The basic reason is that the US rewards heroic interventions, rather than basic medicine, to a much greater degree than other countries, with both prestige and money. Which means that our doctors are incentivized to spend their time and our money on hugely expensive procedures which net people at the end of their lives another 6 months, not necessarily of good quality; whereas stuff like ensuring pregnant women get sufficient vitamins is downplayed, and doesn’t get done. As a result, the US has a lot of low birth weight babies, which results in a high infant mortality, which drives life expectancy down obviously, and the survivors end up sicker throughout their lives, with shorter life expectancies and higher costs. The net result is both high costs and low life expectancy. If you see a table of life expectancies vs age for the US and other countries, you see the results of the above situation; our relative performance is worst at birth, gradually catches up to other countries, and actually becomes best in the world at advanced ages, which is, of course, where Americans get single payer government insurance. .
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