There is a litany of "middlemen"; Drs, Corporations, Hospitals, Insurance, Pharmacies, Drug Companies, marketing, Lawyers ... ALL have a stake in something.
Oh, Please. Don't put the US on a pedestal. There is a shitload of issues that the US needs to fix and a little humility in accepting that others have better solutions, is one of them.
Once out of the umbrella of the FAANGS, there are tons of jobs for SWE, just not at the eye watering salaries.
East Coast, tons of jobs at the 100K range.