The modern business maxim "don't leave money on the table" leads to local maxima, the locus being your own self in the short term. If the clinics self-regulate, don't artificially inflate the number of procedures needed and ostracize clinics who do, then everyone wins in the long run. The alternative is, everyone attempts to maximize gain and the government has to eventually step in with more draconian regulations that hurt everyone. Rational, local altruism can be a path to global self-interest.
Not only has it always been a business maxim, it's a maxim for pretty much every organization and 80% of the population. (I'm being generous, I suspect it is more like 95%.)
Trying to construct a society that relies on people being selfless most of the time is just never going to work.
