Teasing out how much of our poor health outcomes is attributable to lifestyle versus healthcare is incredibly complex.

I think the more interesting question as a nation is: are we satisfied with what we are getting for the money we’re spending? If we’re spending 2-4 times as much as most other (maybe all?) developed countries, is it money well spent?

If it is, then who cares? Most of my friends spend twice as much as I do on houses and cars. Assuming they can afford it, that doesn’t mean they’re wrong, it just means they value those things more than I do.

Do we value a few extra months or maybe years of life at the end of life, purchased with expensive chemotherapy or dialysis or an ICU stay, more than the Spanish? Do we value getting a knee replacement right away rather than waiting 12 months more than the Canadians do? I have no idea. I hope so, because that’s what we’re doing right now. If it’s not true, we should change course.