Insurance companies find common cause in lobbying and the very process of bringing them together on regulatory boards helps cement that commonality of interest. This produces a regulatory climate in which little effective long-term control can be exerted over the industry. So, the insurance industry has a franchise to do business with minimal accountability. Over the years, the steady flow of money from premiums to the medical industry has raised the price of medical care to the point that, for most people, insurance is not a convenience, but a necessity. Nearly everyone needs medical insurance, but only a limited number of companies may offer it.
Prices go up, choice is reduced, accountability declines and the result is bureaucracy.
Meanwhile, at the receiving end of the money train is the medical industry, particularly doctors. As it happens, state and federal law has been written so that accreditation of doctors is performed almost exclusively by state and federal medical associations, private organizations composed of doctors. Since medical groups control their own ability to practice medicine, interesting results occur. For instance, it is almost never possible to get statistical data on operating room morbidity and mortality by specific doctor. As a result, those doctors are not penalized by the market.