Nationalised health systems work very hard on cost control. There is a lot of FUD spread about e.g. the UK's NHS but the actual numbers show that it provides an excellent healthcare service to everyone for the same amount as Medicare+Medicade+health insurance for federal and state employees (in total via these channels half the people in the US have their healthcare paid for by the US taxpayer). I.e. the NHS is nearly twice as efficient as the US system.

I guess just copy their methods?

I'd imagine the lack of billing staff at NHS hospitals probably helps keep the cost down quite a bit?

Sadly they've added a billing system for 'health tourism'. Before that they didn't ask too many questions just treated people. I guess the billing system pays for itself? Not sure.

In the US medical billers make like $8/hr, I'm not sure that's a huge cost center compared to the $400k/yr physician.

But is the ratio 1 to 1? Or are there way more medical billers than physicians?

Anyway, it's an unnecessary cost.

One of my previous employers had approximately a dozen billers for 75-or-so physicians, and the average physician salary was $500k.

Presumably the billers spend a lot of time trying to get money out of insurance companies? We don't have those either..

[We do have private healthcare provides but even they seem much cheaper than the US system]

Edit: Any time the US healthcare system is described on HN it all sounds rather bureaucratic and stressful - as if being sick wasn't bad enough already!