I have a feeling that without the US market capable of paying a hundred thousand dollars a patient, many of those cost-ineffective treatments never get developed. People could still pay for them out of pocket, but without the guarantee of insurance payments the drug companies likely won’t take the risk.
And I don’t think that’s necessarily a bad thing — if a drug costs $500,000 and keeps my cancer at bay for 6 more months, it provides a high personal benefit from my selfish point of view; but at a high cost to society without much societal benefit. I think you’re right that Americans do lack the realism, but it may become easier if those treatments aren’t developed in the first place.
And I don’t think that’s necessarily a bad thing — if a drug costs $500,000 and keeps my cancer at bay for 6 more months, it provides a high personal benefit from my selfish point of view; but at a high cost to society without much societal benefit. I think you’re right that Americans do lack the realism, but it may become easier if those treatments aren’t developed in the first place.