It’s a false excuse. Plenty of countries that also don’t let poor people die because they cannot afford going to the hospital also spend much, much less per capita. Actually, all of them do, and by far. The US really are an anomaly.

The socialism / capitalism argument is a way entrenched interests rile-up the public and stop productive conversation.

Is it more about emergency care or the fact that we pay more for prescription drugs and expensive procedures?

I like to say that there's blame enough for everyone to share. There's truth to virtually every argument. The entire "system" is so "sloppy" and filled with points where money just leaks out.

The emergency care angle is what drives the socialism / capitalism bickering and that's what I see a the biggest impediment to actually making effective change.

As a paramedic (part-time) and someone who has worked in claims benefit management systems, EMTALA (the rules/laws around emergency stabilizing care) are not what make our healthcare astronomical. It's prescriptions, imaging, and labs. You can easily be charged several thousand dollars for diagnostic imaging. My insurance covers labs 100% but a recent stool sample test charged $780 to see if I had blood in a stool.

Speaking of DI, DI is a money-printing machine, with CT and MRI machines that range from a few hundred thousand to over a million have breakeven points well under two years. And the DI companies work to find and gather physicians who want to start a DI practice. Offer financing, consulting, and then, shockingly, we find that physicians who own a DI practice or a share in one tend to over-refer their patients to imaging.

EMTALA (and the ACA) drives the socialism / capitalism bickering that I think is a primary cause of conversations about reform to run aground.