For all the Americans watching the Tokyo Olympics or actually in Tokyo itself, I am sure it will shock you to learn of the extremely low cost of healthcare in Japan because costs are negotiated by the government with very low co-pays. What's more, Japan spends a much smaller percentage of GDP on healthcare than Americans do.
For example, the costs of a simple MRI in the US in 2009 could be $1500 but only costs $98 in Japan. This means that Japanese athletes have a big advantage over American athletes because they are not bankrupted when they get injuries and are free to train harder and push through limits (although I don't think the Japanese are taking as much PEDs as the American ones).