–USA medicine performs dramatically MORE surgical interventions than are performed in Europe and Japan (and they DO have, decade after decade, longer life expectancy and lower infant mortality rates)

–ditto, the rates of pharmaceutical usage rates

Absolutely, a goodly number of surgeries and medications are simply optional and other alternatives might be better. And absolutely, there are many deaths that come immediately after surgery or from taking too many medicines or ones that have iatrogenic effects

–when 100% have some arrangement for pre-payment
(rememberr that far, far less than 100% have health insurance that will pay for surgery that has an elective element)

–when patients have, on their own, educated themselves regarding less complicated interventions and are aware of potential risks and iatrogenesis (and many choose NOT to pursue surgery)

–when patients are well above average in income and education

–when patients have an absolute minimum of complicating medical factors–minimal number of obese patients; diabetic patients; hepatic or renal compromise; orthopedic complications; minimal numbers of complicating pharmaceuticals

–when patients have an absolute minimum of complicating social factors
(minimal family/social support for post surgery care/follow up at home)

Overall, this approach is suitable for an ever smaller percentage of the population.

However, it is good from the standpoint that many patients are taking control–and that means also considering NOT to have surgical intervention.