Imo, medical costs in America, driven by unfettered free markets, has been distorted and out of control for decades due to corporate profits motives. Unlike other western countries, US administrations for decades have underfunded medical costs and services … whilst the US complains other western countries don’t spend enough on defence, those other countries could well argue that the US government doesn’t spend enough on medical costs.
Budgets are about choices and for decades the US has chosen weaponry over its own people.