1) Vast amounts of regulation. 2) Liability. 3) Special interests (not just pharma and insurance, hospitals, doctors, nurses as well). 4) Supply constraints

1) Vast amounts of regulation. 2) Liability. 3) Special interests (not just pharma and insurance, hospitals, doctors, nurses as well). 4) Supply constraints from the above listed reasons. 5) People who go to ER instead of primary or urgent care, some who can't afford it others just from ignorance or panicking. Probably more reasons I'm unaware of.