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It would be fairer to compare by wealth, where the USA is at 30.2%

if you use wealth, we are a back at why americans spend more on per captia than any other countries: because they can (because they are wealthier).

Healthcare, especially in older population, starts to behave like a luxury good at upper ends of cost / care.

US healthcare costs are similar to other developed countries once normalized by per capita GDP?

I thought they were still higher.