Our country pays 17% of GDP for healthcare...
The costs of the bureaucracy aside for a moment, I recently heard (on Freakonomics Radio podcast,Are You Ready for a Glorious Sunset? on Aug 26th, to be precise) that roughly 40% (iirc) of medical expenses are incurred in the last 2 years of life. The argument there is, are we doing this the right way? The US system basicly tries to save everyone's life to whatever extent is possible with current technology, and the costs of doing so (both in terms of actual monetary fees, and quality of life during those final years) are actually a secondary consideration. Whereas it is much more common in Europe for elder Europeans to enter into 'hospice' style care at a much earlier stage in many terminal conditions. Said another way, is it really in the best interests of grandpa, or his grandchildren, to spend $500K to have even an 80% chance that grandpa can suppress that cancerous tumor for another 2 years?
True. One of the reasons the UK NHS is good value for money is that is is pretty ruthless in spending money on what has best bang for the buck - in terms of "QOL" (Quality of Life Years)
So prenatal care is a big focus
Healthy lifestyle education is a big focus.
A&E (ER in US speak) is a big focus.
But a cancer drug that cost 90,000 pounds, but only extended patients' lives six months hasn't been approved.
If you are over 55, you don't get a kidney transplant, only dialysis.
My father died a few years ago, and had dementia in the end. The NHS were fantastic in helping my mother look after him at home. Subsidies for adapting the bathroom, a "dementia day care" centre where he could go to give my mother a break, weekly visits from district nurse, financial help for things like adult diapers, loan of an electric seat (so he could get up unaided), an inflatable cushion device (and training) that made it much easier to get him up after falling down etc, panic buttons etc.
But when he finally went into hospital, following a silly accident (swallowing his dentures) frankly, he was allowed to die of the pneumonia he then caught in hospital. He probably could have been saved, but it wouldn't have been worth it. Allowing him to die in peace, with his family around him, recognising some of us now and again, and in no pain, vs putting him into a very expensive intensive care unit for, maybe, a few months more? It was the right decision.
A couple of days in the ICU would have cost as much, if not more, than all the relatively cheap help he had got before that. And things like building a disabled friendly bathroom had much more impact on his (and my mother looking after him!) QOL than trying to extend his life.
So, yeah, death panels are a thing. But they are rational.