Health expenditure
Financial resources for health are unevenly distributed geographically. Australia, Japan and Singapore have higher health expenditure per capita than the OECD average (USD 4 100, 2018), while most of Asia/Pacific economies spend less than the Asia/Pacific average (USD 1 090). On average across the Asia/Pacific, two-thirds of health expenditure is financed by governments or compulsory insurance schemes, and the rest is financed from voluntary schemes or concerns households’ out-of-pocket expenses (Figure 5.10). More than 80% of total health expenditure in Bhutan, Brunei Darussalam, Japan, Thailand, Tonga and Samoa were financed publicly in 2018, while in countries with a lower GDP per capita such as Armenia, Bangladesh and Turkmenistan, three-quarters of total health expenditure were financed privately.
On average the Asia/Pacific economies experienced annual growth in real health expenditure in GDP per capita of 6.4% over the 2010-18 period (Figure 5.11). Spending on health expenditure per capita in China, Timor-Leste and Turkmenistan grew rapidly in comparison to the growth-rate of GDP per capita. In contrast, in Fiji, Georgia and Lao PDR health expenditure increased by less than what might have been expected on basis of the annual increase in GDP per capita.
Health expenditure as a percentage of GDP grew steadily in most Asia/Pacific countries over the past decade (Figure 5.12). However, compared with the OECD average (8.7%), average health expenditure in the Asia/Pacific region remains relatively low (5.2%). There is also considerable variation across the region: health expenditure in some South East Asian countries such as Bangladesh, Brunei Darussalam, Indonesia, Kazakhstan, Lao PDR and Papua New Guinea was less than 3% of GDP in 2018, while it was in excess of 10% of GDP in Armenia and Japan.
Heath expenditure measures the final consumption of health goods and services. This includes spending by both public and private sources on medical services and goods, public health and prevention programmes and administration, but excludes spending on capital formation (investments). To compare spending levels across countries, per capita health expenditures are converted to a common currency (USD) and adjusted to take account of the different purchasing power of the national currencies (PPPs).
The financing of health care can be analysed from the point of view of the sources of funding (households, employers and the state), financing schemes (compulsory or voluntary insurance), and financing agents (organisations managing the financing schemes). Here “financing” is used in the sense of financing schemes as defined in the System of Health Accounts (OECD/WHO/Eurostat, 2011). Public financing includes expenditure by the general government and social security funds. Private financing covers households’ out-of-pocket payments, private health insurance and other private funds (NGOs and private corporations).
Source: WHO (2021), Global Health Expenditure Database.
Source: WHO (2021), Global Health Expenditure Database; OECD (2021), OECD Health Statistics.