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The high ratio of US expenditure on health is partly indicative of the woeful state of health in USA but also the hugely inefficient method of provision.
The amount of rentseeking corruption and inequity in the US healthcare is unequaled anywhere in the world.
The public health systems such as Australia and New Zealand provide a far better cost effective provision of healthcare.

Equally the amount a government taxes and spends is not a measure of how effectively that government is governing- it can be a measure of how ineffective it is.

China you will not has a very low tax burden on citizens but a highly productive economy that enjoyed ever larger fiscal and trade surpluses.

It is crucial that governments tax, but also how they spend those tax revenuies.
While USA squanders its exceptional privilege on seeking to preserve its petrodollar hegemony China trains millions of engineers and technicians and builds global productive infrastructure for the post industrial economy.

China won the trade war by how well it manages the available resources and economy not how much it taxes and spends.

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