The US spends about 18% of GDP on health care or about $3.5 trillion in 2017. The government as noted at the bottom pays about $1.1 trillion of that and private corporations pay about $1.2 trillion annually. The balance is paid by individuals.

So while 5.9% GDP is a lot of money… it is less than corporations pay for health care (around 6% of GDP). So if the corporations spent the same on health care but merely sent the money to Uncle Sam to pay the health care bills, our government would be spending about the same percentage of GDP as Germany.

So yes, 5.9% of GDP is a lot, but the private sector makes up that in spending on health care for US citizens, so from the perspective of the average citizen, it works out about the same.

I think the real issue is that health care costs are so much more than in Germany because Germany and other European countries use price controls on health care products and services. These price controls mean total health care costs are 6% of GDP less in Europe than in America.

I oppose Medicare for All because I when I was the Chief Financial Officer of the largest Medicare Administrator and a large Medicaid Administrator, I saw how poor a job government does managing health care costs. But I do support government price controls for health care products and services where there is not enough competition to allow free markets to drive down prices (which is true in most of the expensive areas of health care).

A Harvard study concluded that if we had comparable prices to Europe for health care products and services than our health care system would be very competitive with the various single payer systems in Europe. We would still cost about 2–3% of GDP more than Europe because of the costs associated with the higher obesity rates in this country, but that is to be expected. If you can figure out how to get Americans as “active” as Europeans and eating healthier, then we could eventually match European health care spending levels if we had comparable health care prices.

The mistake many people make is comparing our overall “tax” take vs our overall spend rate. Because we run higher deficits in our country, our government spending is far higher as a percent of GDP than our government tax revenues. But spending is the real measure of “effective” societal taxes, if you believe someday it has to be paid back.