You can have medical research without charging $1000 for an ambulance ride, $10k - $20k for having a child, $100,000 for staying in the hospital a few days. Those are the things I'm talking about.
You can, but these are complex systems, where some areas will have a profit incentive and be efficient, and others just mired in regulation, either directly or in a way that prevents competition arising. I don't think anyone deliberately built that hill. It's made up of lots of awesome hills and lots of hideous quagmires.