I can't compare the US or German situation in any depth because I'm neither American nor German. Like you I can only go by appearances when viewing the other. I think that big pharma has got you guys around the balls to a larger extent. For instance, insulin medication has never been expensive over here and we have a thing called the Pharmaceutical Benefits Scheme (PBS) that lets Australians get necessary prescribed medicines without paying full price. The scheme began in 1948. Some medicines which costs thousands in the US are subsidised to the tune of about $10 a month here. That is the extreme end, but drug subsidy is a thing and is tax payer funded.

As to why other rich western countries don't do as well, I'm not sure. I speculate that social policies probably have a great deal to do with it. The US seems to treat socialised anything with a degree of contempt, at least according to the horror stories we hear about. You know, patients without sufficient insurance being refused treatment or massive bill shock after an operation. I'm sufficiently ignorant about this matter to be confident about the detail.

All I can say is that something structural is at work that might explain why the Aussie medical experience is better, and I doubt that it's better or different fast food.