They get applauded when they "dump" the price to $20

They get applauded when they "dump" the price to $20
the secret ingredient is crime (together with corruption and bribery)
insurance companies, medical companies, and providers all do not care. They pass the burden onto the consumer. The medical company charges too much and the provider charges too much, so the insurance company just pays the bill and raises premiums to cover it. And over several years the prices just trickle up and no one cares because they are all still making money.
Government doesn’t do anything because they are all donors, and there is no transparency.