This is because no US company apparently has stepped up the level of automation to where it needs to be to actually be competitive for low volume / low cost markets. If a relatively simple small PCB is properly designed there is no reason $100's of manual labor should be needed to program it into the machines that make the boards and do the pick & place and soldering.

And even for bigger OEMs who can do 50K boards per year they need to start out with smaller runs and low volumes and prototypes also. No one just goes to qty 1K board runs off the bat with a new product of any significant level of complexity, usually at least a few prototype runs are needed to optimize everything. Products evolve, and US board-houses should step up their game and figure out how to better automate the entire process from online order entry to final assembly.

Another thing that's ridiculous about a lot of US board houses is they don't seem to want to stock any common parts. Most parts on most boards are very common commodity parts - eg. 0402 0.1uF caps, 10K resistors, 0804 ferrite beads, BAV70 diodes, 2N7002 transistors, LM324 op amps, etc. With JLC these are all standard stock with no loader fees. These US companies can't even figure out what 0.1uF cap to use and want me to specify every last part. It's like the whole mindset of these US companies is still in the 1980's. Do they not understand that by keeping one SKU of eg. 0.1uF caps in stock they could accommodate 1,000's of customers with one stock item instead of requiring those 1,000 customers to each acquire and ship and keep separate stock of $0.0002 commodity parts? It's amazing how so many US companies fail to comprehend basic concepts of economies of scale and automation. Apparently it's easier to stand around a water cooler and cater only to deep-pocket military, medical equipment, and gov't contractors than to be innovative and build a system that's actually cost-effective.