These numbers alone don't tell the whole story either. In the US total spending on MRIs is higher than in France because there are more machines (per capita) and those machines are generally newer. And this gives patients in the US greater access to MRIs and increases the likelihood of an MRI scan being diagnostic (due to the machines being newer and more sensitive). But note that the number of scans per machine is actually lower in the US than in France, even though you are 4x more likely to actually receive a scan in the US.