OK. The two biggest issues I am hearing are the size of our military and the permissiveness of our society with criminal and non-productive elements.
I will add a third: the health care and health care insurance industries lobbying Congress and the state leges for protecting their interests.
Although the Japanese do not have the obesity factor that we do, the smoke and drink in much higher percentiles that we do.
First off Japan spends 10.6% of GDP on HC and US spends 17.6% on HC(Public and Private spending).. So money is not the reason... US spends far more...
As for permissiveness, Japan has a pretty healthy porn industry, I have been told...
As for the Obesity, yes this is true... But compare budgets spent on public health initiatives.. Also look at the constraints on advertising to children in Japan...
Japan like the Rest of the world does not allow prescription drug advertising... 'Just ask your doctor...' pretty sums up the rest of the worlds view of US help... the patient is telling the qualified person what drug they need, this borders on insanity...
US also has doctors prescribing opiate pain relief as standard... This is a huge no no out side the US... Opiates are highly addictive, unnecessary as alternate no addictive usually work almost as good. Opiates are a gateway drug, that is as plain as day, it led to the black tar heroin epidemic in mid America...
There is many other cost savings around the world which countries are continually robbing ideas of each other. They rob good ones from the US too, 'Care Pathways' comes to mind quickly.... But US seems caught in a mental warp about looking at the best systems and adapting for themselves...