...the missing component is that this process is mandated due to government licensure.

I recently had my state's licensing board send out a survey about the professionals opinions of the practice of requiring state licensure. I kicked it back to them basically saying, why stop at the state level? Many medical professionals that provide services to the geriatric population are not only forced to have these state and national licenses, but are legally forced to bill Medicare and Medicaid. This choked-out system being called "private" or "capitalist" is deceptive; thanks for adding to the attention to this fallacy.