I went to an outpatient clinic yesterday to get an impacted tooth removed. Handling my case yesterday were: one doctor, one anesthesiologist, two receptionists and five nurses. As for space, there was one lobby, a room where a nurse looked through the forms I filled out, the operating theater and a room that led to a loading ramp. The total cost of the 30-minute operation was $800. There are only two surgeons in Norman who are covered under my insurance plan, so I'm sure the other place is quite similar.
Why is it that expensive? It's not that the surgeon himself makes that much money. Take away the cost of the clinic rent, receptionist salary, nurses, materials, liability insurance, and I would estimate that his take from the operation may have been less than $200. Yet, the operation cost my insurance company $800.
I think that the reason is that there is no economy of scale in healthcare. In a country where retailing is dominated by big box stores, medical practices are run like boutiques.