My guess is that doctors in other countries have less choice. In the US a doctor can opt out of Medicare and offer concierge services instead. Which many of them have done because Medicare reimbursements are much lower than in the private market.<p>US doctors also can make money through self-referrals such as ordering a test be done through a clinic in which they are an owner.<p>This article from 2009 talks about the latter case in detail: <a href="http:&#x2F;&#x2F;www.newyorker.com&#x2F;magazine&#x2F;2009&#x2F;06&#x2F;01&#x2F;the-cost-conundrum" rel="nofollow">http:&#x2F;&#x2F;www.newyorker.com&#x2F;magazine&#x2F;2009&#x2F;06&#x2F;01&#x2F;the-cost-conund...</a><p>I supposed we could try to outlaw that practice, but a whole lot of doctors would lobby like hell to prevent that bill from making it through Congress.