Medical expenses in the United States are infamous in the Western World. The high-stakes gamble that uninsured Americans take invites a range of attention from other first world nations, from morbid curiosity to outright pity. One of the most common sights on the forum subreddit, r/askanamerican, is Europeans pitching common medical emergencies to Americans, asking them how much it would cost to receive treatment in an American hospital.

When Americans reply with their own anecdotes — usually ending with an astronomical cost — or how they narrowly avoid crippling debt through private insurance, a single question resounds among the entire editorial board: Why?

As hot of a topic as healthcare cost is in America, few seem to understand why Americans pay such a premium despite the World Health Organization ranking their healthcare system 37th globally. These costs result primarily from the relatively laissez-faire market surrounding pharmaceuticals and medical equipment in the U.S., as well as fearful over-practice of defensive medicine.

America’s reluctance to interfere in any free market permits manufacturers of drugs and medical equipment to develop powerful economic platforms to drive up the price of their products. In many first-world healthcare systems, the government negotiates the prices of drugs and equipment before these products reach the market, saving both the consumer and healthcare systems money. The Congressional Budget Office estimates that applying this system to all U.S. drugs would save the federal government $118 billion over 10 years. In the absence of intervention, prestigious institutions and popular brands can price their products arbitrarily to maximize profit.

Insulin is a case example where abuse of the U.S. patent system allows major producers like Sanofi to maintain exclusive rights to the drug for longer terms than usual. Sanofi submitted 74 separate patent applications for Lantus, a common diabetes medication. This could result in Sanofi controlling U.S. insulin for 37 years without competition, nearly double the standard 20-year patent.

Another facet of American culture drives hundreds of billions in healthcare spending per year: Americans’ infamous tendency toward lawsuits and American physicians’ personal vulnerability to them. Jackson Healthcare Market Research asserts that American physicians’ personal financial liability for medical errors drives them to employ excessive and expensive diagnostic measures, subjecting the patient to unnecessary examinations and costing the healthcare system an extra $650 billion to 850 billion per year according to the same study. Some American physicians apparently distrust their own clinical diagnoses and are considering withdrawing from practice altogether.

The sheer complexity behind the clinical economy in the U.S. creates a labyrinthine paper-trail that one cannot trace without undertaking an extensive inquiry. This obscure interconnectedness leaves Americans at large scratching their heads at the $50,000 price tag on a broken leg when higher quality care for common injuries is available to Europeans for free.

After wading past the smoke and mirrors, we at the Collegian believe that Americans should draw the line on free market practices when distrust, monopoly and corporate interests leave even well-insured Americans with $1,000-plus bills for common injuries. When entities whose primary responsibility is to shareholders are in charge of public well-being, we are all in jeopardy.

The Collegian Editorial Board meets weekly and agrees on the issue of the editorial. The editorial represents the opinion of The Collegian.