Are you really so petty as to call anything not fitting your world view "ragebait"?
...not... ...fraud?
Absent enforcement, proceeds from fraud are invested in more fraud. Given that fraud exists in this area, the shape of the growth curve suggests fraud as a plausible driver.
Ok. Maybe. In areas I'm familiar with fraud is so widespread as to feel like the simpler answer. But I have no context for places with medical fraud so I bow to your experience here