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Spending more, feeling worse: medical care expenditures and self rated health
  1. M S Kaplan1,
  2. B H McFarland2,
  3. J T Newsom3,
  4. N Huguet4
  1. 1School of Community Health, Portland State University, USA
  2. 2Department of Psychiatry, Oregon Health and Science University, USA
  3. 3Institute on Aging, Portland State University
  4. 4School of Community Health, Portland State University
  1. Correspondence to:
 Dr M S Kaplan
 School of Community Health, Portland State University, PO Box 751, Portland, Oregon 97207, USA;

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International comparisons show that the United States spends more on health care than other industrialised nations.1 According to 2000 data, the United States led the way in per capita healthcare spending at $4631, more than double the Organization for Economic Cooperation and Development (OECD) median of $1983 (in purchasing power parities based on the US dollar).2

Despite massive medical care expenditures, the US lags behind its industrialised counterparts in major indicators of population health. For example, researchers have reported that the US has lower life expectancy at birth and higher maternal and infant mortality.3,4 Equally important, cross national studies consistently show that US citizens are less satisfied with their healthcare system than Canadians or Europeans.2

Another key indicator of population health, not previously used in cross national comparisons, …

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