A big cost of the health care system in the US is Torte law, the new doctor spends approx $200,000 a year for insurance, this is part of the cost.(recall John Edwards made $60 million off doctors)..
FWIW my daughter was renting a doctors house near NY city, the doctor had to go to Delaware to practice since the clinic he was part owner of had a death, there was a law suite and he lost his license to practice in NY state.
Another story, my friends daughter graduated from McGill in Montreal, tried to get into medical school in Quebec and couldnt, she went to St Marten(18 months ago) just finished her studies and is going to England for continued training, and then go into residence in the Bronx. I was talking to her and she basically said it is impossible for her to ever practice in Quebec, she would have to redo almost everything, despite being bilingual and this being her home. FWIW she said Saskatchewan was really keen on her going there and would have paid much of her student loans off if she stayed a certain nbr of years.