I am the Villas spouter whose request for lower cost via competition should apply to the medical industry, as in other industries in America. You mentioned that "these are not low-bid jobs." It appears that you are defending non-completion in the name of "your exclusive club." Why do you feel that your industry is beyond competition? Your white coat or other affiliation doesn't make you immune to accountability to the American people. Your comment about "low-bid jobs" is damning. Your industry has a monopoly that is un-American and costly to all of us.