In particular life expectancy is very low by developed world standards and deaths from preventable causes are very high.
I don’t doubt that the US has world leading hospitals but the population level outcomes delivered are poor by developed world standards.
The US is a net exporter of healthcare services but mostly to developing countries and the numbers involved are tiny (https://www.usitc.gov/publications/332/executive_briefings/c...)
The idea that people who want any sort of complex procedure travel to the US is pure fantasy.
As for the COVID-19 vaccines. The first approved vaccine was the “Pfizer” vaccine developed by BioNTech in Germany (https://en.m.wikipedia.org/wiki/Pfizer–BioNTech_COVID-19_vac...).
This isn't true, the US didn't make the first vaccines, it was created by a German company that partnered with Pfizer for trials/production/distribution[0]. People more often travel outside the US for care, we actually have the second highest amount of people leaving their home country for medical care[1], with the top destinations being in South America [1a].
> creates good to better health outcomes on average vs the rest of the world
This would be nice if true, but we spend more and still have worse outcomes in almost every area[2]. The only things I could actually find that are better here is post-op sepsis and 30-day heart attack survival, but in just about every other area it's more dangerous to get care in the US.
[0]: https://en.wikipedia.org/wiki/History_of_COVID-19_vaccine_de...
[1]: https://www.health-tourism.com/medical-tourism/statistics/
[1a]: https://amjmed.org/medical-tourists-incoming-and-outgoing/
[2]: https://www.healthsystemtracker.org/chart-collection/quality...
Of course the biggest issue of all time is that germs are evolving to survive our antibacterial soap, we may need to develop a large variety of antibiotics.
So maybe thats where the extra cost goes? To drive research, and support the infrastructure that creates good to better health outcomes on average vs the rest of the world.
Saying something is a failure just because it costs so much is only looking at one side of the coin.