Because of insurance. It often leads the peculiar case that a healthcare provider might have no real clue about how much a person will ultimately end up being r

Because of insurance. It often leads the peculiar case that a healthcare provider might have no real clue about how much a person will ultimately end up being required to pay for some procedure they're undergoing. It has no clear connection to the price that the provider will bill the insurance for. In many developing nations insurance is the exception, rather than the rule. This changes two big things. The first is that you're expected to pay for things that would have more than a negligible cost before these procedures are done. If you don't like the cost - you go somewhere else. Emergency care, like the US, is an exception - and nobody can be turned away, so you are billed afterwards. But the really big thing this changes is that costs are such that people can actually pay them. For instance in one procedure I had a consultation, x-ray, and medicine. Total cost was about $20, and that's not government subsidized in any way - the hospital is making profit on that cost. And this is not a "hospital" with "doctors". Most of the medical staff are educated in the west and then come back home to work afterwards. As an aside, it also means they generally have great English. It's why developing nations are increasingly a destination for medical care - 'medical tourism'.