The total cost of healthcare is high and allocated all over the place in the US depending almost solely upon the mercy of one's employer. From a total systemic cost the US has the highest cost in the world per person on every metric possible. What typically happens is many will simply drop from insurance pools and because they tend to be poor make the statistics for the insured look better, which makes our conservatives believe the system produces better health outcomes similar to the statistics for charter schools. I'm quite sure that the actual cost per person for the Netherlands is not actually what the system pays in total because there's taxes whether levied upon income or at the side of an employer or other non-government entity will make up the difference. In the US, unless you're desperately poor or retired (Medicaid or Medicare, respectively), your insurance plan is essentially whatever pricing the market will bear, which means "whatever insurers and health providers charge each other."