Where do these numbers come from?

Not that I would ever question my academic betters but a quote from my previous post raised another question;

"Hadidi paid $40,000 in Baltimore for pediatric orthopedic surgeon Shawn Standard to do a procedure called core decompression with stem cell implantation, which is not approved in B.C. for any child with the disease."

Where does this $40,000 get accounted for, in US spending or Canadian? I tried finding out, with no luck, how our national healthcare spending is calculated. Best I can find they calculate/estimate  what healthcare providers collect in revenue then divide by the US population(just citizens or census?), I can not find any reference to adjustments for care provided to foreign nationals. When our average spending is $8,400 per person it doesn't take many visitors at 40K+ each to skew this number. Unlike Americans going to foreign countries for affordable care, people aren't coming to the US to save a penny. Maybe someone knows the answer to how these numbers used to brow beat our system are calculated.

http://www.msnbc.msn.com/id/19809557/ns/health-health_care/t/foreigners-fret-over-funds-us-medical-care/#.UNpQFHdhse4

"Mayo Clinic in Rochester, Minn., which treated about 8,000 foreigners last year at its hospitals, including several hundred children.

The federal government does not track how many of the millions of people who come here on tourist visas are seeking medical care."

One patient who doesn't count in the average...

"Years of lobbying convinced the New Zealand government to cover the $1.4 million cost of Matisse’s planned transplants."

Do we really spend twice as much per citizen as any other country or is it some really sloppy academic work, or just outright propaganda?