However, here are some critical notes.

• There are some further factors why medicine is more expensive here. One is PPP: these drugs are imported with the normal exchange rate, but our money is less worth (i.e., say, if you exchange as much Euros as you'd spend on food for a month in Vienna for levs, you could buy food for two or three months in Sofia).
  
• The discounts a phamraceutical company itself gives and the social discount a welfare state gives are very different things - the latter is paid in the end to the pharmaceutical by the state. To do an European levelling on the latter front, we'd need an EU-wide welfare redistribution framework, not common negotiation with pharmaceuticals. (I would favour it, though.)
  
• That spending on medicines is lower as a percentage of GDP (and not just in absolute per capita numbers) in countries of our region is not a fault of anyone in the West: that damns the priority-setting of our governments.
  
• I think comparing healthcare in our region and Western Europe is not a simple thing. While doctors are overworked and less nice, and hospitals and equipment looks aged, in some countries it is still more comprehensive than in Western Europe, waiting lists are shorter and required in less cases.
  
• Same for (Western) Europe and the USA. In the USA, as others told, there are strong class differences in the level of treatment people get. But every statistics shows that overall, the US level of service is lower, while it is more expensive. Some studies that I saw quoted here on ET pointed mainly at private insurers' administrative costs as reason, but I think a rush to provide profitable (expensive) services even if they aren't necessary (plastic surgery etc.) also plays a role. (Fat suction is more profitable than healing AIDS in the Third World.)
  
• The only field where the European and American healthcare markets are in competition is top-end luxury treatment for jet-set millionaires. That is too small a market to spoil the system at the damage of the overwhelming majority. For the above reasons too, I don't want to see a healthcare 'market' - I want healthcare to be public service.