[aeternum]

Does it actually provide worse health outcomes?

American lifestyles especially in certain states are generally not conducive to good outcomes but the US healthcare system itself is still generally world-renowned for cutting edge procedures.

Analyzing from a cost POV it's quite bad, but in many ways healthcare is the ultimate marginal good so people are willing to spend what they have.

[albert180]

On a population level it does. Higher children mortality than most developing countries and worst life expectancy in G7 can't only be contributed to bad lifestyle. It's also a huge part of not being able to access care, and that's not the cutting edge care, it's cheap basic care