Speaking as a relative of someone who directs an inner city emergency room: Americans, a not-insignificant part of the reason why your health care costs are so high is because your legislators' refusal to allocate money for providing cost-effective care to people with mental health and substance abuse problems means that they instead end up getting cost-ineffective care from the caregiver of last resort - hospitals - instead. Of course they can't pay for that service, so the hospital gets stuck covering their costs by jacking up rates. In a nutshell, what comes off of your tax bill goes onto your health care bills, and then some.
America's approach to dealing with with the less-fortunate is, if nothing else, penny wise and pound foolish.