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In all technology (and heath care is technology driven), first you prove it can be done, then you sell it to a limited group with a lot of money, then (as mass production and amortization and competition cause erosion of price) the price drops. But if you don't have that limited group to spend the initial high cost purchases (the "early adopters") then the technology dies on the vine, and never becomes either available or cheap. This doesn't matter whether you're talking drugs or chips...
The US's private pay system causes it to be the "early adopters", at ridiculous high prices, which skews the whole cost structure. Unfortunately, there is anybody else who will fill that gap is the US stops....
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