[shakil]

The single biggest factor is the cost of medical education. Once a person spends a fortune getting their degree, it creates a gated community that works to preserve its privileges, deny entry to other cheaper alternatives, and keep prices high across the eco-system.

You will see this in any field that transacts with high value goods: real-estate, enterprise software, weapons of war, investment bankers handling M&A ... the higher the cost of the product, the more the people dealing in it feel entitled to charge for their services.