American healthcare might not be the best world, but it is the most expensive - but it wasn't always that way. A big part of the reason that Americans spend so much on healthcare is that hospitals overcharge patients massively. They need to do this to get fairly compensated by insurance companies.
As insurance companies dominated the health care scene they demanded huge discounts on the rates they paid hospitals. To please the powerful insurance companies hospitals jacked up their rates, in order that insurance companies could show a discount. The really evil part is that anyone who loses their insurance pays these inflated rates.