There are by far more barriers to entry to the field than any other profession. THAT is what allows a monster like Gosnell to rise to power quickly. He does it not in spite of the regulations, but because of them. Bad people get weeded out in a free system, and empowered in an un-free one. People like this don't function completely normally in all aspects of life, meanwhile committing isolated atrocities on the side. Their criminal tendencies pervade almost every aspect of life. Creating a protected monopoly doesn't keep them out, it gives them a chance to be part of a special government sponsored racket where prices are inflated, choice and competition is restricted. The government does a terrible job regulating compared to the free market.