Likely because there is a clear separation, and you have more of the Civil Servant boost going on.

The U.S. has shit canned any semblance of trust with it's medical apparatus in my opinion. When you have War on Drugs policies being back door enforced through manufacturers, insurers, etc... (wasn't long ago that FDA was considering tainting ADHD drugs with additives for "anti-abuse" purposes, granting a new patent on an existing treatment, literally giving an official stamp to poison people like they did with cough syrup);

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406920/

Make no mistake. The language is flowery, it sounds good. Insurers use it because it doesn't sound like what it really is: adding complicating factors to treatment regimens that hardly anyone checks in on overtime in order to leverage a political ask (War on Drugs) as an ongoing business opportunity rather than keeping overall complexity down.

When you have for profit hospitals getting federal kickbacks for case reporting;

Caution: Lede is buried in the first part of the article, I'll quote the important bit here, but feel free to read it as a whole: TLDR was no one is getting put on ventilators to get paid more; point I'm more concerned on is I've got immediate people I know who've got relatives going into hospitals and getting reported as COVID, or getting poorer care for not being vaccinated.

https://www.factcheck.org/2020/04/hospital-payments-and-the-...

>It is true, however, that the government will pay more to hospitals for COVID-19 cases in two senses: By paying an additional 20% on top of traditional Medicare rates for COVID-19 patients during the public health emergency, and by reimbursing hospitals for treating the uninsured patients with the disease (at that enhanced Medicare rate).

>Both of those provisions stem from the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act.

Where the above is the accountant/MBA's incentive, and the understandable frustration of medical practitioner's not being listened to due to most normal people's implicit awareness of the monetary incentive misalignment.

When your medical education apparatus is tuned specifically to act as an artificial supply limiter that ensures that massive fee extraction is assured. See AMA and statutory limits on Doctors "blessed" to begin practice a year.

https://skeptics.stackexchange.com/questions/4561/does-the-a...

When your drug approval process is so rife with controversy, 3 of 11 of your non-bureaucratic advisory panel resigns out of frustration because you fast tracked approval of a drug where you had two contraindications studies. (See Aduhelm).

https://www.npr.org/2021/06/11/1005567149/3-experts-have-res...

When you have gems like:
https://arstechnica.com/tech-policy/2018/04/curing-disease-n...

This is a field where even the appearance of impropriety costs lives in the long run. Every actor in the space should be cognizant of and acting as such. There is far too little appreciation and value paid to this fact. Honestly, I'm just astounded more and more that people aren't more aware of how much sketchyness there is.

Maybe people are aware, and just don't care. Maybe I'm the nut. I don't even know anymore.