I want to address the most important factor affecting the cost of medical care, and several other industries: mandated licensure. Licensure is a form of representative intelligence. What I mean is that licensure is an authoritative stamp approval for those who have neither the time or means to discover or discern for themselves the validity of a claim. But, this feature does not preclude fraud, bias, malpractice, or other ethical violations (overselling, overdiagnosing, overprescribing). The FDA does not take tens of samples from every carcass that crosses a slaughterhouse floor. They take a high level view of the operation, and random samples. I'm not advocating for abolition of the AMA. I'm advocating that it be placed where it belongs, as a certification option, and not as a requirement for health professionals and organizations.
We should accept that a certain level of regulation is imposed to preclude legislation. We should also accept that this sort of mechanism was evolved prior to the communication and information accessibility revolution of the 21 century. We have an incredible method of self-regulation available to us called social media feedback, and it's a better barometer of value than any bureaucrat can provide. I think what we'd find evolving would be specialized social media authorities (like Angie's list) that helps individuals evaluate risk and cost at a much lower cost basis than Federal or State agencies. The objectivity of the social media agency being its only value argument for existence. How many people would risk an operation or evaluation from a medical vendor with a 50% satisfaction rating, a 75% satisfaction rating, a 90% satisfaction rating, a 95% satisfaction rating, a 100% satisfaction rating? (assuming the ratings come from a reliable source)
Aside: Theoretically, it takes a certain level of effort (100%) to achieve 100% quality. The fact that this never occurs, indicates that there is always a certain level of acceptable risk or acceptable defect. Competition dictates that those who find an acceptable package of value for an acceptable cost will sell the product, and those who succeed in modifying market expectations will change the equation of value. According to the Pareto distribution, a mere 20% of effort yields 80% of the effects. This is the value argument. It takes 5 times the effort to guarantee the last 1/5 of the result quality. The question of success is always relative to the demand and expectations of the market.
The licensure barrier to entry also prevents some of the brightest candidates from entering various fields, knowing full-well the sacrifices they would have to make, and the multitude of opportunities they will lose thereby.