That the US has a higher GDP (and therefore spends more on most things that can't be imported) isn't divorced from the health policy of the US. It is the prioritization of GDP in the public policy sphere in the US that has, partially, led to the GDP being higher. For example, drug companies in the US make more from patients partially because there is no national collective bargaining program there. This gives them enough profit to meet the testing requirements to get into other countries around the world. There are many similar examples of this.
I'd also argue that more effective people in America are discouraged from working for the state due to cultural prestige differences with other western countries.
The French are healthier. Not as wealthy, but healthier. Healthcare spending is just one part of it. The other part is a culture that emphasizes other parts of life over raw income or cost. Nobody is tallying up the healthcare benefit of eating fresh veggies instead of a pizza pocket, but it is there, even if it is invisible in the numbers.
Also, are there any studies to show that populations in other countries use their medical systems more frequently across the board, or that they use more frequent preventative visits?
You mention the problem with obesity and its co-morbidities. Are there any studies or plots that show health outcomes (lifespan, infant mortality, maternal mortality) as a function of % of population who are obese? I wonder if poor health is linearly correlated with obesity, without regard to healthcare spending...
Refusing to go for checkups, screenings, even after mild heart attacks, refusal to take prescribed medications for blood pressure or diabetes...
I am not a Doctor observing patient populations, but I have lived and worked in East Palo Alto, CA for the last few years, which from my perspective, is a stark case study in all sorts of inequalities (For non-SV residents, East Palo Alto is a small historically socio-economically depressed city wedged between Palo Alto, Facebook, and Google. Zuck's house is a stone throw away from crack houses)
Anecdotally, what I have seen regarding poorer/uninsured people not utilizing health services involves all the things you have mentioned.
Non-emergency healthcare without insurance is pretty much out of the question. Even with insurance, co-pays can be prohibitively expensive. There are people I know living paycheck to paycheck with zero savings and like 50%+ of income going to housing expenses. Even a $50 unplanned-for copay is a painful blow.
Distance is also an issue for a population that may not have consistent access to a car--and the bus system takes too much time. If you are working a few jobs, it's nigh-impossible to take a random 1hr+ bus ride to a medical facility.
Education/knowledge is, unfortunately, also a huge issue. I have observed some astonishingly unhealthy habits that stem primarily from ignorance. Additionally, even navigating our health system requires some level of education, literacy, and time that often seems prohibitive for many in the population I have interacted with. And, with regards to distrust of the medical system, I have observed that as well. I have also seen this coupled with exploitative homeopathic "care" providers...which is doubly sad. These are more complex issues that I don't feel well-equipped to begin to speculate the underlying reasons for. Perhaps some of it is cultural. I am not sure if that is the primary story though.
Generalized ambient anxiety and depression is also, I believe, the more ultimate, albeit distal, cause here, rather these more proximate poverty mechanics. The emotional toll of living in poverty, primarily extreme _relative_ poverty (remember Zuck across the freeway and the swarms of Tesla commuting through your city on their way to high-paying tech jobs that are inaccessible to you) results in all sorts of extremely unhealthy compensatory behaviors. Heavy alcohol and drug use--even if just Marijuana, binge eating fast-food, violent communication styles that contribute to always-on fight or flight reactions, dangerous activities like racing cars or weaving bikes through traffic--perhaps done as some way to "feel something" or perhaps find identity in the only way available--acting out anti-social power displays as a way to reify self-worth contra a system that clearly treats them like shit on nearly all levels. And more.
Frankly, unequal access is both a moral failure and also, I believe, soon to be an instrumental failure for the strength of the United States. Having a large population of enfeebled, diseased people does not bode well for nice things we care about like innovation, improved quality of life, stability of our governance systems, or even things like the strength of our fighting force.
However you want to cut it, the issue of unequal health access is a shame.
Different countries have different definitions of infant mortality. When is it categorized as a miscarriage and when an infant death? The US tries very hard to save premature babies, and counts the failures as infant death rather than miscarriages.
I find it ironic that the net result of pro-life policies is increased mortality rates for babies and mothers.
At least I think that's what GP was saying. I don't actually know what rules are applied. It would be interesting to see a graph of miscarriages month-by-month as well as deaths month-by-month.
It's all over the map, there are even societies where the baby isn't considered a person until some time after birth.
It's certainly enough to question the relevance of the statistics.
What societies? Some of the countries in the graph?
So technically not actually predicting an expected lifespan (thermonuclear war could happen after all) but allows longitudinal and secular analysis.
(any more specifically than those deaths adding to the overall death rate)
If you want greater resolution on a process like this you'll do better to search yourself than to reply on HN commenters like me.
By taking out those with a very general correlation for 'does not take care of their own health', we'd get a truer measure of the relative effectiveness of the respective health care systems.
But it's an available statistic.
If we had doctors report on body fat % (even done with shotty capacitance) or hip/waist ratio we'd be better off.
Also has impressive numbers in other charts.
The question is what the lag on health effects of that was. We know from things like smoking prevention and childhood diseases that the lag can be huge, anything up to half a century.
Framed in the opposite direction: could the US put in any form of price control to equalize this metric without significant impact to the continued investment in the field?
Granted this won't do for comparing all metrics, but it's still an interesting reference point. Here's one article about this: