Universal HealthcareBy NextBestFit
Reference

Sources

Every source cited on this site. Notes give the specific figure used. Advocacy-aligned sources are labeled where relevant.

  1. AAMC · 2024
    67% of graduates had medical education debt, median $200,000.
  2. AAMC · 2024
    Projected shortage of up to 86,000 physicians by 2036.
  3. Accident Compensation Corporation · 2024
    2022/23 lodgement year: 15,411 accepted, 4,931 declined, 20,342 total decided treatment-injury claims; data extracted March 26, 2024; financial year July 1–June 30.
  4. Advanced Research Projects Agency for Health · 2022
    ARPA-H receives $1B from Congress in appropriated funds for the agency's first three years. After numerous public listening sessions... ARPA-H is born. The agency is modeled after DARPA...
  5. AMA Policy Research Perspectives; Health Affairs (Scheffler et al.) · 2023
    4.5% of physicians were in PE-owned groups in 2022, but a single PE firm held over 30% of the market in 108 metro specialty markets; deals rose from 75 in 2012 to 484 in 2021.
  6. America's Health Rankings / UNC Sheps Center · 2024
    181 rural hospitals closed between 2005 and 2022; 52% of rural hospitals had no obstetric services as of 2022.
  7. American Dental Association · 2024
  8. American Economic Review: Insights · 2024
    1,164 hospital mergers, 2002–2020; FTC enforcement action against 13 transactions.
  9. American Hospital Association · 2025
    2024 hospital expenses: labor 56% (~$890B), supplies 13% (~$202B), drugs 9% (~$144B), other 22% (~$352B). The 2026 edition estimates hospitals spent $43B trying to collect payment from insurers.
  10. American Hospital Association · 2024
    AHA’s March 2024 survey of about 1,000 hospitals found 94% reported financial effects and 74% patient-care effects; among hospitals reporting cash-flow effects, nearly 60% reported revenue impacts of at least $1 million per day.
  11. American Journal of Obstetrics and Gynecology · 2017
    99 collaborative hospitals versus 48 comparison hospitals; severe maternal morbidity among women with hemorrhage: 20.8% versus 1.2% reductions; baseline January 2011–December 2014, follow-up October 2015–March 2016.
  12. American Medical Association · 2024
    94% say prior authorization delays necessary care; 24% report a serious adverse event; 78% say patients abandon treatment; practices spend about 12 hours a week on it.
  13. AMN Healthcare / Merritt Hawkins · 2025
    New-patient appointment waits across 15 large U.S. metros average about a month, and more for some specialties.
  14. ASHP / University of Utah Drug Information Service · 2024
    323 active shortages in Q1 2024, the most since tracking began in 2001; about half are sterile injectables.
  15. ASPE (HHS) · 2022
    Analysis of recent data indicates that more than 150 million people with private insurance – including 58 million women and 37 million children – currently can receive preventive services without cost-sharing under the ACA, along with approximately 20 million Medicaid adult expansion enrollees and 61 million Medicare beneficiaries that can benefit from the ACA’s preventive services provisions.
  16. Association of American Medical Colleges · 2024
    As of March 2023, NPs had full, independent practice authority in 27 states; this count concerns NPs, not every profession listed in the path.
  17. Australian Prudential Regulation Authority · 2025
    At 31 December 2024, 12,400,800 people, or 45.2% of the population, were covered by hospital treatment cover.
  18. Baicker & Chandra, Journal of Labor Economics · 2006
    Rising premiums are largely passed on to workers as lower wages.
  19. Bailey & Chorniy, Contemporary Economic Policy · 2016
    The ACA's expansion of dependent coverage did not increase job mobility among young adults (2008 to 2013 Current Population Survey).
  20. Bailey, Small Business Economics · 2017
    The ACA's dependent-coverage mandate did not increase self-employment among young adults overall, but increased it among disabled young adults by 19 to 23%.
  21. BEA via FRED · 2025
    $12.39T in 2024.
  22. BJGP Open · 2024
    Between 31 May and 30 June 2021, England recorded 1,339,862 additional national data opt-outs, increasing the opt-out share of people registered with GP practices from 2.77% to 4.97%.
  23. Blahous, Mercatus Center · 2018
    $32.6T in added federal spending over 2022–2031; national spending roughly flat to slightly lower if provider rates are cut to Medicare levels.
  24. Borgschulte & Vogler, Journal of Health Economics · 2020
    Medicaid expansion reduced all-cause mortality among adults 20 to 64 by 11.36 deaths per 100,000, a 3.6 percent decrease, in its first four years.
  25. British Journal of Clinical Pharmacology · 2020
    A study first published in 2020 found IFR decline rates of 71% for NHS England and 34% for CCGs, with lack of exceptionality cited for 42 of 45 declined requests submitted in 2016–2018.
  26. British Journal of General Practice · 2011
    A 2011 study states that approximately 25% of UK GP income was tied to QOF quality targets and describes exception reporting as a safeguard against inappropriate or excessive treatment.
  27. Bundesministerium für Gesundheit · 2024
  28. Bundesministerium für Gesundheit · 2024
  29. Bureau of Justice Statistics · 2025
    About 1,852,900 people incarcerated in state and federal prisons and local jails at yearend 2023.
  30. Bureau of Labor Statistics · 2026
    Industry and occupation employment and mean wages used for displaced-job estimates.
  31. Bureau of Labor Statistics · 2025
    About 430,000 employees; mean annual wage about $88,000.
  32. California Legislative Analyst's Office · 2025
    1.7 million Medi-Cal enrollees (11%) estimated to be undocumented and have comprehensive coverage.
  33. Canadian Institute for Health Information · 2025
    In 2025, public health spending overall in Canada was projected to represent 5.6% ($22 billion) of total health spending... Spending in the subcategory of prevention and promotion programs only, which captures more traditional public health functions in Canada, was estimated to account for about 3.2% to 3.5% of total health expenditures in 2025.
  34. Canadian Institute for Health Information · 2024
  35. Canadian Institute for Health Information · 2021
  36. Canadian Life and Health Insurance Association · 2025
  37. Centers for Medicare & Medicaid Services · 2026
    10% quarterly bonus, based on the amount Medicare pays for professional services; CMS guidance last modified June 24, 2026.
  38. Centers for Medicare & Medicaid Services · 2025
    CY2025 REH facility monthly payment amount: $285,625.90 with sequestration deducted; 12 monthly installments; same additional payment for every REH.
  39. Centers for Medicare & Medicaid Services · 2024
    Medicare's FY 2025 inpatient capital prospective-payment calculation uses a national capital standard federal base rate of $512.14, subject to applicable payment adjustments.
  40. Centers for Medicare & Medicaid Services · 2024
    12 A/B MACs and 4 DME MACs; processed over 1.1 billion claims; paid $459.7 billion in benefits; served 33.9 million beneficiaries.
  41. Centers for Medicare & Medicaid Services · 2024
    In calendar year 2023... The payments from States were $15.8 billion... Table III.D1—Statement of Operations of the Part D Account in the SMI Trust Fund during Calendar Year 2023: Payments from States: $15,820,910 [in thousands]... State payments were higher than the 2022 report estimates largely because the actual number of full-benefit dually eligible beneficiaries was higher than projected.
  42. Centers for Medicare & Medicaid Services · 2023
    PY3 (2021): 18 of 65 eligible hospitals (28%); approximately 125,000 Medicare patients based on 2021 average inpatient and outpatient utilization.
  43. Centers for Medicare & Medicaid Services · 2023
    First 200 of 1,000 new positions; 100 teaching hospitals across 30 states, DC, and Puerto Rico; effective July 1, 2023; 125 primary care and 20 psychiatry DGME slots.
  44. Centers for Medicare & Medicaid Services · 2021
    Approximately 840,000 telehealth visits in 2019; 52.7 million in 2020; 63-fold increase; Medicare fee-for-service data.
  45. Centers for Medicare & Medicaid Services · 2013
    CMS reported Miami-Dade’s active home health agencies grew from 385 in 2008 to 662 in 2012, a 15% compound annual increase, and that 56% had not billed continuously since 2008, a category including new entrants rather than necessarily intermittent billers.
  46. Centers for Medicare & Medicaid Services (CMS) · 2024
    CMS reported more than $3.26 billion in Change Healthcare emergency payments in June 2024, comprising over $2.55 billion to more than 4,200 Part A providers and over $717.18 million through 4,722 Part B advance payments.
  47. Civica Rx · 2026
    Civica offers all members the same cost-plus price for these products... strives to provide 6 months of buffer inventory... Civica supplies more than 70 essential medicines to over 1,400 hospitals.
  48. Civica Rx · 2024
    Nearly sixty member health systems; approximately 1,400 hospitals; over 30% of licensed U.S. hospital beds; about eighty drugs supplied.
  49. CMS · 2024
    Negotiated prices for the first 10 drugs were 38–79% below list prices; estimated net savings of 22% relative to 2023 net spending.
  50. CMS · 2024
    About 7.7% of Medicare FFS payments in FY2024 were improper, mostly due to insufficient documentation rather than fraud.
  51. CMS Innovation Center / RTI · 2023
    Hospital global budgets held hospital spending growth below national trends.
  52. CMS Office of the Actuary · 2025
    The source for every baseline number on this site.
  53. CMS Office of the Actuary · 2025
  54. Cochrane · 2024
    Caesarean sections: 16% to 15%; RR 0.91, 95% CI 0.84–0.99; 16 studies, 18,037 participants; moderate-certainty evidence; countries: Australia, Canada, China, Ireland, UK.
  55. Commission Nationale de l'Informatique et des Libertés (CNIL) · 2026
    On 26 May 2026, IQVIA OPERATIONS FRANCE was fined €5 million, in particular because it didn't respect guarantees aimed at limiting risks to individuals in the management of health data warehouses (LRX and EMR) covering tens of millions of individuals.
  56. Commonwealth Fund · 2026
    About 28,500 uninsured in 2023; uninsured people can be fined and have premiums taken from wages or social security benefits. This is not free default coverage.
  57. Commonwealth Fund · 2026
    Government spending accounted for 71% of total health expenditure in 2022; the system is mainly financed through the tax system and federal funding.
  58. Commonwealth Fund · 2024
    Appendix 4, measure 3, 2023 survey: UK 4%; US 22%. Measures bill-payment problems across health care, not medical debt specifically or only NHS-covered services.
  59. Commonwealth Fund · 2024
    47 states had implemented the 12-month extension; three were planning or seeking approval; the source uses the term states and does not separately clarify DC in this sentence.
  60. Commonwealth Fund · 2020
    Denmark: four public medical schools; six-year medical studies; none charge tuition fees.
  61. Commonwealth Fund · 2020
    From the 2016 International Health Policy Survey, among adults who saw or needed a specialist: Canada 30%, Norway 28%, New Zealand 20%, England 19%, Sweden 19%, Australia 13%, Switzerland 9%, Netherlands 7%, United States 6%, France 4%, Germany 3%.
  62. Congressional Budget Office · 2024
    Employment-based coverage is about 21% of total federal health insurance subsidies; the 2024 tax exclusion is roughly $400B including payroll taxes.
  63. Congressional Budget Office · 2024
  64. Congressional Budget Office · 2021
    Industry R&D was $83B in 2019, about a quarter of net revenue; expected cost per new drug ranges from under $1B to over $2B, including failures and capital costs.
  65. Congressional Budget Office · 2020
    Five illustrative options: national health spending in 2030 changes by −$0.7T to +$0.3T; federal subsidies rise $1.5T–$3.0T.
  66. Congressional Budget Office · 2019
  67. Congressional Budget Office · 2019
    Estimated about 8 fewer new drugs (of ~300) in 2020–2029 and about 30 fewer in the following decade.
  68. Congressional Budget Office · 2017
    Repeal projected to raise the number of uninsured by 4 million in 2019 and 13 million in 2027.
  69. Congressional Research Service · 2025
    About 1.42 million disputes in 2024 (versus 17,000 a year expected), 99% started by providers; providers won about 85%. The process cost at least $5B through 2024 (Georgetown CHIR).
  70. Congressional Research Service · 2023
    Federal Medicaid funding is open-ended for states and DC but capped for all five territories; FY2023 caps of about $137M (Guam), $135M (USVI), $90M (American Samoa), $66M (CNMI). Territory residents get Enhanced Allotment Program drug help instead of Part D low-income subsidies.
  71. Consumer Financial Protection Bureau · 2024
    December 2022–June 2023 FICO Score 8 gains were about 20 points greater just below the $500 removal threshold than just above it; national credit-bureau policy, not a state-law evaluation.
  72. Cook County Government · 2025
    $664,744,470.53 abolished; 556,815 residents benefited since 2022, reported June 5, 2025.
  73. Danske Regioner · 2024
    Danish regions made a historically high 242,060 referrals to private hospitals and clinics in 2023, as reported by Danske Regioner in January 2024.
  74. Defense Health Agency · 2025
    9.4 million eligible DoD health beneficiaries at end of FY2024, including 1.33 million active-duty members and 1.48 million active-duty family members.
  75. Department of Health and Social Care · 2023
    Around 89% of prescription items dispensed in the community in England are free of charge due to extensive exemption categories.
  76. DHS Office of Homeland Security Statistics · 2024
    About 11.0 million unauthorized immigrants in January 2022.
  77. DHS Office of Homeland Security Statistics · 2023
    About 3.2 million resident nonimmigrants (workers, students, exchange visitors and families) in FY2019.
  78. Doximity · 2025
    Average physician pay rose 3.7% in 2024; wide gaps by specialty, from pediatric endocrinology at the bottom to neurosurgery at the top.
  79. e-Estonia · 2024
  80. European Federation of Pharmaceutical Industries and Associations · 2025
    There remain significant and enduring variations between countries; the fastest is Germany at 128 days, with Portuguese patients now facing the longest wait, at 840 days. The average time from approval to patient access has now reached 578 days.
  81. European Observatory on Health Systems and Policies · 2024
    Oral health care for children and adolescents until the age of 19 (gradually increased to 21 in 2025) is free of charge and either provided by the municipal dental health service or a private practicing dentist, reimbursed by the municipalities... Dental health for children and adolescents is essentially school-based, and the participation rate is nearly 100%.
  82. European Observatory on Health Systems and Policies · 2023
    Over 95% of the population has voluntary complementary health insurance... nearly 20% of the population receives vouchers for complementary insurance.
  83. European Observatory on Health Systems and Policies · 2020
    About 88% in statutory sickness funds (~95 funds), about 11% in substitutive private insurance; private patients get appointments faster.
  84. European Observatory on Health Systems and Policies / WHO · 2020
    7.9% exceeded the 1% cap in 2018; 0.4% exceeded the 2% cap, exempting them from further copayments.
  85. Fairlie, Kapur & Gates (NBER conference paper) · 2009
    Among male workers, business ownership rises from 24.6% just under age 65 (Medicare eligibility) to 28.0% just over it, a statistically significant jump; no such change appears at other ages. A later version was published in the Journal of Health Economics (2011).
  86. Federal Register · 2024
    We are specifying that facilities must provide, at a minimum, 3.48 total nurse staffing hours per resident day (HPRD) of nursing care, with 0.55 RN HPRD and 2.45 NA HPRD... and hardship exemptions from the minimum hours per resident day... requirements.
  87. Federal Trade Commission · 2025
    The three largest PBMs and their affiliated pharmacies earned over $7.3B dispensing drugs above estimated acquisition cost in 2017–2022; affiliates held 68% of specialty dispensing revenue in 2023.
  88. Federal Trade Commission · 2024
    Proposed acquisition of two hospitals terminated following Fourth Circuit injunction pending appeal; source does not measure subsequent price reductions.
  89. Finkelstein, Baicker et al., NEJM / QJE · 2013
    Medicaid coverage raised outpatient use, prescriptions, and ER visits, cut catastrophic medical spending and depression, and showed no detectable change in some physical-health measures within two years.
  90. Finnish Ministry of the Environment · 2023
    ARA statistics, 2008–2022: homeless people living alone decreased 54%; people experiencing long-term homelessness decreased 68%; this is a social outcome, not a measured healthcare saving.
  91. Fraser Institute · 2025
    Median 28.6 weeks from GP referral to treatment (15.3 to specialist + 13.3 to treatment). Range from 19.2 weeks (Ontario) to 60.9 (New Brunswick).
  92. Frontiers in Public Health · 2024
    A 2024 German long-term-care study describes allocation to care grades 1–5 and reports approximately 5 million people needing long-term care in 2021.
  93. Galvani et al., The Lancet · 2020
    Estimated 13% ($450B) annual savings and about 68,000 lives saved per year under single payer.
  94. GAO · 2014
  95. German Federal Ministry of Health · 2024
    Page 7: leistungsunabhängige, zusätzliche Mittel of 120 Millionen Euro for each of 2023 and 2024; July 2024 publication.
  96. Global Public Health (PMC) · 2025
    Reports Puerto Rico's physician workforce fell from about 14,500 in 2009 to about 9,000 by 2020 (citing earlier reporting).
  97. Globalization and Health · 2019
    About 4000 service items and 17,000 pharmaceuticals listed in the fee schedule; uniform payment for the same service regardless of provider ownership, size or location.
  98. Gotham, Barber & Hill, BMJ Global Health · 2018
    Estimated production cost of roughly $2–6 per vial; a profitable price would be $48–71 per person per year for human insulin and $78–133 for analogues.
  99. Governor of California · 2025
    Suggested retail price no more than $55 per five-pack of 3 mL pens; pharmacy price $45; announced October 16, 2025 for January 1, 2026. State contract and branding, not state-owned production.
  100. Green Mountain Care Board · 2024
    Annual responsibility to review and establish budgets for Vermont's 14 community hospitals; FY25 guidance updated April 18, 2024. Scope of review, not an executive-pay outcome.
  101. Health Affairs · 2011
    Ontario physician-practice payer interaction costs: $22,205 per physician annually, 27% of the U.S. estimate of $82,975; estimates in U.S. dollars; not a burnout outcome.
  102. Health Affairs · 2011
    A 2011 Health Affairs study estimated annual payer-interaction costs of $82,975 per U.S. physician versus $22,205 in Ontario, with nursing staff spending 20.6 versus 2.5 hours per physician per week on all payer interactions.
  103. Health Affairs Scholar · 2025
    Table 1: outpatient-to-total charges difference -3.86 (95% CI -7.27 to -0.44), P=.03; relative change -6.91%, using 2011–2022 data. This is a relative change, not 6.91 percentage points.
  104. Health Affairs Scholar · 2024
    A 2026 CARB-X evaluation reports over US$1 billion committed through 2028 and 77 funded applications among the 2016–2019 application cohort, whose outcomes were assessed through February 2024.
  105. Health and Human Rights Journal · 2024
    A June 2025 article describes Taiwan NHI premiums as 5.17% of monthly income, contributing 89% of its annual budget, and describes the government contribution as statutorily capped at 36%.
  106. Health Canada · 2025
    Approximately C$1 billion was reciprocally billed in 2023–2024 for insured hospital and physician services outside residents' home jurisdictions. Original URL loaded successfully during verification.
  107. Health Canada · 2025
    In March 2025, more than $62.2 million in Canada Health Transfer deductions were levied to NL, NS, NB, QC, ON, SK, AB, BC, and YK as a result of patient charges for medically necessary services.
  108. Health Canada · 2024
    The October 31, 2024 release reports more than 1 million recipients of care and more than 2.7 million approved applicants. The coverage percentages apply to established CDCP fees, not necessarily the provider's full bill; verified separately at https://www.canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html. Both pages loaded successfully.
  109. Health Care Management Science · 2008
    the classification tree model... has the highest overall accuracy of 99%
  110. Health Policy · 2010
  111. Health Services Insights · 2021
    Healthcare providers are reimbursed on a fee-for-service basis according to the fee schedule that set prices uniformly at the national level. This fee schedule is routinely revised every 2 years...
  112. Health Services Research · 2020
    A 2020 nonexperimental evaluation of 139 VA medical centres found that a 10% increase in privileged primary-care NPs was associated with about 4% shorter new-patient waits, equivalent to 0.30 days.
  113. Health Services Research · 2013
    The ratios were phased beginning January 1, 2004, the staffing ratio for medical-surgical areas was set at 1 : 6; in March 2005, the ratio was enriched to 1 : 5. In 2008, additional specialty units were subject to the regulations.
  114. Health Services Research · 2012
    79 percent of German home care beneficiaries (and 47.4 percent of LTC insurance beneficiaries, including nursing home residents) choose the cash benefit... although the value of that benefit is... 50 percent less at each benefit level.
  115. Health Services Research · 2010
    California nurses cared for an average of one fewer patient each in 2006; on medical/surgical units, over two fewer than New Jersey and 1.7 fewer than Pennsylvania; cross-sectional comparison.
  116. Health Services Safety Investigations Body · 2026
    April 1, 2025–March 31, 2026: 16 published investigation reports, 20 safety recommendations to national bodies, 16 newly launched investigations; activity counts do not measure error reduction.
  117. HHS Office of Inspector General · 2022
    10 contracts awarded March 30–May 28, 2020, totaling nearly $2.9 billion to supply approximately 198,000 ventilators by the end of 2020; these are contract commitments, not confirmed deliveries.
  118. HHS Office of the Assistant Secretary for Planning and Evaluation · 2026
    24% decline in out-of-network emergency-service bills at any facility in 2022 versus 2019; 17% decline for non-emergency services at in-network facilities. Not a PE-specific result.
  119. Himmelstein, Campbell & Woolhandler, Annals of Internal Medicine · 2020
    Administration was about 34% of U.S. health spending versus 17% in Canada (authors are single-payer advocates; their estimates are at the high end).
  120. Holgash & Heberlein, Health Affairs Forefront · 2019
    In 2017, 74% of physicians accepted new Medicaid patients, compared with 88% for Medicare and 96% for private insurance.
  121. HRSA · 2025
    About 137 million people (roughly 40% of the population) live in a mental health shortage area as of December 2025.
  122. HRSA · 2024
    June 2024: 7,501 primary care HPSAs (75.0M people, 47% of need met); 6,234 mental health HPSAs (122.4M people, 27% of need met).
  123. HRSA National Center for Health Workforce Analysis · 2024
  124. Human Resources for Health · 2021
    Jichi five-year contractual workforce retention: n=683, 98%; retention means graduates did not buy out their tuition obligation, rather than proof all were currently in rural posts.
  125. I-MAK (advocacy group) · 2020
    247 U.S. patent applications, 89% filed after FDA approval; biosimilars reached Europe in 2018 but the U.S. only in 2023. Advocacy estimates of the extra cost to U.S. payers range from $14B to $77B.
  126. Indian Health Service · 2026
    IHS serves approximately 2.8 million American Indians and Alaska Natives.
  127. Institute for Quality and Efficiency in Health Care (IQWiG) · 2024
    After regular benefit assessment and GKV price negotiations: 18 price decreases, 2 unchanged prices, 3 price increases.
  128. International Trade Administration · 2026
    68.3 million international visitor arrivals in 2025.
  129. IRS Statistics of Income · 2024
    160.7M returns, $15.1T adjusted gross income.
  130. JAMA Network Open · 2021
    Among older Medicare fee-for-service beneficiaries, receipt of at least one of 32 measured low-value services declined from 36.3% in 2014 to 33.6% in 2018, a descriptive trend that does not isolate the effect of voluntary guidelines or clinician feedback.
  131. JAMA Network Open · 2020
    Mean annual health expenditures in 2017: $1,629 per unauthorized immigrant vs $6,088 per U.S.-born person.
  132. Jiwani et al., BMC Health Services Research · 2014
    Billing and insurance-related costs are about 13% of physician revenue and 8.5% of hospital revenue.
  133. Joint Committee on Taxation / Treasury Green Book · 2024
  134. Journal of General Internal Medicine · 2020
    Physician care coverage: 67% in 1960; 99.9% by 1965. Precedent concerns phased service expansion, not lowering an age threshold.
  135. Journal of the American Association of Nurse Practitioners · 2024
    Thirteen of the 28 states and the D.C. have FPA granted on initial licensure. The remaining 14 states... have a transition to practice (TTP) hour associated with the granting of FPA... ranging from 1,040 to 4,600 hours.
  136. Journal of the American Pharmacists Association · 2017
    38 community pharmacy organizations: 14 central and 24 remote; questionnaire administered December 2015–February 2016; 27 organizations responded (71.1%).
  137. Kaufman Hall · 2025
    Median hospital operating margin was 4.9% in 2024 (2.7% in 2023), with wide variation between hospitals.
  138. KFF · 2026
    In 2025, 51% of firms with 10 to 24 workers offered health benefits, against 97% of firms with at least 200 employees.
  139. KFF · 2025
    36% of adults skipped or postponed needed care in the past year because of cost; three-quarters of uninsured adults did.
  140. KFF · 2025
    Average premium $9,325 single and $26,993 family; workers pay $1,440 and $6,850.
  141. KFF · 2025
    Gross margins per enrollee were highest in Medicare Advantage ($1,655) and lowest in Medicaid managed care ($608).
  142. KFF · 2025
    Figure 2: 2018 10.4%; 2019 10.9%. These are descriptive rates, not an estimate of the mandate repeal's causal effect.
  143. KFF · 2025
    12,244 non-pediatric physicians, or 1.2%, formally opted out as of November 2024; not an estimate of acceptance of new Medicare patients.
  144. KFF · 2025
    Emergency Medicaid: $3.8 billion and 0.4% of total Medicaid spending in FY 2023; includes undocumented and some lawfully present immigrants.
  145. KFF · 2025
    ACS 2024, civilian noninstitutionalized: 281.6 million U.S.-born citizens; 25.6 million naturalized citizens.
  146. KFF · 2025
    Territories' federal Medicaid funding is capped; Puerto Rico's FMAP is 76% through FY2027 with a capped allotment of about $3.6 billion for FY2026; other territories' FMAP is 83%.
  147. KFF · 2024
  148. KFF · 2024
    MedPAC's 2024 estimate: 22% more per Medicare Advantage enrollee, or $83 billion, than for similar traditional Medicare beneficiaries; projected comparison, not realized savings from folding MA.
  149. KFF · 2024
    Only about 1 in 5 (19%) nursing facilities would meet all three standards in the final rule with current staffing levels, including 11% of for-profit facilities and 41% of non-profit facilities.
  150. KFF · 2024
    KFF explains that the Inflation Reduction Act prohibits using QALY-based health outcomes evidence in Medicare's negotiation of a maximum fair drug price.
  151. KFF · 2023
    58% of insured adults had a problem using coverage in the past year; 18% had a claim denied (21% employer coverage, 20% Marketplace, 12% Medicaid, 10% Medicare).
  152. KFF · 2023
    80% of adults with employer-sponsored insurance rate their insurance excellent or good (Marketplace 73%, Medicaid 83%).
  153. KFF · 2019
    Medicaid paid on average 72% of Medicare for all services in 2019 (67% for primary care).
  154. KFF · 2016
    Estimated NEMT spending: $3 billion annually, less than one percent of total Medicaid expenditures; estimate attributed to an October 2014 Transit Cooperative Research Program report; comprehensive state spending data unavailable.
  155. KFF / KHN / NPR · 2022
    About 4 in 10 adults (roughly 100 million people) have health care debt; 79% of them skipped or delayed care because of cost.
  156. MACPAC · 2026
    FY2024 Medicaid benefit spending of $3,293 per full-year-equivalent enrollee in Puerto Rico vs $10,302 average; Puerto Rico FY2024 full-year-equivalent enrollment 1,429,830.
  157. MACPAC · 2023
  158. MACPAC · 2017
  159. Madrian, Quarterly Journal of Economics · 1994
    Job lock reduces the voluntary turnover rate of people with employer-provided health insurance by 25 percent, from 16 to 12 percent a year (1987 data).
  160. March of Dimes · 2024
    Over 35% of U.S. counties are maternity care deserts; more than 5.5 million women live in counties with no or limited maternity care; more than 100 hospitals closed obstetric units in 2021–22.
  161. Medicare Payment Advisory Commission · 2025
    Hospital Medicare FFS margins about −13% in 2023; Medicare Advantage payments about 20% above FFS-equivalent spending ($84B in 2025).
  162. Medicare Payment Advisory Commission (MedPAC) · 2024
    In 2021, the Medicare aggregate margin was considerably higher for for-profit hospices (19.2 percent) than for nonprofit hospices (5.2 percent). The FFS Medicare aggregate margin for freestanding nonprofit hospices was 8.5 percent.
  163. Medicare Trustees · 2025
  164. MedPAC · 2025
    2023: 1.7M beneficiaries, about 6,500 providers, $25.7B in Medicare spending. 2024 (March 2026 report): $28.3B for 1.8M beneficiaries.
  165. Medscape (via Becker's) · 2024
    Average resident salary about $70,000.
  166. Mello, Chandra, Gawande & Studdert, Health Affairs · 2010
    $55.6B a year (2008 dollars), 2.4% of spending, of which defensive medicine is about $45.6B.
  167. Migration Policy Institute · 2026
    About 12.8 million lawful permanent residents (January 2024); 13.7 million unauthorized immigrants (mid-2023); 574,000 new LPRs admitted from abroad in FY2024.
  168. MPI Studies on Intellectual Property and Competition Law / Springer · 2014
    November 2006 licence permitted import of 66,000 bottles from India at half Merck's offered price, increasing access for an additional 20,000 patients.
  169. NAIC · 2024
    Net earnings fell from about $25B (2.2% margin) in 2023 to about $9B (0.8%) in 2024; combined ratio 100.1%.
  170. National Association of Insurance Commissioners / state revenue reports · 2024
  171. National Audit Office · 2001
    The NAO's 2001 investigation covered nine trusts with inappropriate waiting-list adjustments and recommended investigating 13 trusts meeting both thresholds: over 10% suspended and over 2% waiting longer than twelve months.
  172. National Health Care Anti-Fraud Association · 2018
    Conservatively about 3% of health spending is lost to fraud; some government and law-enforcement estimates run as high as 10%.
  173. National Health Insurance Administration, Ministry of Health and Welfare · 2024
    Hospital medical points in 2023: 602 billion (68.0%), comprising 340 billion outpatient and 262 billion inpatient; payment points are not currency amounts.
  174. National Institute for Health and Care Excellence · 2024
    NICE's technology-appraisal appeal procedure allows consultees 15 working days after final draft guidance is issued to submit an appeal before final guidance.
  175. NEJM AI · 2025
    238 outpatient physicians; Nabla: -9.5% versus control (95% CI -17.2% to -1.8%, P=.02); DAX: -1.7% (95% CI -9.4% to +5.9%, P=.66); trial November 2024–January 2025.
  176. New England Journal of Medicine · 2011
    Adherence was 4 to 6 percentage points higher with full coverage (P<0.001); usual-coverage adherence ranged from 35.9% to 49.0%.
  177. NHS England · 2025
    About 7.4 million cases on the waiting list in 2025, with roughly 59–60% treated within the 18-week standard (target 92%).
  178. NHS England · 2024
    December 2023: 760,589 incidents handled; 380,793 incidents conveyed to A&E; 889,389 calls to 999.
  179. NHS England · 2023
    Global sum per weighted patient: £99.70 to £102.28, effective April 1, 2023; out-of-hours deduction 4.75%; global sum is one component of GP funding.
  180. NHS England · 2023
    ICB core services health inequalities/unmet need weighting increased from 10% to 10.2%; primary medical care 15%, specialised services 5%; allocation weights are not outcome measures.
  181. NHS England · 2022
    Maximum contract value: £10 million a year for up to 10 years; initial deal covered two antimicrobial drugs.
  182. North Carolina Department of Health and Human Services / UNC Sheps Center · 2026
    North Carolina’s innovative Healthy Opportunities Pilots (HOP) reduced health care costs by an average of $164 per month for NC Medicaid beneficiaries, according to the results of a study announced today by NCDHHS and conducted by the Cecil G. Sheps Center for Health Services Research at UNC... The more than 31,000 people part of the study, enrolled from March 15, 2022... through Nov. 30, 2024, also experienced a decrease in food, housing and transportation needs.
  183. NPR / Rice University · 2024
    Nonprofit health system CEOs averaged about $1.3M a year; pay grew 30% between 2012 and 2019.
  184. NYU Langone Health · 2024
    136 accelerated graduates versus 681 four-year peers; average preclerkship exam scores 84% versus 83%; some USMLE components were lower for accelerated graduates.
  185. OECD · 2025
    Spending as a share of GDP, per-capita spending in PPP dollars, physicians and MRI units per capita, life expectancy. Figures on this site are rounded.
  186. OECD · 2025
    2.7 practising doctors per 1,000 population in Canada (OECD average 3.9); 2.5 hospital beds per 1,000 (OECD average 4.2).
  187. OECD · 2025
    2.7 practising doctors per 1,000 population in the United States (OECD average 3.9); 2.8 hospital beds per 1,000 (OECD average 4.2).
  188. OECD · 2023
    Canada, 2023: 100% of population; insurance type: public and primary voluntary health insurance. Coverage scale, not a measured job-mobility effect.
  189. OECD · 2023
    Difference between German self-employed specialists and GPs: about 12%; Figure 8.11 data refer to 2021 or nearest year; average gross income normally excludes practice expenses.
  190. OECD Health Policy Studies · 2013
    Average experienced waiting time for elective surgery fell from approximately 12 weeks in 2001 to 7.6 weeks in 2011 following waiting-time guarantee reforms.
  191. Office for National Statistics · 2025
    Government-financed healthcare expenditure was estimated at £280 billion in 2025, accounting for 81% of total healthcare spending.
  192. Office of the National Coordinator for Health IT (ONC) · 2026
    Total number of information blocking portal submissions received: 2,563; total possible claims of information blocking: 2,450 (1,554 from patients, 1,938 against healthcare providers, 338 against certified health IT developers) through July 2026.
  193. Oregon Health Authority · 2026
    34 assigned spending floors covering 58 hospitals or health systems; 27 (79.4%) met or exceeded their floor in 2024.
  194. Oregon Health Authority · 2024
    1,161,226 people (80.5%) kept benefits among 1,442,038 completing renewal by December 13, 2024. OHA says two-year eligibility does not directly affect the renewal rate.
  195. Patented Medicine Prices Review Board · 2025
    Section D, Spotlight on Canada, reports an average 11-month interval for new-to-Canada medicines with sales in Canada and the PMPRB11. This figure is in the 9th edition, published June 2025, and does not describe every internationally approved medicine.
  196. Patented Medicine Prices Review Board · 2024
    Approximately 84% of patented medicine sales had a list price above the PMPRB11 median in 2023; sales-weighted share, not share of drug products.
  197. Patented Medicine Prices Review Board · 2024
    The page's 2021/22 Ontario section gives a standard fee of C$8.83 and rural fees up to C$13.25, except for long-term care capitation. Original URL loaded successfully during verification.
  198. Peterson-KFF Health System Tracker · 2025
    Among firms with 10 or more workers offering health benefits, 4% funded individual-market coverage in 2025; survey measure includes ICHRAs and similar arrangements.
  199. Pew Research Center · 2025
    14 million unauthorized immigrants in 2023, including about 6 million with temporary protections (e.g., TPS, pending asylum).
  200. PLOS ONE · 2024
    A 2024 Swedish primary-care study describes salaried professionals and centres averaging four GPs and 20 staff, with a mean patient list of 8,280 in its 2016 data.
  201. Pollin et al., Political Economy Research Institute (UMass Amherst) · 2018
    Projected 10% lower national spending; estimated about 1.8 million jobs displaced and proposed transition assistance.
  202. Polsky et al., NEJM · 2015
    Callers posing as Medicaid patients got primary-care appointments much less often than privately insured callers, and availability rose when Medicaid fees rose.
  203. Proceedings of the National Academy of Sciences · 2018
    All 210 FDA-approved new drugs, 2010–2016, associated with NIH-funded research; project costs >$100 billion over 2000–2016, including basic research on targets.
  204. RAND Corporation · 2024
    Employers and private insurers paid on average 254% of what Medicare would have paid in 2022.
  205. RAND Corporation · 2024
    U.S. prices for all drugs averaged 278% of prices in 33 OECD comparison countries; brand-name drugs 422%; unbranded generics 67%.
  206. RAND Corporation · 1986
    Free care raised spending about 30% compared with high cost-sharing, with little measurable health effect for the average person but benefits for poor, sick participants.
  207. Rhode Island Office of the Health Insurance Commissioner / Bailit Health Purchasing · 2013
    Aggregate primary care spending share: 5.4% in 2007, 9.1% in 2012, a reported 69% increase; 2012 figure was subject to revision as of April 2013; increases began before the 2010 standard.
  208. RTI International · 2024
    RTI’s 2024 report, using 2021 claims, found medical/surgical office-visit reimbursement averaged 21.7% higher than behavioral-health reimbursement and behavioral-health out-of-network clinician use was 3.5 times as frequent, without establishing that the payment disparity caused that difference.
  209. Sahni, Mishra, Carrus, Cutler (McKinsey / Harvard) · 2021
    About $950B a year (roughly 25% of spending) is administrative; about $265B of it could be removed with existing interventions.
  210. Scandinavian Journal of Primary Health Care · 2024
    A 2025 article describes Danish GP remuneration as approximately one-third capitation payments and two-thirds fee-for-service payments.
  211. Scandinavian Journal of Public Health · 2022
    A 2022 review reports private ownership of 44% of Swedish primary care centres, compared with about 30% before reform, and cites an earlier three-region survey in which about 60% felt they had chosen their provider.
  212. Scientific Reports · 2022
    Among 695 assessed cases, too-harsh decisions: 11.08% under anonymous review in 2016 and 2.59% under signed review in 2017; overall inappropriate decisions: 15.11% and 15.40%.
  213. Service-Public.fr · 2026
    The general reduction applies to earnings up to 3 times the minimum wage (SMIC), offering a maximum coefficient of 0.3981 to 0.4021 at the SMIC level.
  214. Shrank, Rogstad & Parekh, JAMA · 2019
    Waste of $760–935B a year: administrative complexity $266B; pricing failure $231–241B; failure of care delivery $102–166B; overtreatment or low-value care $76–101B; fraud and abuse $59–84B; failure of care coordination $27–78B.
  215. Social Security Administration / Boards of Trustees · 2024
    Administrative expenses: HI 1.4%; SMI 0.9% of 2023 program costs. Includes SSA, HHS and Treasury administration; excludes private insurers' and providers' own administrative costs.
  216. State of Vermont · 2014
    Vermont's December 2014 Green Mountain Care report estimated $2.580 billion in needed new state tax revenue for 2017 and modeled an 11.5% employer payroll tax plus income-based public premiums up to 9.5%.
  217. Statistics Canada · 2025
    2023 highest household income quintile: 60.9%; lowest quintile: 42.8%; perceived health, unadjusted for other factors; illustrates remaining inequality, not the causal effect of universal coverage.
  218. Supreme Court of Canada · 2005
    The prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver timely health care. In a 4-3 judgment, the Court held the prohibition violated the Quebec Charter.
  219. Swiss Federal Council / Swiss Parliament · 2024
    2023 administrative costs: 4.9% of earned compulsory health insurance (OKP) premiums. Descriptive cost share, not a causal estimate of nonprofit status.
  220. Taiwan Ministry of Health and Welfare · 2024
    End of 2023: 30,838 contracted health facilities, of which 23,085 were hospitals and clinics, accounting for 91.6% of medical institutions nationwide; broad participation, not literally every provider.
  221. Taiwan National Health Insurance Administration · 2024
    Single payer since 1995; administrative cost under 2% of spending; universal smart card.
  222. Tax Foundation · 2024
    In 2022, on average, OECD countries' VAT revenue accounted for almost 22 percent of total tax revenue.
  223. Tax Policy Center / JCT estimates of comparable proposals · 2021
  224. Tennessee General Assembly Fiscal Review Committee · 2026
    March 7, 2026, page 2: currently two approved foreign training licenses and one pending approval in the state.
  225. Texas Department of Insurance · 2024
    74% of providers meeting the threshold for evaluation got a gold card; only 4% of providers had 5 requests in a six-month period. Post-implementation survey reported in 2024; survey period unspecified.
  226. The American Journal on Addictions · 2004
    The French study reported approximately 65,000 buprenorphine patients annually—about ten times the number treated under restrictive methadone policies—and a coincident 79% decline in overdose deaths from 1995 to 1999.
  227. The BMJ · 2019
    Between 2011 and 2017, IQWiG assessed 216 German-market drug approvals, comprising 152 new molecular entities and 64 new indications, and found no proven added benefit over standard care in 125 assessments (58%).
  228. The Commonwealth Fund · 2024
    The U.S. ranked last overall among 10 high-income countries.
  229. The Commonwealth Fund · 2017
    The average wait time to start treatment was 60 days during the first four months of 2017. This represents a decrease of four days relative to the same time last year, and a 13 percent reduction over the past four years.
  230. The EPMA Journal · 2010
    Taiwan's 15-year Health and Medical Care Plan began in July 1985, and by 2000 its hospitals had 126,476 beds, or 5.7 beds per 1,000 population.
  231. The Gerontologist · 2001
    Denmark’s nursing-home beds declined 30% between 1985 and 1997 as home services and adapted housing expanded; the cited paper dates legislation limiting new nursing-home construction to 1988.
  232. The King's Fund · 2011
    In England in 2011, the Dilnot Commission recommended a £35,000 cap on lifetime individual care contributions, while its briefing described one in ten people over 65 facing care costs exceeding £100,000.
  233. The Lancet · 2011
    Fatal overdose rate within 500 m of the facility decreased by 35.0% (from 253.8 to 165.1 deaths per 100,000 person-years) after opening, compared with 9.3% in the rest of Vancouver.
  234. The Milbank Quarterly · 2000
    Germany introduced mandatory long-term-care insurance in 1995 with a 1.0% gross-income contribution, rising to 1.7% in July 1996, replacing much public assistance previously received by about 80% of nursing-home residents.
  235. U.S. Census Bureau · 2026
    U.S. resident population (50 states and DC) of 341,784,857 on July 1, 2025.
  236. U.S. Census Bureau · 2026
    26.7 million people uninsured for the entire 2025 calendar year (CPS ASEC).
  237. U.S. Census Bureau · 2026
    Puerto Rico resident population 3,184,835 (July 1, 2025).
  238. U.S. Census Bureau · 2025
    Uninsured working-age adults (19–64) in 2024: 31.8% of noncitizens vs 8.4% of native-born and 8.6% of naturalized citizens.
  239. U.S. Census Bureau · 2022
  240. U.S. Census Bureau · 2021
    2020 populations: Guam 153,836; U.S. Virgin Islands 87,146; American Samoa 49,710; Northern Mariana Islands 47,329.
  241. U.S. Department of Labor · 2024
    Approximately 76.7% obtained new employment within 6 months of exiting the program in FY2023; participant outcomes, not a causal evaluation or healthcare-billing-worker result.
  242. U.S. Department of Veterans Affairs · 2025
    About 9.1 million veterans enrolled in VA health care.
  243. U.S. Department of Veterans Affairs · 2014
    PACT implementation associated with acute hospital admissions decreasing 12% and urgent-care use decreasing 33%; agency report of association, not a randomized causal estimate.
  244. U.S. Government Accountability Office · 2024
    Full compliance with machine-readable-file and shoppable-services requirements: 27% in February 2021; 70% in November 2022, estimates by CMS officials cited by GAO.
  245. U.S. Government Accountability Office · 2021
    Social Security recipients in Puerto Rico are automatically enrolled in Medicare Part A but not Part B; Medicare Savings Programs are not available there.
  246. U.S. Government Accountability Office · 2016
    The ACA provided the five territories $7.3 billion in additional Medicaid and CHIP funding available through at least FY2019.
  247. U.S. Government Accountability Office · 2014
    Estimated federal Medicaid spending of $1.1–$2.1 billion for Puerto Rico as a state in 2011, versus $685 million actually spent in FY2011 (excluding nursing home and home health costs).
  248. U.S. Government Accountability Office · 1993
    GAO’s 1993 report states that Maine guidelines for 20 conditions and procedures in four specialties acquired the force and effect of state law on January 1, 1992, for the participating-physician liability demonstration.
  249. U.S. House of Representatives · 2023
  250. U.S. Senate · 2023
  251. U.S. Supreme Court · 2012
    Congress cannot coerce states by threatening all existing Medicaid funding.
  252. UK Parliament / Department of Health and Social Care · 2024
    Approximately 89% of prescription items dispensed free of charge in the community in England. This reflects exemptions, not a universal abolition of prescription charges.
  253. UK Visas and Immigration · 2024
    You can start using the NHS free of charge from the date your visa starts. You must have already paid the IHS if you need to... £776 per year for students, their dependants... £776 per year for visa and immigration applicants who are under the age of 18... £1,035 per year for all other visa and immigration applications.
  254. Urban Institute · 2019
    Single payer raises federal spending about $34T over 2020–2029 and national spending about $7T.
  255. Washington Health Benefit Exchange · 2025
    94,000 customers in Cascade Select public option plans; up 50% from 2024.