The US has the best cancer and heart disease survival rates in the world. But spending levels are still not commensurate with indicators.

One possible explanation is that a lot of money is spent on healthcare toward the end of life, and much of it is just chasing a sliver of hope. In a system where people spend according to their priorities, instead of to improve some statistical indicator of system-wide efficacy, 'irrational' spending like this could be much higher in the US.