[3pt14159]

I agree with most of what you said, though I want to highlight something as a matter of looking at it from a different angle.

That the US has a higher GDP (and therefore spends more on most things that can't be imported) isn't divorced from the health policy of the US. It is the prioritization of GDP in the public policy sphere in the US that has, partially, led to the GDP being higher. For example, drug companies in the US make more from patients partially because there is no national collective bargaining program there. This gives them enough profit to meet the testing requirements to get into other countries around the world. There are many similar examples of this.

I'd also argue that more effective people in America are discouraged from working for the state due to cultural prestige differences with other western countries.

The French are healthier. Not as wealthy, but healthier. Healthcare spending is just one part of it. The other part is a culture that emphasizes other parts of life over raw income or cost. Nobody is tallying up the healthcare benefit of eating fresh veggies instead of a pizza pocket, but it is there, even if it is invisible in the numbers.