[2skep]

You may have misunderstood. I was not trying to explain the $5000 gap. Administrative costs is one example of the cost difference. Research shows that 'socialised' health systms spend up to $ 800-900 less per patient per year on admin. (I think it was diff between USA and Canada) I am not sure of other systems but in NHS England there is no tracking of actual number of patients seen in primary care and details of each patient's complaint. The last audit done on that was over 5 years ago which was also based on data sampling and no such audit is currently planned. There are other reasons for high cost - one of the is the list pricing of actual products used (socialised systems pay less for products, UK pays about 20% less for pharmaceutical products than many other industrial nations). UK consultants and surgeons are not paid for how many procedures they do, 'coincidentally' UK surgeons operate less frequently. I am sure there are several other reasons that explain the $5000 gap but these are just a few.