It is just one other indicator of the flaws of the free market approach to everything in the US. Whether it is health care or education, treating it as a product or service sold to consumers creates perverse incentives.

The market has become a religion in the US. It is taken as dogma that it is always the most efficient way to do things. When it is stunningly inefficient. I've used health care in the US a number of times, at it is quite grotesque how they treat it as a sales transaction dishing out as much pills and treatment as they can, almost like a car salesman trying to get you to buy add-ons.

My US doctor insisted on giving me anti-biotics despite the fact that I had the common cold and protested that this does not work for a virus infection. Whatever you issue is they attempt to give you the most expensive treatment even if something cheaper would do. And there is in an unhealthy obsession with unnecessary frills. Anything to get the customer to keep coming back.

I quite liked American university, but it was extremely lax. They gave students endless opportunities to fix their grades. Again anything to make the customers happy. Grades was rather pointless as it only seemed like A's mattered.