Iinm medicaid/medicare is a government health insurance scheme that only given to selected individuals, and care is provided by private owned hospital, while Europe(and a lot of other place in the world) practice universal public healthcare, where the hospital is owned and run by government. This way, the government wouldn’t get squeezed dry by the exorbitant cost of private healthcare, while at the same time wouldn’t need to pick and choose who is eligible. Private hospital is there to provide value added service for people who can afford it.