Huge parts of the money are going to middlemen who do nothing productive at all (gigantic health insurance companies hiring armies of paper pushers that cause a

Huge parts of the money are going to middlemen who do nothing productive at all (gigantic health insurance companies hiring armies of paper pushers that cause a need for more paper pushers in hospitals and pharmacies etc). Another large chunk is the enormous profits of drug manufacturers, who, entirely uniquely in the world, can set prices however they want with no government negotiation - ending up in madness like insulin being an expensive drug in the USA. While obesity is a huge issue and a huge cost factor, there are more obese countries with nevertheless a tiny sliver of the US medical budget - even after adjusting for life expectancy.