He's actually right about exploding costs outside the US. Just as costs have exploded in the US, they have also exploded in most other first world countries (and also many non-first world countries). Source provided below.

Yes, the US has the highest cost. But the ratio between the US and others has stayed roughly the same over the last 50 years (maybe longer--that's as far back as my data source goes). The US pays twice as much as France now because we paid twice as much as France in 1990, and both systems have had costs explode by about the same factor since then.

Here's a table of costs per capita in US dollars for the UK, France, and the US:

  Year   UK   FR    US
  1980  385  659  1036
  1990  782 1458  2700
  2000 1561 2686  4557
  2010 2871 4048  7939
  2018 4070 4965 10586

Here it is, with each country's cost divided by that country's 1980 cost:

  Year   UK  FR   US
  1990  2.0 2.2  2.6
  2000  4.1 4.1  4.4
  2010  7.5 6.1  7.7
  2018 10.6 7.5 10.2

If you do the same thing with most other EU countries, or OECD countries, or other first world countries, the results are similar. Everyone's costs are going up at rates that are in about the same ballpark.

Source:

1. Go to https://data.oecd.org/healthres/health-spending.htm

2. Uncheck "latest data available". This enables the year range selector control.

3. Use the year range selector to expand the range to 1970-2018.

4. The chart will then show the total costs in US dollars/capita by year of health care in 50 countries. You can use the "Highlighted Countries" drop down to narrow that to select a "background" of OECD, EU, Euro Area, G7, or G20 if you want. You can then add individual countries using the list on the left of that dialog.

5. You can change what is shown from total to government/compulsory, voluntary, or out-of-pocket and you can change the measure from per capita to % of GDP.

Please find me another country that creates as many new drugs as the US and that has a national health care system. If you dont have such an example it cannot be a fair comparison. the world is not summed up by a single variable.

Why are you moving the goalposts by now requiring the country in question to "create as many new drugs as the US"? I don't see how that relates to this discussion at all.

Many new drugs are developed in European countries. This is not something that's unique to the US. Americans just pay more for the same drugs.

> Many new drugs are developed in European countries. This is not something that's unique to the US. Americans just pay more for the same drugs.

About 50% of all R&D worldwide happens in the US. The US's global share has shrunk a bit, but only because China and India have grown rapidly, not because Europe has ramped up (it hasn't).

Some new drugs are developed in European countries, or by European pharmaceutical companies - that's true. But European pharmaceutical companies all make a disproportionate amount of their revenue off of sales in the US market. So Europeans quite literally benefit the most from the fact that Americans pay more for the same drugs.

Yeah, but that's America's choice to pay so much more for drugs that the rest of the world pays less for. It doesn't make the US system in any way better.

> Yeah, but that's America's choice to pay so much more for drugs that the rest of the world pays less for. It doesn't make the US system in any way better.

Yes, I agree that it's a foolish choice for the US to subsidize foreign countries' healthcare in this manner. Regardless of this decision that we both agree is foolish, it means that it's misleading to compare cost-effectiveness between the US and other countries directly.

I disagree. You can still compare. There's nothing that requires the US to subsidise corporations. They just choose to do so by not negotiating lower prices.

switzerland has way more new drug patents (per capita) and universal healthcare

Switzerland (unfortunately) doesn't have what I (as an Australian) would recognise as universal healthcare. It's very similar to the "public option" to use the US terminology. It is still closer to modern healthcare than the US, but it's not the same thing (and suffers from problems that other more progressive healthcare systems do not suffer from).

> suffers from problems that other more progressive healthcare systems do not suffer from

Can you elaborate? Genuinely interested in the details.

That’s because several major pharmaceutical companies are head quartered there - not because the actual research is done there.