Health
The EU spends far less on health than the US, and people live longer. Most of it is paid with public money, but each country differs in how many doctors it has and how much patients pay themselves.
Between two giants
The US spends far more on health than anyone else. The EU spends less and lives longer.
In 2023, the US spent 16.7% of its GDP on health; the EU, 10%, and China, 5.9%. In 2000 the figures were 12.5%, 8.4% and 4.5%. The pandemic pushed spending up in 2020 and 2021, and it fell back afterwards.
The US spends 16.7% of its GDP on health; the EU, 10%, and China, less than 6%
Current health expenditure, public and private, as % of GDP
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Per person, the gap is even wider. The US spent $13,473 per person, 2.3 times as much as the EU ($5,806), measured at purchasing power parity. China spent $1,487. And yet people in the EU live three years longer than in the US: 81.4 years against 78.4 in 2023, as shown in the freedoms, well-being and climate theme.
Per person, the US spends 2.3 times as much on health as the EU
Current health expenditure per person, in current international dollars at purchasing power parity
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Is Europe losing, or choosing?
Europe chose healthcare paid mostly with public money. That does not make it free for patients.
In the EU, government and social security pay 74.4% of health spending. In the US, 54%, and in China, 57.1%. The gap has narrowed: in 2000, public spending was 44.4% of the total in the US and 22% in China, while in the EU it has barely changed (74.8%).
Three in every four euros of European healthcare are public; in the US and China, just over half
Health spending by government and social security, as % of current health expenditure
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But public funding does not always spare patients from paying. In 2023, US households paid 10.9% of health spending out of pocket; EU households, 14.9%. Only in Luxembourg, France and Croatia was the share lower than in the US. In Bulgaria, Latvia and Greece it is above 34%; in Spain, 20.9%. This is a share: since the US spends so much more, its households pay more money, $1,472 per person against $898 in the EU. Malta and Belgium exceed the US even on that measure.
In 24 of the 27 EU countries, patients pay a larger share of health spending out of pocket than in the US
Direct payments by households (co-payments, medicines, private visits), as % of current health expenditure
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Europe from within
Behind the European average lie very different systems, in doctors and in who goes without care.
In 2024, Greece, Italy and Austria had more than 560 practising doctors per 100,000 people. Latvia and Belgium, about 340. Spain, with 464, is above the median of the 27 (410). The series are not always comparable over time, which is why the chart shows only the latest year.
Greece, Italy and Austria have more than 560 doctors per 100,000 people; Latvia and Belgium, about 340
Practising physicians per 100,000 people, 2024
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The number of doctors does not tell the whole story. In 2025, 2.4% of Europeans aged 16 and over said they had gone without an examination or treatment they needed because of cost, distance or a waiting list. In Greece, which tops the ranking for doctors, it was 11.5%, mainly because of cost (8.8%). In Finland (7.8%) and Estonia (7.7%), mainly because of waiting lists. Since 2023, waiting lists have weighed more than cost across the EU as a whole. In Spain, 1.6%, almost all because of waiting, up from 0.4% in 2015 to 1.5%.
Cost keeps many Greeks from getting medical care; waiting lists, many Finns and Estonians
People aged 16 and over who report not getting a medical examination or treatment they needed, by reason, in %
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Other themes
- AI and digitalThe EU is adopting artificial intelligence faster than ever, but almost all the technology it uses is designed elsewhere.
- Trade and dependenciesFor decades the EU was the world's largest trading power. China has overtaken it, and Europe increasingly depends on others to buy and to sell.
- Productivity and growthThe EU weighs as much in the world economy as the United States, but it produces less per hour and much less per person. The question is how much of that gap is lagging behind and how much is choice.
- Freedoms, well-being and climateEurope lives longer, pollutes less and protects freedoms more than the United States or China. But those advantages are not equal across its countries, and some are eroding.
- Money and paymentsThe euro area holds more cash relative to its economy than the US and China, but uses it less and less to pay. Cards are filling the gap, largely through non-European networks. The digital euro is the EU's bet to keep public money present in electronic payments.
- Housing and the cost of livingHousing has risen less in the euro area than in the US, and so have rents. Almost seven in ten Europeans live in a home they own, but those renting at market prices bear far higher costs, and the gaps between countries in cost and space are huge.
- EnergyThe EU uses less than half as much energy per person as the US, and China has now overtaken it. Its electricity relies far less on fossil fuels, but renewables cover only a quarter of all its energy, and industry pays considerably more for power than before the 2022 crisis.