Spending a staggering $4.5 trillion annually and delivering some of the most expensive and unequal health outcomes in the developed world, the United States healthcare system is a behemoth of contradictions, defined as much by its groundbreaking innovation as by its profound disparities and soaring costs.
Key Takeaways
- In 2022, national health expenditures in the United States totaled $4.5 trillion, representing 17.3% of the nation's Gross Domestic Product.
- Per capita health spending in the US reached $12,914 in 2022, more than double the average of comparable OECD countries.
- Prescription drug spending accounted for 9.0% of total national health expenditures in 2022, amounting to $405.5 billion.
- In 2021, 8.6% of Americans, or 28.9 million people, were uninsured.
- Medicaid covered 85.2 million people in FY 2022, including expansions under the ACA.
- Employer-sponsored insurance covered 155 million non-elderly adults in 2022.
- 86.5% of US adults had a usual source of care in 2022.
- 24.1% of adults delayed medical care due to cost in 2022.
- Rural Americans are 20% less likely to have a primary care physician compared to urban.
- Life expectancy at birth in the US was 77.5 years in 2022, below pre-pandemic levels.
- Infant mortality rate was 5.44 per 1,000 live births in 2022.
- Age-adjusted cancer death rate fell to 146.4 per 100,000 in 2021.
- Active physicians per 1,000 population: 2.6 in US vs. 3.5 OECD average.
- Nurse practitioners: 355,000 licensed in 2023.
- Registered nurses: 3.3 million employed in 2022.
US healthcare spending is extraordinarily high yet leaves many Americans underinsured and without adequate care.
Access to Care
186.5% of US adults had a usual source of care in 2022.
Verified224.1% of adults delayed medical care due to cost in 2022.
Verified3Rural Americans are 20% less likely to have a primary care physician compared to urban.
Verified4Emergency department visits totaled 139 million in 2022.
Directional5Only 56% of US adults received recommended preventive services in 2021.
Single source611.2% of children lacked a usual source of care in 2022.
Verified7Telehealth utilization surged to 43% of adults post-pandemic in 2022.
Verified878 million Americans live in primary care Health Professional Shortage Areas.
Verified9Average wait time for new patient specialist appointment is 26 days nationally.
Directional1028% of low-income adults skipped needed care due to cost in 2022.
Single source11Dental care access: 65 million Americans live in dental HPSAs.
Verified12Mental health treatment gap: 15 million adults with serious mental illness untreated.
Verified1340% of rural hospitals are at risk of closure due to access issues.
Verified14Mammography screening rates: 78.4% of women aged 50-74 in 2020.
Directional15Colorectal cancer screening: 72.5% of adults 45-75 in 2021.
Single source1619% of adults report trouble finding a new primary care provider.
Verified17Home health care recipients numbered 12 million in 2022.
Verified1850% of Americans live within 10 miles of a hospital emergency department.
Verified1937.1% of adults had PCP visit in past year 2022.
Directional20Cost-related avoidance of prescriptions: 18% adults 2022.
Single source21Mental health provider shortage areas cover 107 million.
Verified22Outpatient visits: 919 million in 2021.
Verified23Unmet dental needs due to cost: 12% adults.
Verified24Average time to mental health appt: 25 days.
Directional251 in 5 adults report fair/poor access to specialists.
Single source26FQHC visits: 140 million in 2022.
Verified27Vision care access: 30% skipped due to cost.
Verified28Postpartum care within 21 days: only 54% receive.
Verified29Urgent care centers: 11,000 nationwide 2023.
Directional30Cancer screening disparities: Black women 68% mammograms.
Single source31Long-term care waitlists: 600,000 for Medicaid HCBS.
Verified32Pharmacy deserts affect 1 in 8 rural residents.
Verified33Pediatric wait times average 27 days new patient.
Verified34Hospice care access: 1.55 million beneficiaries 2021.
Directional35Avoided care due to transportation: 6% adults.
Single sourceAccess to Care Interpretation
The American healthcare system presents a paradox of high-tech convenience and profound neglect, where most people have a doctor in theory but face a gauntlet of delays, costs, and shortages that force them to gamble with their health until an emergency makes the choice for them.
Insurance and Coverage
1In 2021, 8.6% of Americans, or 28.9 million people, were uninsured.
Verified2Medicaid covered 85.2 million people in FY 2022, including expansions under the ACA.
Verified3Employer-sponsored insurance covered 155 million non-elderly adults in 2022.
Verified4Medicare enrolled 65.0 million beneficiaries in 2023, with 50.1 million in traditional Medicare.
Directional5Marketplace enrollment under the ACA reached a record 21.3 million in 2024.
Single source691.4% of the US population had health insurance coverage in 2022.
Verified7Children under 19 had an uninsured rate of 5.4% in 2022, down from 9.4% pre-ACA.
Verified8TRICARE and other VA/DoD coverage served 9.3 million people in 2022.
Verified9Direct-purchase insurance covered 10.5 million non-elderly adults in 2022.
Directional10Uninsured rate among non-elderly adults dropped to 9.3% in 2022 from 16.0% in 2010.
Single source1127.4 million nonelderly individuals remained uninsured in 2022 despite ACA gains.
Verified12Medicaid/CHIP covered 38% of US children under 19 in FY 2022.
Verified13Average Marketplace premium before subsidies was $591 per month in 2023.
Verified1493% of Marketplace enrollees received premium tax credits in 2023.
Directional15Medicare Advantage enrollment hit 31 million in 2023, 51% of beneficiaries.
Single source16In 2022, 13.9% of non-elderly Black Americans were uninsured, compared to 7.9% of whites.
Verified17Hispanic uninsured rate was 18.2% for non-elderly in 2022.
Verified1892 million Americans were underinsured in 2022, facing high out-of-pocket costs.
Verified19In 2021, 41% of working-age Americans were inadequately insured.
Directional20CHIP enrollment stood at 9.1 million children in FY 2022.
Single source21Uninsured rate for adults 18-64: 11.1% in 2023.
Verified2214.5 million enrolled in Medicaid expansion by 2023.
Verified23Employer coverage stability: 49% of firms offer in 2023.
Verified24Dual-eligible Medicare-Medicaid: 12.4 million in 2022.
Directional25Off-Marketplace individual coverage: 5.5 million in 2022.
Single source26Coverage gains reversed slightly: uninsured up 1 million 2022-2023.
Verified27Asian American uninsured rate: 5.1% non-elderly 2022.
Verified28Short-term plans cover 3 million, often inadequate.
Verified29Average silver plan premium: $456/month pre-subsidy 2024.
Directional30Medicaid disenrollment post-unwinding: 20 million by 2024.
Single source31Employer plans cover 180 million total lives 2023.
Verified32AIAN uninsured rate: 19.1% non-elderly 2022.
Verified33Underinsured defined as spending >10% income on premiums.
Verified34VA coverage: 9.1 million veterans enrolled 2023.
Directional3525% of uninsured cite cost as main barrier 2023.
Single source368.4% uninsured rate overall in first half 2023.
VerifiedInsurance and Coverage Interpretation
While we've heroically patched together a quilt of coverage that now drapes over 91.4% of Americans, the remaining threads—27.4 million still uncovered, rampant underinsurance, and stark racial disparities—reveal a fabric that is still uncomfortably threadbare for far too many.
Quality and Outcomes
1Life expectancy at birth in the US was 77.5 years in 2022, below pre-pandemic levels.
Verified2Infant mortality rate was 5.44 per 1,000 live births in 2022.
Verified3Age-adjusted cancer death rate fell to 146.4 per 100,000 in 2021.
Verified4Maternal mortality ratio was 32.9 deaths per 100,000 live births in 2021.
Directional5Heart disease remains the leading cause of death, with 695,000 deaths in 2022.
Single source6US ranks last among 11 high-income countries in amenable mortality.
Verified7Hospital-acquired infections affect 1 in 31 patients, costing $45 billion annually.
Verified830-day hospital readmission rate for Medicare patients is 15.3%.
Verified9Avoidable hospitalizations per 100,000 population: 1,800 in US vs. 500 in top countries.
Directional10Obesity prevalence among adults: 41.9% in 2021-2023.
Single source11Diabetes prevalence: 14.7% of adults, or 38.4 million in 2022.
Verified12Opioid overdose deaths: 81,806 in 2022.
Verified13Suicide rate: 14.2 per 100,000 in 2021.
Verified14Hospital patient safety grade: Only 30% of hospitals earn A from Leapfrog.
Directional15Postoperative mortality within 30 days: 1.4% for elective surgery.
Single source16Breast cancer 5-year survival rate: 91.1% in US.
Verified17Stroke death rate: 37.2 per 100,000 in 2022.
Verified18Alzheimer's disease deaths: 119,399 in 2021.
Verified19COVID-19 deaths totaled 1.1 million through 2023.
Directional20Preventive care effectiveness: 55% adherence to USPSTF recommendations.
Single source21Drug overdose death rate 32.6 per 100k 2022.
Verified22Preterm birth rate 10.41% in 2022.
Verified23Kidney disease death rate 14.5 per 100k.
Verified24HCAHPS scores: 73% rate hospital 9-10.
Directional25Sepsis mortality: 15-30% in hospitals.
Single source26COPD death rate 41.0 per 100k 2022.
Verified275-year survival for prostate cancer: 97.1%.
Verified28Influenza deaths average 34,000 annually.
Verified29Central line infections reduced 44% since 2015.
Directional30Low birthweight rate 8.52% 2022.
Single source31Firearm homicide rate 6.5 per 100k 2021.
Verified32C. diff infections: 29,000 deaths yearly.
Verified33Melanoma survival 5-year: 94.4%.
Verified34Unintentional injury death rate 61.6 per 100k.
Directional35Palliative care availability in 87% of hospitals.
Single source36Child mortality rate under 5: 6.0 per 1k.
Verified37HIV death rate 1.9 per 100k 2021.
Verified38Hospital mortality index average 0.95.
VerifiedQuality and Outcomes Interpretation
The American healthcare system is a dazzling paradox where we can perform medical miracles on demand while simultaneously failing at the fundamentals, like keeping people alive longer than the 1980s, not infecting them when they come for help, or preventing them from needing to come at all.
Spending and Costs
1In 2022, national health expenditures in the United States totaled $4.5 trillion, representing 17.3% of the nation's Gross Domestic Product.
Verified2Per capita health spending in the US reached $12,914 in 2022, more than double the average of comparable OECD countries.
Verified3Prescription drug spending accounted for 9.0% of total national health expenditures in 2022, amounting to $405.5 billion.
Verified4Hospital care expenditures grew by 6.5% in 2022 to $1.3 trillion, driven by increased utilization post-COVID.
Directional5Medicare spending increased by 6.6% to $944.3 billion in 2022, representing 21% of total NHE.
Single source6Private health insurance spending rose 10.7% to $1.3 trillion in 2022, the fastest growth since 1984.
Verified7Out-of-pocket spending by Americans was $433.7 billion in 2022, or 9.7% of total health expenditures.
Verified8Administrative costs in the US healthcare system consume about 8% of total health spending, compared to 1-3% in other countries.
Verified9The average family health insurance premium in 2023 was $23,968, up 7% from 2022.
Directional10US healthcare spending per capita is projected to reach $14,160 by 2031.
Single source11In 2022, national health expenditures grew 4.1% to $4.5 trillion.
Verified12Retail prescription drugs cost $461 billion in 2023 projections.
Verified13Medicaid spending grew 9.7% to $824 billion in 2022.
Verified14Physician and clinical services spending: $807 billion in 2022.
Directional15Nursing care facilities spending up 4.3% to $175 billion.
Single source16Health spending growth averaged 4.5% annually 2018-2022.
Verified17US spends 31% more on admin than Canada per capita.
Verified18Average deductible for single coverage: $1,735 in 2023.
Verified19Hospital prices rose 47% from 2001-2020.
Directional20Freestanding ER spending per visit: $1,794 vs. $1,309 hospital.
Single sourceSpending and Costs Interpretation
We are spending twice as much as other wealthy nations for a system where nearly a fifth of every dollar goes to healthcare, a growing share of our paychecks gets devoured by insurance premiums, and the only thing outpacing our spending is our administrative paperwork.
Workforce
1Active physicians per 1,000 population: 2.6 in US vs. 3.5 OECD average.
Verified2Nurse practitioners: 355,000 licensed in 2023.
Verified3Registered nurses: 3.3 million employed in 2022.
Verified4Physician shortage projected at 37,800-124,000 by 2034.
Directional547% of physicians reported burnout in 2022.
Single source6Dental hygienists: 213,000 in 2022.
Verified7Pharmacists: 330,000 employed in 2022.
Verified8Home health aides: 4.1 million in 2022.
Verified9Average physician age: 52.5 years in 2022.
Directional10International medical graduates comprise 25% of US physicians.
Single source11Nurse turnover rate: 27.2% in hospitals in 2022.
Verified12Primary care physicians: 93.9 per 100,000 population.
Verified13Psychiatrists: 12.0 per 100,000 adults.
Verified14OB/GYNs: 25.6 per 100,000 women aged 15-44.
Directional15Rural physician shortage: 60.7 per 100,000 vs. 84.5 urban.
Single source16Medical residents: 140,000 in ACGME programs in 2023.
Verified17Physician assistants: 148,000 in 2022.
Verified18Turnover intent among nurses: 31% plan to leave in 2023.
Verified1976% of physicians are employees, up from 60% in 2019.
Directional20Average annual wage for physicians: $239,200 in 2022.
Single source21RN median wage: $81,220 in 2022.
Verified22Active dentists: 200,000 in 2022.
Verified23Optometrists: 42,000 practicing.
Verified24Physical therapists: 258,000 in 2022.
Directional25Burnout among nurses: 62% in 2022.
Single source26Geriatricians shortage: only 7,000 for 50 million seniors.
Verified27Surgical specialists: 20% of physician workforce.
Verified28LPNs: 657,000 employed 2022.
Verified29Rural nurse shortage: 17% vacancy rate.
Directional30IMG retention: 80% stay post-residency.
Single source31Midwives: 13,000 certified 2023.
VerifiedWorkforce Interpretation
While we are training an army of nurses and assistants to fill the ranks, we are simultaneously bleeding them dry through burnout and high turnover, all while our aging core of doctors shrinks relative to demand, creating a healthcare system frantically trying to build a house while half the builders are quitting and the architects are retiring.
Sources & References
- Reference 1CMScms.govVisit source
- Reference 2HEALTHSYSTEMTRACKERhealthsystemtracker.orgVisit source
- Reference 3HEALTHAFFAIRShealthaffairs.orgVisit source
- Reference 4KFFkff.orgVisit source
- Reference 5AHAaha.orgVisit source
- Reference 6BMJbmj.comVisit source
- Reference 7CENSUScensus.govVisit source
- Reference 8MEDICAIDmedicaid.govVisit source
- Reference 9CDCcdc.govVisit source
- Reference 10COMMONWEALTHFUNDcommonwealthfund.orgVisit source
- Reference 11GALLUPgallup.comVisit source
- Reference 12RURALHEALTHINFOruralhealthinfo.orgVisit source
- Reference 13MCHBmchb.hrsa.govVisit source
- Reference 14MCKINSEYmckinsey.comVisit source
- Reference 15BHWbhw.hrsa.govVisit source
- Reference 16MERRITT-HAWKINSmerritt-hawkins.comVisit source
- Reference 17NAMInami.orgVisit source
- Reference 18CHARTISchartis.comVisit source
- Reference 19AMA-ASSNama-assn.orgVisit source
- Reference 20NAHCnahc.orgVisit source
- Reference 21DATAdata.cms.govVisit source
- Reference 22OECDoecd.orgVisit source
- Reference 23NIDAnida.nih.govVisit source
- Reference 24HOSPITALSAFETYSCOREhospitalsafetyscore.orgVisit source
- Reference 25AHRQahrq.govVisit source
- Reference 26SEERseer.cancer.govVisit source
- Reference 27ALZalz.orgVisit source
- Reference 28AAMCaamc.orgVisit source
- Reference 29AANPaanp.orgVisit source
- Reference 30BLSbls.govVisit source
- Reference 31MAYOCLINICPROCEEDINGSmayoclinicproceedings.orgVisit source
- Reference 32AAFPaafp.orgVisit source
- Reference 33NURSINGWORLDnursingworld.orgVisit source
- Reference 34ACOGacog.orgVisit source
- Reference 35ACGMEacgme.orgVisit source
- Reference 36NSIONLINEnsionline.comVisit source
- Reference 37ASPEaspe.hhs.govVisit source
- Reference 38CBPPcbpp.orgVisit source
- Reference 39VAva.govVisit source
- Reference 40PSYCHIATRYpsychiatry.orgVisit source
- Reference 41BPHCbphc.hrsa.govVisit source
- Reference 42AARPaarp.orgVisit source
- Reference 43URGENTCAREASSOCIATIONurgentcareassociation.orgVisit source
- Reference 44PROGRESSREPORTprogressreport.cancer.govVisit source
- Reference 45RURALHEALTHQUARTERLYruralhealthquarterly.comVisit source
- Reference 46RWJFrwjf.orgVisit source
- Reference 47LUNGlung.orgVisit source
- Reference 48MARCHOFDIMESmarchofdimes.orgVisit source
- Reference 49CAPCcapc.orgVisit source
- Reference 50LEAPFROGGROUPleapfroggroup.orgVisit source
- Reference 51ADAada.orgVisit source
- Reference 52RCNrcn.org.ukVisit source
- Reference 53AMERICANGERIATRICSamericangeriatrics.orgVisit source
- Reference 54RURALHEALTHruralhealth.usVisit source
- Reference 55ACNMacnm.orgVisit source