1. You have identified the increased use of specialists. Sounds plausible to me.
I think we will see this as a norm going forward, given the rise of networks for GP's where they can share overhead costs with other GP's especially in the heavily populated cities of the nation.
2. The widespread use of med insurance for things such as doctor's visits and birth control pills has caused an explosion in paperwork and tends to hide costs from the consumer. This is the same consumer that still has to pay those costs.
GP's do very well just with office visits and routine exams and health monitoring for older patients like me with more than a few health issues. Yes insurance covers more things than they did in the past, but let's face it, they have to with the discovery of more and better ways to deal with those illnesses and issues they can no longer IGNORE for lack of knowledge, and the removal of caps on treatments of those very expensive procedures. Logic suggest the more people the higher the costs as we add the poorest among us, and we had to see the growing population of aged citizens seeing doctors, coming decades ago.
3. The development of drugs and treatments for illnesses that once were just in the "send them home to die" category means that people with those illnesses now survive. That's the good news. The bad news is the drugs and treatments are unbelievably expensive.
As is the research and development of those drugs and treatments so naturally there is the inevitable return on that investment, which includes the patents that give exclusive pricing to those companies that lasts for years.
4. The widespread practice of suing doctors and hospitals for anything and everything, with settlements amounting to millions and millions of dollars, has resulted in a defensive practice of medicine resulting in increased costs.
Add the costs of debt collection to those costs for those they can take legal actions against when they cannot pay for whatever reason. Most large businesses take this course of legal action, and pursue them aggressively to mitigate losses. I guess you never got sick, couldn't work, and found your wages or bank accounts garnished when you did get back to work. You could lose everything or filed for bankruptcy.
I don't think settling lawsuits instead of fighting them is a cost that should be passed onto consumers nor any other legal actions for wrongdoing, or bad decisions, nor used as an excuse since most of us have no clue about what's defensive medicine or what's a necessary and reasonable since medicine as advanced as we are s not a sure thing for good outcomes.
The bottom line is the fact that cost are rising much faster than wages and there are many why's as to the reasons for that. Just remember that it is another human that decides to jack up the price to cover those costs and make a few bucks in the process. That's the supply side capitalist way.
I guess we all want a way to pay that doesn't break the bank, but as you have found out you pay, or steal, or just don't buy what they are selling. See, you have a choice in the matter. Living longer isn't a right is it?