The reason is obesity.
On average, the US obesity rate is about 42%. In Europe, the average obesity rate is only 16%.
https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity
More than 2 in 5 adults (42.4%) have obesity (including severe obesity).
In the EU, the obesity rate was 16.8 per cent in men while it was slightly lower in women (16.3 per cent).
The top 5 biggest expenditures in the US all go to obesity or obesity-related diseases:
https://healthadministrationdegree.usc.edu/blog/most-expensive-disease-to-treat-infographic
Alzheimer's, diabetes, heart disease and stroke, cancer, and obesity.
It speaks for itself that a country where far more people live a unhealthy lifestyle, you will see higher healthcare expenditures. It is remarkable that this is routinely ignored in the healthcare debate, and the blame always shifts to insurance companies, the pharma industry, conservatives, or any other number of culprits.
This is crucial, because it shifts the popular argument entirely. Major healthcare costs are always painted as inevitable catastrophes that are outside a person's control. Think of the stereotypical unaffordable ambulance that shows up to squeeze an innocent dying civilian for all they're worth.
The facts however show that this is not what the bulk of healthcare expenditures looks like. The bulk of expenditures is a result of people's own choices to live a unhealthy lifestyle. This is an uncomfortable fact that does not allow us to paint healthcare consumers as victims of politicians or pharma companies, and is thus politically useless and even inconvenient for activists.
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