The U.S. government spends more money on healthcare than any other nation in the world, including countries with universal healthcare programs such as Canada and the U.K., according to a study published online Jan. 21 in the American Journal of Public Health.

The finding runs contrary to many experts’ estimates and the predominant perception of U.S. healthcare as a privately funded system, according to co-authors David Himmelstein, MD, and Steffie Woolhandler, MD, MPH, of the City University of New York School of Public Health at Hunter College.

“Contrary to public perceptions and official Centers for Medicare and Medicaid Services estimates, government funds most health care in the United States,” the authors wrote.

For the study, Himmelstein and Woolhandler analyzed official CMS data on government spending for health programs and public employees’ health benefits for 2013, then calculated total private spending tax subsidies using federal budget documents and tax figures.

Their results showed that the U.S. government’s share of overall health spending was 64 percent of national health expenditures in 2013, with an expected increase to 67 percent by 2024. Total tax-funded health spending in 2013 was $1.9 trillion, with that number expected to nearly double to $3.6 trillion by 2024.

“Government health expenditures in the United States account for a larger share of gross domestic product than do total health expenditures in any other nation,” the authors noted.

The results of the study raise interesting and important questions about how public funds are being spent and how best to maximize government healthcare spending in the future, according to Himmelstein and Woolhandler.

“Although taxpayers fund the vast majority of health spending, overall priorities for this funding are rarely discussed,” the authors concluded. “Appreciation of the magnitude of government funding might encourage more explicit, appropriate, and equitable targeting of these expenditures as components of a total health budget.”