Probably some inefficiencies baked into the price? There are massive inefficiencies at every level. I probably wouldn't share this "it's the way it is because it has to be" reasoning if you've never looked into why US healthcare is as expensive as it is.
You need context for that because your article is incorrect about Canada. Across all of Canada, on average, there are still 1.1 clerks per bed. (1,100 clerks for every 1,000 beds) [0]
Interesting. What do all of those clerks do in the Canadian system vs the US system? Would you say that the Canadian system is a paragon of efficiency?