It is precisely the lack of competition in the healthcare marketplace that has driven costs through the roof. If, for instance, individuals were at risk for the first 5K of medical bills, and they could keep the money if they didn't spend it, then EVERY consumer would be asking "what is that test for, is it necessary?" Instead, because doctors want to eliminate any possibility of missing something for fear of being sued, coupled with the fact that the more procedures they run, the more money they make, we have the opposite of free markets. We have, as TM7 describes, a gool ol' boy system.
Put people back in the drivers seat. Give them all 5k that they must spend before insurance kicks in, let them keep it if they don't, and let the bidding begin.
No, tort exposure drives much of the medical decisions, and over use, in America. Add to that declining reimbursement for procedures forcing doctors to increase volume of activity to drive income, and you have monopolistic behavior. Humans err, that doesn't mean that they are negligent, just imperfect. Babys die, people die, doctors aren't machine perfect, so let's sue them all so that they will discover that plumbing pays better, screw medical school.