A random blogger who no one's ever heard of explains this in excruciating detail and very persuasively: https://randomcriticalanalysis.com/why-conventional-wis

A random blogger who no one's ever heard of explains this in excruciating detail and very persuasively: https://randomcriticalanalysis.com/why-conventional-wisdom-on-health-care-is-wrong-a-primer/#rcatoc-diminishing-returns-to-spending-and-worse-lifestyle-factors-explain-americas-mediocre-health-outcomes https://randomcriticalanalysis.com/why-conventional-wisdom-o... He agrees with the linked article that lifestyle factors are what drives the worse health outcomes in the US relative to other wealthy countries. They're not primarily driven by differences in access to or effectiveness in health care. He also makes the case for a few other very unintuitive points: * Health care spending is a direct function of national wealth. If a country gets richer it spends more on health care, and every country at every time in modern history spends about the same amount on health care as a function of its wealth. * The US looks like an outlier in health care spending because GDP is not a perfect measure of wealth. Actual Individual Consumption is a less well-known but much more relevant measure of national wealth. AIC shows the US is more of an outlier in wealth, which makes its high health care spending less remarkable. * There's no magic bullet. Single payer nations pay less than the US mostly because they are less wealthy and health care spending is a function of wealth. Other countries have better health outcomes mostly because of demographics and culture, which can't be fixed by the health care system. And even though finding obvious waste and inefficiency in the US health care system is easy, at a macro level it doesn't look like the US is remarkably less efficient than other rich countries, and most spending goes towards things that patients want.