Politics
U.S. Healthcare is a Global Outlier, and Not in a Good Way
Historically, the United States has spent more money than any other country on healthcare.
In the late 1990s, for example, the U.S. spent roughly 13% of GDP on healthcare, compared to about a 9.5% average for all high income countries.
However, in recent years, the difference has become more stark. Last year, as Obamacare continued to roll out, costs in the U.S. reached an all-time high of 17.5% of GDP. That’s over $3 trillion spent on healthcare annually, and the rate of spending is expected accelerate over the next decade.
High Costs, High Benefit?
With all that money being poured into healthcare, surely the U.S. must be getting better care in contrast to other high income countries.
At least, that’s what one would think.
Today’s chart comes to us from economist Max Roser (h/t @NinjaEconomics) and it shows the extreme divergence of the U.S. healthcare system using two simple stats: life expectancy vs. health expenditures per capita.
The Divergence of U.S. Healthcare
As you can see, Americans are spending more money – but they are not receiving results using the most basic metric of life expectancy. The divergence starts just before 1980, and it widens all the way to 2014.
It’s worth noting that the 2015 statistics are not plotted on this chart. However, given that healthcare spend was 17.5% of GDP in 2015, the divergence is likely to continue to widen. U.S. spending is now closing in on $10,000 per person.
Perhaps the most concerning revelation from this data?
Not only is U.S. healthcare spending wildly inefficient, but it’s also relatively ineffective. It would be one thing to spend more money and get the same results, but according to the above data that is not true. In fact, Americans on average will have shorter lives people in other high income countries.
Life expectancy in the U.S. has nearly flatlined, and it hasn’t yet crossed the 80 year threshold. Meanwhile, Chileans, Greeks, and Israelis are all outliving their American counterparts for a fraction of the associated costs.
Economy
The Bloc Effect: International Trade with Geopolitical Allies on the Rise
Rising geopolitical tensions are shaping the future of international trade, but what is the effect on trading among G7 and BRICS countries?
The Bloc Effect: International Trade with Allies on the Rise
International trade has become increasingly fragmented over the last five years as countries have shifted to trading more with their geopolitical allies.
This graphic from The Hinrich Foundation, the first in a three-part series covering the future of trade, provides visual context to the growing divide in trade in G7 and pre-expansion BRICS countries, which are used as proxies for geopolitical blocs.
Trade Shifts in G7 and BRICS Countries
This analysis uses IMF data to examine differences in shares of exports within and between trading blocs from 2018 to 2023. For example, we looked at the percentage of China’s exports with other BRICS members as well as with G7 members to see how these proportions shifted in percentage points (pp) over time.
Countries traded nearly $270 billion more with allies in 2023 compared to 2018. This shift came at the expense of trade with rival blocs, which saw a decline of $314 billion.
Country Change in Exports Within Bloc (pp) Change in Exports With Other Bloc (pp)
🇮🇳 India 0.0 3.9
🇷🇺 Russia 0.7 -3.8
🇮🇹 Italy 0.8 -0.7
🇨🇦 Canada 0.9 -0.7
🇫🇷 France 1.0 -1.1
🇪🇺 EU 1.1 -1.5
🇩🇪 Germany 1.4 -2.1
🇿🇦 South Africa 1.5 1.5
🇺🇸 U.S. 1.6 -0.4
🇯🇵 Japan 2.0 -1.7
🇨🇳 China 2.1 -5.2
🇧🇷 Brazil 3.7 -3.3
🇬🇧 UK 10.2 0.5
All shifts reported are in percentage points. For example, the EU saw its share of exports to G7 countries rise from 74.3% in 2018 to 75.4% in 2023, which equates to a 1.1 percentage point increase.
The UK saw the largest uptick in trading with other countries within the G7 (+10.2 percentage points), namely the EU, as the post-Brexit trade slump to the region recovered.
Meanwhile, the U.S.-China trade dispute caused China’s share of exports to the G7 to fall by 5.2 percentage points from 2018 to 2023, the largest decline in our sample set. In fact, partly as a result of the conflict, the U.S. has by far the highest number of harmful tariffs in place.
The Russia-Ukraine War and ensuing sanctions by the West contributed to Russia’s share of exports to the G7 falling by 3.8 percentage points over the same timeframe.
India, South Africa, and the UK bucked the trend and continued to witness advances in exports with the opposing bloc.
Average Trade Shifts of G7 and BRICS Blocs
Though results varied significantly on a country-by-country basis, the broader trend towards favoring geopolitical allies in international trade is clear.
Bloc Change in Exports Within Bloc (pp) Change in Exports With Other Bloc (pp)
Average 2.1 -1.1
BRICS 1.6 -1.4
G7 incl. EU 2.4 -1.0
Overall, BRICS countries saw a larger shift away from exports with the other bloc, while for G7 countries the shift within their own bloc was more pronounced. This implies that though BRICS countries are trading less with the G7, they are relying more on trade partners outside their bloc to make up for the lost G7 share.
A Global Shift in International Trade and Geopolitical Proximity
The movement towards strengthening trade relations based on geopolitical proximity is a global trend.
The United Nations categorizes countries along a scale of geopolitical proximity based on UN voting records.
According to the organization’s analysis, international trade between geopolitically close countries rose from the first quarter of 2022 (when Russia first invaded Ukraine) to the third quarter of 2023 by over 6%. Conversely, trade with geopolitically distant countries declined.
The second piece in this series will explore China’s gradual move away from using the U.S. dollar in trade settlements.
Visit the Hinrich Foundation to learn more about the future of geopolitical trade
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