Outcomes, capture, name-brand drugs, and devices — USA first, then the next-most-expensive market. Substitutes are labeled, never swapped in silence.
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Everything here is open to read, copy, and cite. The thing it argues for — a clinic that posts its prices, an employer that pays them directly, insurance kept for the catastrophic — does not exist yet. The first step is a list of people who want it, and a clear idea of what each of them can do.
Not limited to this site's Top 20. Rankings use approximate age-standardized death rates per 100,000(GBD / WHO / OECD-style), so a young country isn't “winning” just because people die of infections first. Dementia lows in Africa are often under-counting — flagged below.
Heart disease (ischaemic). Coronary / ischaemic heart disease deaths. GBD 2021 syntheses (San Marino, Japan, Korea, France low-ASMR band). Tiny states can top charts. Among large countries, Japan / South Korea / France are the usual low-IHD story. Why = educated guess. US ≈ 85/100k on this illustrative scale.
Decades of lower saturated-fat / higher-fish diet, lower average cholesterol historically; coronaries stayed rare while stroke/salt was the bigger problem. Cheap frequent visits help catch BP early.
solid
3
South Korea
35
0.41×
Same East-Asian low-IHD pattern plus a fast drop as care and BP control scaled; diet still less “corn-oil + mega-portion” than the US.
Southern Europe diet pattern + sharp IHD mortality declines as smoking and acute cardiac care improved.
solid
6
Spain
42
0.49×
Mediterranean diet pattern, later obesity wave than the US, and solid infarct care networks.
solid
7
Italy
45
0.53×
Same Mediterranean cluster: diet, olive oil, walking culture historically; regional gaps but national IHD ASDR stays low vs Anglo/Eastern Europe.
solid
8
Peru
48
0.56×
Lower average cholesterol/obesity historically than US; more infection/other deaths in poorer regions — but ASDR still shows relatively low coronary deaths.
solid
9
Chile
52
0.61×
Latin America mid-tier: not Eastern-Europe vodka-IHD levels; improving secondary prevention pulls ASDR down.
solid
10
Israel
55
0.65×
High-tech cardiac care + Mediterranean-influenced diet in parts of the population; younger mix than Japan but IHD controlled for SDI.
solid
Leaders at a glance: Heart disease (ischaemic): Japan (~32/100k; US ~85) · All cancer: Mexico (~115/100k; US ~145) · Chronic lung disease (COPD / CRD): Kuwait (~2.7/100k; US ~35) · Dementia (Alzheimer & other): Mexico (~22/100k; US ~40)
552 beds · 92,000 ED visits · 28,400 discharges. Modeled as the highest-capability hospital in its metro: Level I trauma, comprehensive stroke, STEMI, high-volume OB, full oncology, transplant referral partner. Numbers are illustrative national mid/high benchmarks, not a real chargemaster.
