[OC] Verwaltungsausgaben im Gesundheitswesen pro Person: USA vs. Kanada – und was die Anbieter allein für die Abrechnung kosten

**Tool:** Python (matplotlib), drawn programmatically.

**Left panel — administrative spending per person, US vs Canada (2017):**
Himmelstein DU, Campbell T, Woolhandler S. „Health Care Administrative Costs in the United States and Canada, 2017.“ *Annals of Internal Medicine*, 2020.
Journal: [https://www.acpjournals.org/doi/10.7326/M19-2818](https://www.acpjournals.org/doi/10.7326/M19-2818)
PubMed: [https://pubmed.ncbi.nlm.nih.gov/31905376/](https://pubmed.ncbi.nlm.nih.gov/31905376/)
Free full-text PDF: [https://medstaff.chsbuffalo.org/wp-content/uploads/2020/02/Health-Care-Administrative-Costs-in-the-United-States-and-Canada-2017.pdf](https://medstaff.chsbuffalo.org/wp-content/uploads/2020/02/Health-Care-Administrative-Costs-in-the-United-States-and-Canada-2017.pdf)
Category figures are per-capita: hospital administration $933 vs $196; insurer overhead $844 vs $146; physicians‘ insurance-related costs $465 vs $87; nursing home/home care/hospice administration $255 vs $123. Totals: $2,497 vs $551 per person, or 34.2% vs 17.0% of national health expenditures.
Disclosure worth flagging up front: the lead authors co-founded Physicians for a National Health Program, an advocacy organization. The study itself is peer-reviewed, and methods are detailed in the journal supplement.

**Right panel — billing & insurance-related cost per encounter:**
Tseng P, Kaplan RS, Richman BD, Shah MA, Schulman KA. „Administrative Costs Associated With Physician Billing and Insurance-Related Activities at an Academic Health Care System.“ *JAMA*, 2018.
Journal: [https://jamanetwork.com/journals/jama/fullarticle/2673148](https://jamanetwork.com/journals/jama/fullarticle/2673148)
PubMed: [https://pubmed.ncbi.nlm.nih.gov/29466590/](https://pubmed.ncbi.nlm.nih.gov/29466590/)
Free full text (PMC): [https://pmc.ncbi.nlm.nih.gov/articles/PMC5839285/](https://pmc.ncbi.nlm.nih.gov/articles/PMC5839285/)
Time-driven activity-based costing at a large academic health system. Notable: costs were measured with a fully implemented certified EHR, and the authors attributed the costs to heterogeneous payer requirements rather than inefficiency or duplicated effort.

Happy to discuss methods or limitations of either study.

Compared to Canada, the US pays twice as much on healthcare per capita, and they live three years less.