Academically this sounds enlightening, but it only takes one cursory walk around a supermarket in the US to see this is unequivocally false. Healthcare is an externality, not a base of anything. From the average customer to the product in the aisle to the marketing - everything is 100% not a direct cost benefit function in terms of healthcare.
Unfortunately I think your comment is even less enlightening.
I mean, not all healthcare problems are caused by lifestyle. So clearly healthcare is a base layer - there is no situation where it wouldn’t exist.
So I'll break down my reasoning a bit. It requires a full blog post to get out, so please forgive the abridged version.
Healthcare is a catch all for all the other problems of society. The top costly conditions in the US are (in order of this barely sourced article): Mental Disorders, Heart Conditions, Trauma-Related Injuries, Diabetes, Cancer, COPD and Asthma.
Every single one of these is plainly racking up unneeded costs by the daily actions of all of us. My quip on the supermarket was a remark on the total view of health (from mental to reproductive care to basic carcinogens to ...).
How many people are mindlessly scrolling on Instagram while performing another task, how many people smell of cigarettes, the marketing of 'sinful goods' (depending on the state), the near impossibility to avoid added sugar in every packaged foodstuff, the number of 'alcohol noses' you can see down a 50ft isle, the parenting of children, the smell of fossil fuel exhaust from the parking lot, the gait of the elderly, injured, or soon-to-be, the accommodations (or lack thereof) for those in wheelchairs and with living assistance, and still the primary food at checkout - And to include everyone in the conversation: think of the anyone working two jobs and has 0 time to prepare fresh food for themselves or anyone else, the eventual cost is in the habitual behaviors made in the constraints of under-compensated labor.... I could keep going and I've left out other observations contributing to other conditions but I think you understand.
The thing I'm trying to say is that there are interventions all over the place - however, the up-front costs (ignoring all else) of a 'double blind randomized trial' for every single one of them to earn the proper authority to define its relative utility to cost is unrealistic at the moment (also most governments do not allow for risk based price of care) - an economic externality.
Couple this externality behavior with a market of near perfect inelasticity for good health (and before someone comments, yes, suicide / assisted euthanasia may not be inelastic in price on this metric) - and you can't say "Healthcare is such a base layer of the economy" - an alternative analysis is "Healthcare is an externality that is priced in a government controlled market"
[Edit] I completely left out the externality of the high reward litigation industry on malpractice and all of the above conditions as evidence of harm - adding pressure on compensation to the highest paid professionals.
They're most obvious with "basic" products like energy and comms - in theory what is delivered is mostly undifferentiated kWh or GB but through the magic of "confusing plans", marketers have succeeded in making comparisons very difficult for regular people.
(You can do it, but you need OCD, a year of billing data and a spreadsheet - which greatly exceeds the cognitive effort most people will invest in choosing a mobile or energy provider).
The US healthcare sector seems to be the largest, most intricate and most successful (in terms of gdp extraction) confusopoly in history.
Also a marginal Joule that you can demand at will is different from one that you committed to months in advance.
Similarly for data.
Of course, in practice most plans don't reflect this 'essential' complexity, but are full of accidental complexity to confuse people.
do you have evidence to support these claims? what makes the US patient population or their expectations or the US taxation system unique in the world?
A part of the latter is based on the actual superiority of the quality of medical care in this country -- due to the high levels of wealth produced by this (mostly market-oriented) economy and advanced medical technology, doctors can in fact perform miracles here that they cannot elsewhere.
How is it superior? Sure, some countries fare worse. But folks aren't getting the healthcare they need because of cost, and the results aren't exactly the best in the world. I'm not convinced that "culturally" folks have high expectations either, and sure, you might want to change your lifestyle to lose weight - but at the same time, you might just need medical oversight to do so. Not to mention that a bunch of things medicine helps are not things that lifestyle just fixes.
I've been hospitalized in four different countries. The least sane was America. The sanest was a private hospital in England, but the public hospital in England was fine too. My home country of Canada is sane, reliable, and reliably slow and mediocre bordering on subpar. Cyprus lacked toilet seats, but at least the food was fantastic.
America's healthcare system is bananas. Even trying to come up with a metaphor here is difficult. It's $5k a day stays with Wonderbread, tuna, and bad not-actually-mayo-mayo for lunch. It's well groomed, well respected, monied indentured second and third opinion servants. It's Moloch's own mediation on Moloch[0] sold on the discount rack of the bookstore pharmacy downstairs.
You can think Americans are different. They are not. They move to Canada all the time and we service their bum knees just fine.
You can think Americans do all the medical research in the world. They don't. Plenty comes out of Europe, China, and elsewhere.
You can think your tax code is unique. Ok this one I kinda agree with. It's almost as bananas as your medical system. But it doesn't change the fact that Americans put up with absolute bananaspants insanity for a healthcare system when they're perfectly capable of funding their libraries and roads.
China beats you on scale. And so on.
The basic fact is that Americans have what is essentially a psychopathic medical system at the best of times. One can negotiate with a psychopath, but Kafka returns your offer with a can of stale soup and doesn't even laugh.
[0] https://slatestarcodex.com/2014/07/30/meditations-on-moloch/
https://en.wikipedia.org/wiki/List_of_countries_by_research_...
This is a big thing. I'm in the UK, where healthcare is very socialised, but I very much appreciate the fact that the US invests in making and productionising the next generation of healthcare, which we can then buy in bulk at a discount.
