As I read it, your argument seems to be that American healthcare must be more expensive than similar-quality healthcare elsewhere because we're paying higher pharmaceutical prices to fund research. If we accept that premise, shouldn't that mean that: 1. The "medicine" portion of costs increases, causing the total cost to increase 2. Administrative effort, and therefore absolute cost, remains the same (we're paying X% more for drugs, not thinking X% harder about whether a given drug is needed by a given patient) 3. Administrative overhead as a percentage of total cost should be lower given a similar efficiency level, because higher drug prices inflated the divisor (total cost) while having no effect on the dividend (administrative costs)