Yes. Technology is a key part. - businesses are more optimized and driven to improve efficiency and metrics. - technology for record keeping has improved so t

Yes. Technology is a key part. - businesses are more optimized and driven to improve efficiency and metrics. - technology for record keeping has improved so that the threat of debt is more scary (can’t just flee to another state, etc) - people are more reliant on the industrialized healthcare system to full that need than in the past (less countryside medicine, etc) - the legal system supporting doctors keeps strengthening (government recognized experts in many more areas) - more inequality. One person who will pay covers 10 who won’t.