No, I&#x27;m saying our health system is as good as, if not better, than anywhere else.  The problem is there are a lot of Americans who have such a high opinion of the medical system they think they can adopt whatever habits they want to adopt without repercussion.  Because the doctors can fix whatever problems result.  This is a fantasy.<p>I&#x27;m pretty sure there are <i>some</i> additional costs that result from lifestyle choices, but I don&#x27;t know how much they impact the bottom line.<p>And I don&#x27;t think you can compare spending across countries like that.  Americans have different expectations from the medical system - they don&#x27;t accept money as a reason heroic measures shouldn&#x27;t be taken, particularly at end-of-life.<p>There are a lot of countries where it&#x27;s reasonable to say to the family &quot;Look, your father is very old.  We could operate and maybe put his cancer into remission, but he&#x27;s likely to die in a month or two anyway and we only have so much money.&quot;  The US isn&#x27;t one of them, and my suspicion is when we get a single payer system the costs won&#x27;t actually come down much if at all.