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Access to healthcare doesn't really explain the US, at least according to the same people talking about Japan and Spain:


If you consider that Medicaid tends to be quite focused on outcomes (spending money where it's effective) and covers ~1/4 of the country, this isn't surprising.

Better diets and less drug use should both be rather cheap to impact at a policy level. I think much of the problem is that it's popular in the US to oppose the government having policies that would improve the quality of life of poor people.

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