That's part of the problem today. If you do a little research you will find that the great majority of medical facilities--hospitals, specifically--are incorporated as
non-profit institutions. It's one of the reasons that it is so very puzzling that medical costs have increased many multiples of the cost of living increase over the past 10-20 years.
Though I know part of the problem today is what you might call hospital administrator and physician ego. For instance, in Houston 20 years ago which even then had one of the world's largest medical centers, if you needed a thalium stress test, your doctor had to refer you to Texas Heart Institute for the actual test because they were the only facility in Houston that had the machine. The suckers cost over $1 million each. Within 5 years there were cardiologists in Houston that had one
in their office and small general care hospitals in the suburbs that were adding wings just so they could have one on premises. (The suckers are also big. You can't just move a patient bed out of a room and install one.

) You and I are paying through the nose that we don't have to drive across town to get a highly specialized test--even if we are willing to drive the distance. The doctor/hospital don't want to share the profit from that test with anyone across town.