I mean one can go look at the health outcomes of the average american vs other developed nations, and see that we do not get much for the amount of money we spend. I won't bother to argue this with you. If you're genuinely operating in good faith, you're just as capable of finding the studies as I am, and if not, there's really no point

When comparing average Americans and their health to average, say, Spaniards, we should not ignore the 400 lb gorilla in the room named "obesity".

Even Europeans are getting bigger, but America is way, way worse. Seeing those extreme landwhale-type people who cannot even walk around the mall and navigate it using a motorized cart, throwing bulk packages of horrible shitty ultraprocessed food and drinks into said cart, always makes me wonder how the hell is your healthcare system even capable of keeping them alive.

That is nothing short of a miracle, and should be taken into account in all international comparisons.

Uhuh, That's why we're #1 in the world in conditions uncorrelated with obesity like infant mortality right?

Does this concern an average American, or mostly the poorest quintile of the population?

We're not discussing whether your healthcare system is friendly to the poor; everyone knows that the US is not particularly kind to its poor, in any aspect.

The original topic was if its overall quality declined in the last decade for the average American, who is not poor.