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Health Care Cost Containment Strategies Used in Four Other High-Income Countries Hold Lessons for the United States


Canada, France, Germany, United Kingdom

The Issue

Data collected by the Organization for Economic Cooperation and Development show that between 2000 and 2010, average per capita spending among member countries increased by more than 70 percent. In the past decade or more, Canada, France, Germany, and England in particular have undertaken a variety of strategies to slow this rate of spending.

What the Study Found

Researchers supported by The Commonwealth Fund reviewed the range of strategies used to contain health system costs in Canada, England, France, and Germany. All four countries rely on technology assessments to identify more cost-effective drugs and technologies; use hospital payment systems based on diagnosis-related groups; and tailor payment to reflect value. Although these strategies have likely led to more efficient use of health care resources, the researchers contend that, so far, they have failed to contain costs. Meanwhile, costs have remained lower overall in the four countries because they make far greater use of pricing and volume controls than does the U.S. 


Similar to Canada, France, Germany and England, the U.S. is moving toward policies aimed at promoting value and economic efficiency in health care without restricting coverage. But given the unlikelihood that the U.S. health care system will also adopt the volume and price controls used in these countries, this study concludes "it is likely that the large gap in health care spending between the four countries in our study and the United States will remain."

Publication Details

Publication Date: April 8, 2013
Author: Mark Stabile, Sarah Thomson, Sara Allin, Seán Boyle, Reinhard Busse, Karine Chevreul, Greg Marchildon, and Elias Mossialos
Summary Writer: Naomi Freundlich
Citation: M. Stabile, S. Thomson, S. Allin et al., "Health Care Cost Containment Strategies Used in Four Other High-Income Countries Hold Lessons for the United States," Health Affairs, April 2013 32(4):643–52.