Take a look at the comment by the poster called "N.J." on your link, which handily demolishes the whole thing. Key point is that if data is processed for European countries as it is for the US, the European countries suddenly come out on top, despite spending far less. Also, people who don't receive treatment or who stop receiving treatment aren't counted in the US. Here's another point from another comment on another story (http://mjperry.blogspot.com/2009/08/us-vs-europe-life-expectancy-and-cancer.html): Americans get sick earlier in life, and younger people are more resilient to disease, so survival rates are raised by that, even though the situation itself is actually worse. As an example of that, the more childhood cancer in a country, the better the cancer survival rates (I'm not saying that I know childhood cancer to be more prevalent in the US, it's an example). European governments sometimes run campaigns to increase awareness of health information, which is probably related to the potential for such campaigns to directly decrease health expenditure, and governments are very much involved in deciding for example what additives are legal in food, so I don't think that it's fair to say that prevention is outside the purview of the health care system. The US system just chooses not to engage that angle as much because the incentive isn't there.