As an immigrant coming to America, honestly the most shocking and surprising thing (apart from the state of homeless in San Francisco being tolerated as normal) is the medical care expenses. How on Earth is it that I can walk into a doctor's office or hospital to get medical treatment and have no idea how much it's going to cost? $10? $100? $1000? Who knows. I had an ear infection once, went to the doctor who looked at it for a minute and said "give it a few days". I assumed this would cost maybe $20 or something? Nope. $400. There's just no way of even knowing. In no other industry would you buy something without knowing the price ahead of time. With medical care it's even more screwed up because, well, it's your health? You're generally more desperate for services now, so it's not like shopping around for clothes or something.