[yadent]

Cost-shifting. The US citizen helps fund most other countries ‘free’ health care especially in pharmaceuticals and medical devices.

[kenavi]

You’re right, the manufacturers can recoup their investment in new drugs and devices through U.S. sales, after that, they have to cover only the direct material and marketing costs in their foreign sales.

[khelus]

Cost-shifting. The US citizen helps fund most other countries ‘free’ health care especially in pharmaceuticals and medical devices.

Thanks. This is one significant factor that is seldom mentioned. The medical consumers in the US fund R & D for pharmaceuticals and medical devices for the world.