Cost
Can you afford it?
Brand-drug prices run more than double the peer average, hospitals charge private plans two to three times Medicare, surprise-bill arbitration now tilts to providers, roughly one health dollar in thirteen goes to administration, and premiums are again outrunning wages. The same bill lands everywhere.
Prescription drug spending per person, US vs peers, 2022
Each bar is annual per-person spending on prescription drugs. The reference line is the peer median.
Read it this way The United States bar sits well above every peer nation and above the $816 peer-median line. This comparison covers drug spending only, so it does not explain the hospital, admin, or premium costs covered in the sub-dashboards below.
⊞ data table⬇ CSV
| Country | Drug spending per person, USD, 2022 |
|---|---|
| United States | 1432 |
| Germany | 948 |
| Switzerland | 912 |
| Japan | 850 |
| Canada | 782 |
| France | 640 |
| United Kingdom | 544 |
OECD Health Statistics via KFF Health System Tracker · 2022 · source
Legislation in play that touches cost
- Access to Prescription Digital Therapeutics Act of 2025
- Medicare Audiology Access Improvement Act of 2025
- Providing for consideration of the bill (H.R. 8646) making appropriations for…
Counts from Congress.gov + state-legislation trackers, keyword-mapped to this Iron Triangle force. As of 2026-06-18. See the methodology note on the legislation dashboard.
Follow the premium dollar: large-group employer coverage, 2022
Where each dollar of employer large-group premium went in 2022. Care is paid claims, the rest is insurer administration and margin.
Read it this way Follow the width of each flow: care claims take the large majority of the premium dollar, 89.22 percent, while administration and margin together take about one dollar in nine. This is the large-group commercial market only, so it does not describe Medicare, Medicaid, or the individual market covered elsewhere on this page.
Caveat Large-group commercial market only. Margin is premium minus paid claims minus administrative expense (arithmetically exact). The ACA loss-ratio floor for large-group plans is 85 percent.
⊞ data table⬇ CSV
| Destination | Dollars, billions, 2022 | Share of premium |
|---|---|---|
| Medical claims (care) | 451.9 | 89.22% |
| Administration | 37.3 | 7.37% |
| Margin and other | 17.3 | 3.41% |
CMS, Medical Loss Ratio Public Use File · 2022 · source
Sources & methodology
- RAND, International Prescription Drug Price Comparisons (RR-2956)
- CMS, Medicare Drug Price Negotiation Program, negotiated prices for 2026
- IQVIA Institute, protected-brand list vs net price growth (NJ PDAC slideshow)
- GAO, Medicare Part D rebates by therapeutic class (GAO-23-105270)
- CBO, Prices for Brand-Name Drugs Under Selected Federal Programs
- HHS Office of Inspector General, AMP and ASP relative to AWP
- MACPAC, Medicaid gross spending and rebates for drugs (Exhibit 28)
- CMS, Medicare Part D Spending by Drug
- RAND, Prices Paid to Hospitals by Private Health Plans (Round 5.1)
- Hospital machine-readable files, CMS Hospital Price Transparency rule
- PatientRightsAdvocate.org, Semi-Annual Hospital Price Transparency Reports
- Congressional Research Service, NSA IDR Data Analysis for 2024 (R48738)
- CMS, Federal IDR Supplemental Background Public Use Files
- Georgetown CHIR, No Surprises Act IDR process, early 2025 data
- AHIP and BCBSA, surprise-bill reduction survey
- Congressional Budget Office, No Surprises Act budgetary effects
- CMS, Medical Loss Ratio Public Use File
- KFF, Medical Loss Ratio Rebates
- CMS Office of the Actuary, National Health Expenditure Accounts (Table 2)
- Himmelstein et al., Health Affairs, hospital administrative costs in eight nations
- Health Affairs Scholar, HCRIS administrative and general costs 2011-2022
- Trilliant Health, hospital administrative expenditures
- KFF State Health Facts, Marketplace average benchmark premiums
- KFF State Health Facts, marketplace premiums by metal tier
- US Bureau of Labor Statistics, Employment Cost Index and CPI-U
- CMS, Effectuated Enrollment and average APTC
- AHRQ, Medical Expenditure Panel Survey (MEPS-IC and MEPS-HC)
- Commonwealth Fund, Biennial Health Insurance Survey
- CMS Provider Data Catalog · Hospital Care Compare
- CMS HCRIS cost reports, FY2019-2023 (HealthPulse ingest)
Per-chart citation straps carry the in-context detail; this is the full bibliography.