I think that depends on which "healthcare" you're discussing. If you're talking about emergency services, they administer services first and then talk about billing second. The doctors are removed from the billing process, for the most post (other than keeping a scan of what they use). They aren't thinking, "I'm going to use this more expensive surgical thread to get this poor drunk fool who crashed his car into a playground to pay more, because then the thread industry will pay me more!" While twirling his mustaches. Now when it comes to pharmaceuticals, there are the distributors who make the pricing out of control. Agreed. But the whole system isn't designed to make a profit, rather the supply chain is, and the equation of the two has been spread and the blame has been laid (often) as mistrust at the feet of doctors and nurses who are the face of the healthcare system to most people.