The US ' problem goes beyond just a simple public vs . private debate . I ' m from there and when people try to simplify it to that level , it shows a clear lack of understanding of the issues . There are a lot of problems but it ' s worth remembering that IIRC , the US has the world ' s largest single payer system Mecicare , too . The biggest issue is that the only major players that have ANY incentive to keep the costs down are the insurance companies , and they get attacked when they do . Patients have insurance which means they care little about the price of care though high deductible plans are changing that slightly , doctors still want to charge like crazy , so the insurance company comes out as the only one in the mix with an incentive to lower costs and they get played as greedy corporations trying to keep people between them and their doctors . I left before Obamacare and I was only back for a year with decent insurance but I didn ' t have insurance and it was nearly impossible to even know what anything would cost prior to going in . Obviously unexpected things happen but at least here in Spain I can ask How much is XYZ procedure ? and get a straight answer . Doctors ' salaries are also a problem . Nobody says doctors shouldn ' t be well paid , but it ' s to a ridiculous level in the US , but a lot of that is because it ' s normal to leave medical school with hundreds of thousands of dollars in debt . but it ' s still a great investment because of the massive salariesAlso , medicare the single payer system is forbidden by law from negotiating drug prices , and since those prices are generally the floor for the market , prices only go up massively from there . Now not to even talk about the inefficiency of how things actually have to get billed and medical coding . Even the smallest thing requires a complicated process of billing so a bandage in a hospital costs 10 dollars each because every single one needs people to spend time entering that code into a system and then get verified and then invoiced . It ' s the time that ' s expensive , not the material . To compare , you can look at the dental market in the US which is much less regulated and a much more efficient private market and you find that prices are pretty in line with rich countries around the world . Another example of a good private medical market in the US is eye surgery . Prices are fairly competitive and in line with global standards because they have to be up front about pricing , and it ' s generally people paying their own money . I ' m not an advocate for more privatization or more public in general , there are smart and dumb ways to do both . I just think that saying one or the other is the problem for everything is not taking a look at the real problem . Wow . this rant got to be a lot longer than I thought