[kalap_ur]

There is no need. The personnel cost multiplier is 3.6x, the non-acute drug multiplier is 6.25x and the "something else" multiplier 77x. So we can debate that there are ~4x more people in the US and CoL is higher maybe by 0.5x turns, but there is no debate that the 77x shows something is awfully wrong.

My bet is the private insurance because we dont have transparent data on how much does the same procedure (broken down by personnel (doctor, nurse, admin), implied equipment amortization, rent, drugs) cost with and without insurance.

I could totally imagine that there are plus personnel expenses buried within the "something else", or acute drug prices, which are administered during an emergency at a hospital. But we don't know, because healthcare spending is a black box in the US.