An article in The New York Times reports on the high costs of joint replacement in the United States compared to other developed countries. These procedures are “many more times” as expensive in the United States than they are in other countries. Several factors contribute to these costs, including “multiple intermediaries” that mark up prices. The article explains that medical device manufactures are identified as “cartels” by some economists, and that these companies “defend this turf ferociously” by lobbying and swiftly settling any lawsuits brought against them. Although prices vary widely depending on case specifics, the article provides one example of a patient in Belgium whose total charges for a hip replacement amounted to $13,660, while an American counterpart saw total charges around $100,000.