Comment by rcdmd

A few things off the cuff as a physician-- the US has dangerously unequal access to care. I suspect most of the "drag" on life expectancy is from patients without access (this is conjecture but based on personal experience). Even patients eligible for medicaid don't necessarily go through the steps to get it. Often we see patients show up to the hospital who haven't seen docs in a many years until they've developed terrible sequelae like gangrene requiring an amputation. At that point, during admission, the hospital generally helps get them on medicaid. Also, obesity is becoming the new normal in US with all of its associated co-morbidities (a common morbidity/mortality sequence is obesity -> diabetes, hypertension -> coronary artery disease, end stage renal disease, general vascular disease -> death. More healthcare spending is required to treat patients, but the root cause for a growing part of the population's illnesses can't be cured by medicine yet. Also, economically speaking-- the US spends a lot more per capita on mostly everything-- its GDP per capita is higher than these other countries. But, mostly, I suspect the US's health mortality problem is access related. We're spending a lot of money on things that don't help people with poor access to care until their original diseases have done irreversible damage.