[rcafdm]

US also has "programs" and generally spends more on preventative medicine. Further, actual medical evidence suggests medicine doesn't have good treatments for obesity (getting people to lose much weight and keep it off), save the surgical inventions (which aren't used often enough to explain much). It's also clear that obesity rates are rising throughout the developed world despite rising spending.

https://i1.wp.com/randomcriticalanalysis.com/wp-content/uplo...

[jorblumesea]

> US also has "programs" and generally spends more on preventative medicine.

These programs are often implemented by insurers with already healthy populations, such as large corporations. Hardly the populations that medicare supports. It's not surprising that Microsoft has good support for smoking cessation (and spends lots of $$$), but a mother of two working multiple jobs has no such access or funding.

> Further, actual medical evidence suggests medicine doesn't have good treatments for obesity

Depends on how you define "medicine". Are societal programs like healthy school lunches and subsidized healthy meals part of public health plans? Europe would agree, the US would disagree. Part of the issue is the US scope of interest isn't holistic.

[rcafdm]

One can come up with a narrative to support almost any argument. The question is, do you have data to support it, is it credible, and how much can it actually explain? The truth is richer countries tend to be significantly fatter countries and countries are getting fatter, even though these same countries also spend significantly (increasingly) more money on healthcare and a variety of other social services. These are empirically verifiable points that actually explain things and make quite a lot of sense theoretically.

The high average caloric consumption in the US is likely substantially explained by our income levels. Humans are not genetically adapted to living in an age of cheap, plentiful, readily available, and highly palatable food. Above and beyond high average income levels and particularly affordable food prices, countries also differ in a number of other dimensions. For example, it's quite clear the US escaped the malthusian trap long before most of Europe because of the ample amount of fertile land settlers had at their disposal. Americans were taller and fatter than Europeans in Europe long before the development of the welfare state. This is also verifiable. It's quite possible such differences lingering effects on dietary preferences, serving sizes, and other variables that impact food consumption.

Further, there are clearly large spatial differences in the United States and they're unlikely to be well explained by the sorts of policy you mentioned. Parts of the US settled by people that migrated from periphery of the UK (Scotland, N. Ireland, Wales, and Northern England) suffer from these issues much more than most Americans and more than can be explained by observables like income, education, and the like. This residual also seems to play out in the UK today

https://www.bmj.com/content/342/bmj.d508.full.pdf+html

I've done my own analysis and found this maps well to genetic population structure (not yet published), but whether this is genetic or some sort of subtle cultural phenomenon is a different question.

While I'm quite skeptical that existing non-medical programs of that sort have significant effects (evidence?) or even vary nearly as much as you seem to believe (US affluence has implications for purchasing power of all households, even allowing for somewhat higher inqequality, and size of welfare state often underestimated), I think you need to explain how it is that these higher income, higher spending countries with larger welfare states achieve results no better (probably somewhat worse) than much poorer countries.

https://i1.wp.com/randomcriticalanalysis.com/wp-content/uplo...

Also, you should probably also be able to explain why it is that socioeconomic gaps in life expectancy and other health outcomes are probably at least as large in Finland, Norway, and the like.

https://twitter.com/RCAFDM/status/1203715358152167424

[hdlothia]

What about the financial costs to the patients? Are other countries able to get the same outcomes at lower costs to the patient?

[s1artibartfast]

Broadly speaking, yes. The post suggests that we are operating in a regime where outcomes are insensitive to cost.