You have huge variation in the life expectancy between rich and poor individuals in the US. Here you have a lot of poor people with no healthcare and then you have more affluent people who may be spending hundreds of thousands of dollars a year on healthcare. If I have a few million dollars saved and I can spend a couple hundred thousand to live a few more years there’s a good chance that I’ll take that option. This system is not intended to provide the greatest benefit to the most people but rather to provide the greatest benefit to those people who can afford it. Coming from Canada and seeing the quality/detail of care you get with private insurance here is astounding. There is certainly a lot of fat in the US system but it’s also incredibly comprehensive if you’re fortunate enough to have good insurance.
