Do not dispute that there are big differences. One of the costs of medicine is producing a new medicine in the first place. Present cost for a new drug starts at around 1 billion dollars.

As for managing costs in places with universal coverage it varies.

In Britain at either 65 or 70 dialysis is no longer provided unless the patient can pay for it. In Norway, no antibiotics are given unless the patient got sick outside of Norway. Other countries have other limitations. It is all about being able to afford it.

They also have a 40%+ tax rate, which is more than double ours.