It is indeed amazing that we pay enormous amounts of cash to support an entire industry of healthcare middlemen. It seems like the system is set up so that companies have every incentive to profit without actually having to worry about something like satisfying their customers.
As a potential future participant in the US medical system, I worry every day that I'll end up being stuck as some kind of two-faced gatekeeper (like Carla's internist) who works to help some company turn a profit while pretending to have the patients best interests at heart.