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U.S. health care spending highest on earth. Here's why

By: Clare McGrane and Teo Popescu

3:15 p.m. on Thursday, February 26, 2026

Most health care services in the U.S. cost at least twice what they do in other countries, and sometimes up to ten times as much.

How does this show up on your hospital bill? To break it down, meet a pair of fictional twins. Emma and Sarah live on either side of the U.S.-Canada border. Below, we break down roughly how much it will cost for each of them to have a baby. Then we share what you can do about the (possibly giant) number at the bottom of your next medical bill.





In British Columbia’s health care system, the cost of each service is set by the government and publicly available online. The centralized, state-run insurance program knows the average cost of each stage of pregnancy, delivery, and post-partum care. In the United States, we can estimate the total cost of having a baby using insurance data, but pricing depends on an individual hospital and insurance plan. The cost of a service is highly variable.

If you’re facing a large medical bill, resources like the Marshall Allen Project can help make sure your bill is accurate and fair. Here are three tips generated by the Marshall Allen Project’s MAC chatbot:

  • Don’t pay your first bill – start by double-checking all the items on your bill to make sure you aren’t being double-charged or charged for a service you didn’t receive.
  • Compare prices using resources like Fair Health Consumer, Billy and Healthcare Bluebook.
  • If you spot errors or overpricing, contact your provider in writing to tell them. Ask for corrections, a cash price or financial assistance.


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Credits

Story: Clare McGrane and Teo Popescu

Design: Teo Popescu

Editor: Phyllis Fletcher

Product Manager: Lisa Wang



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