Those are valid considerations.  Doctors invest a lot into developing their credentials and practice and should be compensated fairly for that.  But are the factors you cited really multiple times more expensive in Alaska?  From Wohlforth's September 10th column: "A standard rate for a knee replacement is $2,042 in Seattle but $10,218 in Anchorage, according to data from Premera Blue Cross Blue Shield of Alaska."

No one's defending the other 'parasites' in the system, but since Dr. Hall is an orthopedic specialist (who performs knee replacements one can assume), he is ideally positioned to explain why they cost 5x higher in Alaska than Seattle.  I wonder what he charges for one?