According to the American Hospital Association, less that 20% are for-profit [1]. I'm sure all are extremely budget-conscious, but that's not the same as being profit-driven.
It seems to me that the US optimizes for quality to the detriment of cost and, more recently, access.
[1] https://paddockpost.com/2021/06/10/executive-compensation-at... [2] https://www.healthaffairs.org/doi/10.1377/hlthaff.2022.01542
2. In my mind keeping costs lower is a form of charity. Especially with something as frequently difficult to understand as health care costs.
3. Executives do deserve to make a fair amount for their skills and effort. I'm not sure myself what salary I consider it fair pay vs taking greedy advantage of not-for-profit status.
Do you want the best doctors involved in care for patients and training juniors, or do you want them to spend time jockeying for a position in the hierarchy because that's a plausible but also the only way to 2x their income?
This doesn't fully answer the question, of course, but it suggests that large pay disparities are extremely wasteful for society as a whole.
Also, of the groups of ambitious hustlers that I know nearby, many are looking to get into running healthcare clinics because there's so much profit to be made.