Medical Care Expenditures in Seven Countries

More than 5 years have passed since publication of Brian Abel-Smith’s study for the World Health Organization (WHO) ;1 It still is widely recognized as the only definitive study in the international health field with adequate comparability of data. An earlier Social Security Administration (SSA) analysis, attempting to update the figures in the 1967 WHO study, appeared in the BULLETIN for December 19’70.* This earlier Office of Research and Statistics analysis was based largely on estimates prepared by the British Office of Health Economics (OHE) in their 1970 adjustment of the WHO figures.2 To further update this material, the Social Security Administration has developed estimates through 1969 for seven countries, including the United States and five others that were among the countries covered in the WHO study. Limited resources precluded duplicating the WHO approach of sending out extensive questionnaires to each country to obtain standardized information and data. The method used, instead, has basically been to isolate statistical aggregates in the health care field that, in combination, closely approximate the level of expenditures reported in the WHO study for appropriate years. By developing index numbers from corresponding data in subsequent years it has been possible to arrive at estimates that bring the WHO figures up to date. As indicated in the earlier note, ONE itself had pointed out deficiencies in its figures. Many of the same shortcomings may be attributed to the Social Security Administration estimates presented here. They are first of all only approxima-