The fundamental basis of the US economy (and I speak as one who lived there for 27 years) is the notion that people are merely the means whereby corporations make profits. The health insurance companies make a fortune by sitting between individuals and health services providers. Next up, lawyers. These folk ensure that most medical services in the USA are provided in the context of ever-present risk of litigation, thus driving costs up and driving efficacy down. These two factors alone account for much of the excess US cost of medical treatment. When we add in the abysmal drug-purchase policies, the fact 86% of US citizens are fat and therefore riddled with obesity-related ailments, and it's easy to see why the US approach to health care provision is among the very worst in the world. The NHS may be a sad joke, but the US way of doing things is beyond satire.