Procedure cost is a huge factor: AFAICT, it's generally cheaper everywhere than the US, frequently dramatically cheaper, for the same procedure, for out-of-pocket (non-insurance) cost.

Here in Japan, everyone has insurance, either private through their company, or public through the government, and the insurance pays a flat 70% of the cost, and the patient pays the other 30%. But the procedure costs are generally not that high to begin with, so the 30% copay ends up being pretty cheap usually.