Large hospitals systems have been forming regional monopolies for the last few decades. First they would buy other hospitals to increase negotiating leverage with insurers, then they started buying outpatient clinics to control patient flow. They can also increase the amount they charge at outpatient clinics once the larger hospital system buys them.

Hospital spend represents 30% of US healthcare spend, and physician spend represents 20%. Physician employment by hospitals is at an all-time high. Busting local healthcare monopolies would do a ton to lower healthcare costs

Unfortunately that is difficult. The hospital lobby spends about as much as the pharma lobby. But the hospital industry has much more "soft" political power. Hospitals are one of the biggest employers in almost every county. So for a politician to fight hospitals would mean fighting their largest employers.

Hopefully more people become aware of this behavior by hospitals. You dont read much about it in the media. I'd imagine this has is because no one is incentivized to call out this behavior by hospitals