If you really want to compare US health care costs compared to other countries, it is a lot simpler than you think. Take 30% right off the top to adjust for the higher obesity rates and the rated chronic diseases that result there from.

Compare what the average reimbursement rate per unit of service is in Europe to America. You have now explained most of the difference.

You are correct, that private health insurance costs more than government health care programs to administer, but the cost differences are more than offset by savings achieved through managing utilization better. In fact, the best comparison of government vs private health insurance can be seen in Medicare where some people have traditional Medicare and some have Medicare Advantage (a private health insurance product paid for largely by Medicare)… the reimbursement for Medicare Advantage is less than that for traditional Medicare… yet even with less money and higher overhead Medicare Advantage health insurance companies make a profit.

So it is really simple… if we want our life expectancy equal to Europe, many of us… and I include myself… need to lose weight…

Next, if we want to lower our health care costs… we need to move many of our unmanaged government health care programs under some form of managed care (best done by private health insurance companies) and charge the government to use their power to drive down reimbursement rates over time to something closer to European reimbursement rates and making these rates available to everyone including private health insurers, employers and individuals…

I suspect over time, we could get our health care costs in line with Europe’s except for the “obesity” factor, which will require lifestyle changes that could take a generation or more to fix.