A lot of it is the privatization and therefore optimization of healthcare. Why does the hospital only employ one doctor? Yes, maybe they have the headcount and it's an actual shortage of doctors, but I'd guess that the admins have reduced headcount and are trying to be cost-efficient. (This is why nurses are perpetually understaffed; either they're actively trying to keep headcount down, or they're underpaying so the headcount stays open.) Why do they need tonsillectomies to take 14 minutes? Again, trying to "optimize" healthcare.