MRI is like 5x cheaper here (I paid less than 300$ for both knees) without any insurance just doing it privately. The reason I think is that it's easier to open a medical business here, people can't sue for damages (or they can but will never be awarded anything substantial), there is less regulation you need to comply with and the doctors and technicians make less money. All this makes it possible to provide medical services at reasonable price.

We have public single payer healthcare. The quality is low and lines are long (it's several months at least if you would like to get free MRI using that option and then like a year or more to get actual arthroscopy). Still I think shitty but somehow working public option keeps private providers in check because they can't charge arbitrary amount as there is always shitty option to fall back on.

To give you an idea about prices here if you go private: typical doctor visit: 40$, dentist (one tooth filling): 60$, arthroscopy: 1000$, full blood panel with about everything under the sun included (hormones, vitamins, minerals, insulin response etc.): 200$. The quality of service is low but higher than in major metro areas in US (according to my sister who lives in NYC). This is Poland so low wages are surely one component that makes cheap services possible but I think not the only nor the most important one.

> The quality of service is low but higher than in major metro areas in US

This is always my question when I hear about service being "great" or "terrible" - relative to what? I honestly have no idea if my healthcare is "good" or "bad", because I've only experienced one system. I have plenty of complaints, but there are also lots of things that don't go wrong that could.

People complain about lines in other countries, but me/my family has had waits of 2-6 months getting appts for new ob/gyn, dermatologists, rheumatologists, sleep specialists, etc. Mental health experiences have been worse until we stopped trying to do it through insurance at all and just ate the costs. Involved treatments (e.g. at a hospital, even outpatient) involve multiple, pricey bills.

So when you say "quality is low", what does that MEAN?

I am assessing it in two ways. One is comparing it to other services: do they have modern equipment? Is bureaucracy a burden? Do people working in those services generally act like decent human beings? Are doctors/technicians competent? Is it easy to imagine a service at higher quality and how much would it cost? Using those criteria I think medical services in my country are low quality, especially the public option.

Another way is comparing to other countries. I have family living in US (both immigrants from different countries, now US citizens, having children there) and very close friends living in Switzerland. Both lived in Poland for many years and often visit so we are all in good position to make comparisons. Both US and Poland suck in comparison to Switzerland in all imaginable respects. They comparison between US and Poland comes out about equal at least according to us.

Healthcare is driven by profits in the US and in the absence of any safeguards companies will charge as much as they can get away with.

He's comparing the higher per-person costs of elderly care to lower per-person costs of whole-population care.

I think we agree. I'm just saying it's not a single fundamental difference between the US system and other systems, it's myriad differences that combine to make things way more expensive in the US.

But you eliminate negotiation as one of those factors using other countries as a reasoning. I've never heard that this is debunked (though I don't expect that it is the sole factor). Do you have sources?

Or did I misunderstand and you are just saying that negotiation (or lack thereof) alone isn't responsible for all the cost headaches?