I work in the medtech/health IT field at a startup doing a lot of clinical analytics. There's a very blunt and obvious explanation of what's wrong here, and it's the very unpolitical one.

Here's the deal. Physicians and nurses and administrators are overworked and untrained to handle a modern operational model. The hospitals tend to be based around politics rather than patient care, though the party line is invariably "help the patient". Doctors will, under the aegis of "help the patient", justify hoarding equipment, setting up alarm thresholds that screw up operations across the unit, block acquisitions, and in general just make everything terrible left to their own devices.

Nurses are overworked and are charged with increasingly important parts of patient care, and at the same time are treated as annoying appendages of the rest of the medical apparatus and not given the respect or authority that they require to perform well at their jobs.

Billing is handled through arcane back-and-forths between the care providers themselves, the hospitals, insurance companies, the government, and collections agencies. I've seen at least one local children's hospital (the economics of such institutions are quite fascinating) have banking and financing services occupying the same building as care (something you'd expect at a car lot, not a place where injured children are healed). Claims may take months or years to process, which is absurd.

The whole stinking mess should have been grist for the capitalist grinder decades ago. However, clever regulatory capture by hospitals and manufacturers and labor policies restricting the supply of new physicians has managed to prevent any of the normal efficiencies from being introduced.

When trying to introduce new technology, you have to fight the most conservative and risk-averse institutions you'll ever encounter. People that do not understand basic statistics or mathematics, or that flat out refuse to recognize the value of operational data research in making decisions because "they know better". You'll be turned away because you're not one of the chosen few, and ignored unless you can convince them that they get to put their name on the new shiny.

This is but the first level of the fractal of sadness and absurdity that is modern medicine in America.