I always had the idea that American health care is more expensive because there's not much competition - there are just a few major companies that control the pharma industry and the hospitals, and it's pretty much impossible for someone to just barge in and start offering their services at a lower price - they'd have to pass by the government first (with their impossibly high fees and heavy regulations), then if successful, they'd be harrased to bankruptcy by the established monopoly.

It's much easier to open a private practice or hospital in the EU, for example...