The whole debate is about what insurance companies are paying for those services, right? It's when one walks in without insurance that you see the true cost of the service.

> The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance

What alternatives does a tourist have? If Japan truly had cheaper procedures, it would see a huge uptick in medical tourism. There's no doubt that Japan has state-of-the-art facilities and treatment options, comparable to the US. It's no surprise that costs are comparable too.