As I understand it, administration costs are a huge contributor to overall health care costs in the US, due to the number of insurance companies involved.
Remember the link I posted a couple of weeks ago about the cost of healthcare, and someone kept mentioning companies that had health care workers while I was trying to make the point about Drs, hospitals, clinics, etc? Look at the average pay for surgeons in the US vs Europe- here, they're paid extremely well while in Europe, not so much. One site where I checked showed that European surgeons average about $89K while some in the US can make millions if they choose the high paying areas. Malpractice insurance is another factor- the cost is extremely high because of the litigious nature of this country.
The Orthopedic surgeon who initially checked my knee didn't order an MRI, wanted to argue about what I told him (like the fact that my left kneecap is lower than my right) and made assumptions about what constitutes 'returning to 100%". He sent me to physical therapy, where the goal was to improve strength but if the MRI had been ordered, that should never have happened. When we looked at the MRI together, his first comment was "Wow- that's a lot worse than I thought", then admitted that he'd made a bad diagnosis. He then recommended that I go to a Sports Medicine specialist, to get a second opinion. That Dr immediately aid he wanted to see X-Rays, which showed, surprise!, that my left kneecap is a full inch lower than the right. He talked about what could happen if surgery happens and he definitely didn't fill me with warm fuzzies, that's for sure.