Few Australians would see America's healthcare system as one we'd choose to emulate. But obligations we acquire via the Trans Pacific Partnership Agreement could drive us inexorably towards the US model. And on Wednesday, the US Congress granted President Obama "fast track" negotiating authority – so the conclusion of the TPP is now in sight.

In the US, healthcare costs more, per person, than anywhere else in the world. In 2013 it accounted for more than 17 per cent of GDP, close to double Australia's 9.0 per cent. And America spent a staggering $US5,149 more per person than Australia – more than twice our per capita expenditure.

TPP could drive up costs and hit patients in the pocket. Credit:Glenn Hunt

Spending a lot doesn't always deliver results. In the US, many health dollars are wasted on the administrative overheads that come with multiple for-profit insurance providers, or on unnecessary high tech diagnostics and treatments. They bolster the bottom lines of manufacturers, insurers, physicians and hospitals. And with virtually no constraints on prices, high out-of-pocket costs for patients are the norm.

Paying a lot of money doesn't mean better access to care, either. Despite the tremendous expenditure, there are massive inequalities in access to health care services in the US. While the number of Americans without health insurance has significantly declined with the advent of 'Obamacare', as many as 31 million people remain underinsured.