Efficiencies from health care competition are illusory when you properly scope it to include paperwork hassles, time hassles, and pressure on provides to skimp.

There basically is no healthcare competition in the US at all regardless of any qualifiers. You often don’t even know how much a procedure will cost you. That fact alone means there is no price competition. Even if in the past there were hospital competition (assuming you’re in the position where you have the time to shop around), hospitals are merging regionally to take care of that.

The US healthcare system is incredibly expensive and ineffective. Americans often like to come up explanations for this status quo but the fact is the system is trash when compared internationally.

This is patently false. 250k+ is readily available in cheaper cities. You just have to work at BigCoSoulStompers.