The New Yorker had an article last week by Atul Gawande concerning the costs of health care. He uses McAllen, TX with its high costs to compare with other cities with lower costs. His analysis, in brief: Some treatments clearly work, others are more uncertain and some carry both possible gains and risks. But most treatments cost money. Some physicians care about money, some don't. It's partially a personal trait, but also a result of the culture in a city. American culture and social institutions particularly encourage thinking about money (as opposed, for example, to worrying about risks and the patients' overall health) and activity ("do something, don't just stand there").
My stereotypical conservative would argue that following the money always conduces to better health care, but not so.
Gawande is always interesting. In this case, I think he could have mentioned the specialization of care a bit more.