U.S. health care spending is the 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.
Support the show!
Support us by supporting our home, KUOW Public Radio in Seattle.
Sources:
- The Insane Things Hospitals Can Charge You for When you Give Birth, Vice, 2018
- Health Care Costs and Affordability, Kaiser Family Foundation, 2025
- Health costs associated with pregnancy, childbirth, and infant care, Peterson-KFF (Kaiser Family Foundatino) Health System Tracker, 2025
- Utah Dad Posts Hospital Bill With Nearly $40 Fee for Skin-to-Skin Contact After Son's Birth, ABC News, 2016
- As Americans Struggled, Health Insurers Made a Record-Breaking $71.3 Billion in Profits, Wendell Potter on Substack, 2025
- Health Care Debt In The U.S.: The Broad Consequences Of Medical And Dental Bills, Kaiser Family Foundation, 2022
- The Marshall Allen Project
- Cost Data from the British Columbia Ministry of Health
- Interview with Gerard Anderson, Johns Hopkins Professor of Health Policy and Management
- Trump struck deals with 16 drug companies. But they're still raising prices this year, NPR, 2026
Credits
Story: Clare McGrane and Teo Popescu
Design: Teo Popescu
Editor: Phyllis Fletcher
Product Manager: Lisa Wang
Feedback
We would like to hear your feedback on our reporting.
Let us know your thoughts at kuow.org/connect.