I would say to you that in the normal case, in general, across all fields - bicycles, clothing, tables, chocolate, holidays, houses, butlers, what-have-you - cost is related to outcome, and this is what would be expected.

In the normal case, I would then think that cost in medicine and medical services would be related to outcome.

To the extent this generalization is true, then when cost is not related to outcome, this is not a normal situation, and then the question would be "why?" - what's going on to make a situation which on the face of it is not normal.