National expenditures on social security and health in selected countries.

Drawing on data from various sources, this article compares the 1980 and 1983 levels of spending on social security and health in the United States with the levels in seven other countries: Canada, the Netherlands, the United Kingdom, Germany, France, Sweden, and Japan. Currently, in the United States, social security is customarily understood to include only old-age, survivors, and disability insurance (OASDI). Based on this narrow definition of social security, the United States ranks in the lower half among these countries in terms of social security spending as a share of gross national product (GNP), considerably below several of the countries, especially the Netherlands, which has the highest level of spending in this regard. When a broader definition of social security, such as that usually used by international organizations, is employed, the gap between spending in the United States and that in the top-ranked countries is even greater. However, if the latter figures are adjusted to include total national spending on health care, creating a third category of rankings according to combined spending on health and social security, the gap between the countries with the highest spending and the United States narrows considerably. In all three categories, Japan registers the lowest level of spending as a share of GNP; the United States is consistently in the lower half; and Germany, France, Sweden, and the Netherlands are in the upper half of the rankings.