In Europe, Canada, Australia, etc everyone has access. Why doesn’t access drive up their cost? Clearly access isn’t what is driving up the costs in the USA.
Canada's HAQ index in 2015 was 87.6 vs. 81.3 for the US. However, Canada spent about $27B US on R&D vs. $495B for the US. On a per capita basis, the US outspends most the world on medical R&D. That drives the US total healthcare costs up while helping to drive down the healthcare quality costs elsewhere. To a certain extent, the US subsidizes the healthcare costs through much of the world, effectively allowing them to optimize for a 2 parameter model while the U.S. must still deal with a 3 parameter model.
I'm not trying to be dismissive, I just don't know how it's germane to the discussion unless we view all the other data through the same lens. The data I linked is per country in absolute and per capita basis that tries to put it in unbiased terms.
Are you claiming the US is disproportionately funding non-useful research? If so, how do we measure "useful" research funding?
[1] https://wtfhappenedin1971home.files.wordpress.com/2020/05/ey...
However, the point between comparing countries still holds. If you use older data, you'll see that the U.S. had even more disproportionate R&D funding
I don't think there's a single perfect measure but if you put it in broader context of measures like Nobel prizes R&D spending, patents, etc. it does seem to paint the picture that the US disproportionately contributes to medical innovation.
It's very similar to the measure of health. There is no single great metric. Using a single metric like BMI or blood pressure is flawed. However, you can get a clearer picture if you bring together multiple metrics.