The NHS forces costs down as a monopsony. Also there is not the separation between provider and payer which results in providers angling for the most expensive

The NHS forces costs down as a monopsony. Also there is not the separation between provider and payer which results in providers angling for the most expensive treatments, only forced down by a payer who regards the patient as an unwanted liability. (This has been partially subverted in the British NHS by ill advised privatization.)