The US healthcare system is built around money and profit. A cheaper procedure which does not require general anaesthetic costs less, and reduces profit. That can be beneficial to the providers but bloat is incentivised in the US healthcare system as providers battle with insurance companies for money. Crudely healthcare providers don’t care about saving you money; they want to take as much money as they can get.

Meanwhile, countries with tax funded health care opt for the most cost effective procedures, investigations and treatments. The incentive is to reduce costs and offer the most effective things to the most people possible. That can also sometimes have negative side effects if not carefully regulated but in such systems generally Doctors advocate for the best procedure and best medical practice, as they themselves do not directly benefit financially from which procedure is pushed. The downside is you do get the opposite side of things where patients are dissuaded from things as they’re not deemed cost effective by those who control the spending.