between 2010 and 2012 as measures were introduced to contain public spending. This was followed by a return to moderate growth. In 2020, widespread lockdowns and other public health measures severely restricting economic activity sent many OECD economies into freefall, while health spending soared. Russia’s war on Ukraine, the energy crisis, and supply chain disruptions later led to high inflation and slower-than-expected growth in 2022 and 2023. As countries moved beyond the acute phase of COVID‑19, real per capita health spending declined on average by 2.5% in 2022 and stagnated in 2023. However, in 2024, health spending began to return to pre‑pandemic growth rates, with per capita expenditure estimated to have increased by more than 3% in real terms.
Trends in the health expenditure‑to-GDP ratio over this period translate into a distinct pattern with significant step increases in 2009 and 2020, and a period of stability in between (Figure 7.3). Italy and the United Kingdom, for example, closely followed this trend, with the latter showing an even more pronounced jump in 2020 and maintaining elevated levels through 2024. In contrast, Italy’s ratio has gradually declined since the pandemic peak, falling below pre‑pandemic levels. Germany has seen a rather continual increase in the share of GDP over time. Throughout the period, the United States allocated by far the highest proportion of their economic output to health among all OECD countries, exceeding 17% in 2024 after peaking at 18.5% in 2020. Despite the various shocks, health spending as a share of GDP in Korea has seen a near continual and steady increase throughout the last 20 years until 2022, when the share peaked at 8.8% before declining slightly.
