The point is the correlation between spend and value to the citizenry has become detached in the US. The market is working great if you consider the value produced and extracted in dollar terms because that's what markets are good at. But is this what the citizenry want or deserve?
Making healthcare more expensive doesn't make it better.
As an example, the price of Clopidogrel (Plavix), developped in France is sold 5x more expensive in the US than in France. Do patients in the US experience better outcomes by paying more? No, it's the same drug.
"Providing more" for healthcare, means better overall health, fewer avoidable deaths and longer life expectancy.
Presumably, the makers of Plavix had an estimate of what they could sell the drug for in the US. It's possible it would not have been a viable investment if they weren't able to sell it for 5x in the US. This never bringing it to market.
No because in order to be reimbursed by the French insurance, they must argue their development costs in order to make their case for pricing at which the government will reimburse the drug. Otherwise it is not covered by insurance (which is rare).
So anything sold oversees is pure profit (minus marketing / lobbying).