I agree the sum total cost may be significantly different but I was simply acknowledging that inefficient health care administration wasn't purely an American phenomenon.
It is not unique to healthcare either. It is simple a common aspect of large organisations that have too many stake holders that need to coordinate to get things done.
It is an interesting organisational problem.
But inefficient does not mean expensive. Generally you see a lot of inefficiency, much like with code, when it is not the hot path. If you would fix all the obvious inefficiencies it will not drastically reduce cost (actually: it would mean the hospitals have more money, so anybody selling anything to them would up their prices)
Inefficiency only makes a difference when the price is based on cost not on negotiation position (i.e. value based). So in a red ocean as they say, there is a strong economic incentive to fix all in efficiencies and squeeze the last dollar out of it. This is referred to a race to the bottom.
But health care is the opposite of a red ocean. And no price is too high if it means survival, so the consumer (i.e. the patient) needs a much better negotiation position. For example: having all patients collectively negotiating the price. If only over time the invisible hand of the market would have created structures for this purpose again and again everywhere in the world. Oh wait! It did. It's called government.
