In the US you get to see the cost of care every time you have reason to see the physician - there's the copay for the physician visit and medications, and then there's the explanation of benefits, where you, as a patient, get to reconcile accounts. In NIH Britain OTOH, you get to see nothing of that sort (except a small copay for medication), and healthcare costs are better contained. It's the US that is the outlier, and shifting even more burden on the patient won't fix matters, it hasn't fixed matters in the past.