Changes in out-of-pocket spending probably account for 15 percentage points of the U.S. health spending gap that developed between the U.S. and other countries between 1980 and 2015.
from Forbes Real Time https://www.forbes.com/sites/theapothecary/2018/05/20/solving-the-mystery-of-american-health-spending-after-1980-part-1-out-of-pocket-spending/
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