The biggest joke is that Americans think that the amounts they are charged for healthcare services is what those services really cost to administer. It's really not even close. A heart attack does not cost $20k+ to treat in other developed countries. A broken arm costs maybe $200 equivalent in the UK vs multiple thousands in the US. I'm not talking about how much the patient is charged, I'm talking about paying the doctors for their time and affording the equipment to perform the treatment.

There's always the anecdata that floats around the internet claiming that you can fly to Spain, live their for 6 months, get a hip replacement, and fly back to the US for the same amount as the outpatient surgery costs in the US. It's basically true, though the numbers may have drifted slightly since it first started making the rounds.

> it's the same as a tax to pay for healthcare for the country, except it goes to insurance companies, and you have to deal with in network and out of network

I think this is one of the strongest ways to frame government-provided healthcare. It's no different paying a tax vs paying the company directly, and in the former case you have the whole US government bargaining on your behalf for reasonable healthcare costs (in the case of single-payer a la M4A).

> capped at 20% by ACA

20% is a lot when we're talking about these outrageous numbers.