> The real difference is that it's 2-3 times as expensive in the US.

Yes. Which may be caused by the same three issues:

1. Doctors afraid of being litigated by patients, doing unnecessary treatments and paying costly insurance.

2. Corruption and bribery leading to things like Medicare being unable to negotiate drug prices and doctors prescribing addictive opioids to the tune of billions of dollars.

3. Inverted competition: Hospitals run a for-profit business while patients will prefer the best and most expensive service they/their insurance affords them. Who chooses a treatment based on price when your health is at stake? Also, somehow, drug prices are much higher than anywhere else, even completely generic stuff like insulin.

Nobody looses, except everyone else