@hoser: Canada and the EU both set price controls on medicine that is invented and often manufactured in the US. So let’s say a medicine costs $100/dose to create during its 10-15 year patent validity (invention, manufacturing, FDA approval etc), but the production cost is $10/dose the EU/Canada tell the companies, if you want to sell here you can only ask $15/dose. The manufacturers stil do it because of the $5 profit, but effectively that $85 remainder is now paid for by making that even more expensive medicine in the US. Same for hospital supplies like MRI machines etc, the ‘invention’ cost is not paid by Canada because Canada is broke when it comes to that.
On the other hand, the invention itself is often largely funded by US taxpayers. The US spends more than the next 4 economies combined (that is China, UK, Russia and EU in order) on health research. Canada spends a fraction of a fraction compared to the US on healthcare research. And when it comes to private investment in medicine, the US drives 70% of the world in investments while only being ~30% of the market in purchasing power parity. A simple example is that of COVID vaccines - the US spent $40B on the R&D, China and EU each provided $100M in loans with the rest of their ‘investment’ going into not R&D but just a $2B pre-order (which ended up having the distribution footed by the US companies).
Now you have a few options, you basically tell Canada and EU no more, which is what the Trump admin is doing - we cannot keep subsidizing your healthcare by making ours more expensive, which now causes even more shortages and price hikes in those socialist markets. The other thing to do would be to stop Medicaid/Medicare waste which is where most of those cost ends up hiding, as the taxpayer has endless pockets.