"UPS and FedEx are doing just fine"
You know why, because they have a cosy duopoly and just raise prices when they want to make more profit.
5 years ago, I was a regular customer of Amazon. Books could be shipped easily and cheaply to me. The cost of shipping was about 1/2 or 1/3 of the cost of the titles. Now, the shipping cost is 2 or 3 times the cost of the books, and I've stopped using Amazon entirely and Ebay I'm very careful with.
Someone is making a profit out of internet purchasing - the shippers!
The parallel with health Insurance companies and medical professionals is eeriely similar, IMHO...