Comparisons of health system spending between the United States and other industrialized countries reveal the U.S. to be an extreme outlier, far outspending any other country. This project will generate baseline health system cost data, to be updated on a biennial basis, comparing U.S. spending with spending in selected countries within the Organization for Economic Cooperation and Development (OECD) on hospital costs for 25 procedures, hospital administrative costs, a market basket of the top 50 pharmaceuticals, a set of high-volume/high-cost medical devices, and physician specialty incomes. These data will be integrated with pilot data from the OECD comparing the costs of more than 25 hospital procedures. Findings will be presented at The Commonwealth Fund’s 2012 International Symposium on Health Care Policy and summarized in a paper for Health Affairs.