You misunderstood his arguments. Re-read it, he is pointing out that both groups are curbing the abilities of Doctors to practice free-market medicine. Hospitals carve out a nice position by being "non-profit" yet their administrators make six to seven figure salaries. Then when doctors want to build a hospital and offer better prices to consumers they block them. NPs and Optoms undercut physicians by pretending to offer equivalent health-care and thus demand equal reimbursement from third party government payers. Some doctors have even hired these para-professionals in an attempt to make ends meet. In the end, the patients get it in the back end. They simply don't have the training.