Nobody was responsible for the consequence of adding tests and all kinds of procedures. Certainly, practicing medicine 20 years ago was a completely different story. Nobody really cared about costs. This certainly drove the employers to the point of mutiny. It was really this system, where no one really cared, that created managed care.
Medical care IS very expensive.
The fact is, things cost a lot. Drugs are expensive. We pay more in America for drugs, but still, they're expensive everywhere, especially chemotherapy. Lab tests are expensive. Salaries are expensive.