But we don't pay 10 times as much for healthcare. The credit card fee differential is inexplicable.

The differential isn't actually 10 times. The part Visa/MC keeps in the US is more like 0.05% to 0.65%, not 2-3%.

In the US, debit card interchange fees are capped at 0.05% + $0.22, since 2010. That was in the Durbin amendment to the Dodd-Frank Wall Street Reform Act.

Credit card interchange runs up to about 2.9%, but that's only on the cards with the most benefits: those that pay the largest percentage back to the cardholder. That's up to 2% back in cash, reward points or miles... plus 90 day accidental damage protection on all purchases, 1 year extension on all product warranties, travel insurance, concierge service, etc.

Interchange fees for the credit cards without rewards programs start at 0.65%.

> Credit card interchange runs up to about 2.9%, but that's only on the cards with the most benefits

Repeating what I asked in another comment, it's important to know what percentage of cards have those benefits. If most credit cards in the U.S. and Canada have cash back, miles, or rewards, then it follows that merchants pay 2-3% on most transactions. In my experience in the U.S. and Canada, almost everyone seems to use a cash-back or reward-type credit card.

Actually, we arguably do. Go try to price a US health insurance policy with the same level of coverage and cost insulation [1] you could get in Europe: get ER or primary care, at any time, with the promptness they would get for appointments, while never paying anything other than the premiums.

I'd be surprised if you could even find such a policy.

[1] And, of course, the same "we won't pay for this" cutoffs impose by e.g. UK's NICE board.

The law covers what amount can be tacked on to the consumers bill that depends on how they are paying. Not how much the provider can charge the merchant. In the US very few places charge different amounts depending on payment type.

We pay more than 10 times as much as many countries for healthcare if you're counting only individual expenses. If you're counting both individual and public expense, we still spend almost 10x more than Turkey.

Right, only 4 times. Which is still hard to explain.

It's really not. Some country has to provide financial incentives for companies to develop new drugs - a multi million dollar task - and the USA is the country that subsidiaries the rest of the world

I've seen this said a bunch of times but never anything to actually back it up. The fact that big pharma companies tend to have fantastic margins and spend similar amounts on R&D as they do on marketing makes me think that it's probably bollocks.

The idea that big pharma companies are happily scalping Americans just so they can provide drugs to countries that can't actually afford them is just... absurd.

Here is a recent blog post that has some references to economics research papers around this general topic, but likely not directly addressing your exact claim. Nonetheless, you may find it interesting: http://slatestarcodex.com/2016/09/07/reverse-voxsplaining-br...

Grandparent is correct.

For GSK: R&D was 15% of their budget, while 'selling, general and administration' was 39%.[1]

[1]http://www.bizjournals.com/triangle/news/2016/07/19/where-gs...

That's a nice (and popular) story but it really isn't as simple as that. Not only does the accounting get a bit creative, but also the research is more expensive to do in the US for partially for precisely the same reasons that the health care is (a lot of the cost of R&D goes directly into the health care system). Chicken, meet egg.

Even without this, drug development cost doesn't get anywhere close to accounting for the whole cost difference.