[aksss]

I think it was mostly a function of two things: regulatory capture by profit-incentivized doctors, and the labs not having (or wanting to have) consumer-oriented sales processes.

The internet has made the latter easier in a number of ways - making research easier for consumers to know what to order and interpret results, and offering COTS systems for commerce, document management, authentication, shopping carts, and inventory tracking.

I would bet that in most states, laws were less of an issue than the labs not wanting street-facing sales - same way some hardware companies only sell to distributors (i.e. street sales (and consumer support) are a pain in the ass vs curated partners).

[helloworld11]

Despite all of these reasons, it still strikes me as incredible, and that labs wouldn't try to create a customer-oriented sales process. Where I live, in my country, anyone at all can go and get any number of lab tests for any reason they please at very competitive prices that are widely advertised. Doctors also often prescribe tests, but you go get them yourself from a commercial provider and don't need to prove any doctor prescription for them. Overall, it's great simply because the pricing is low through competition and getting a professional lab test done is very quick and easy.