What's missing here?

From an NPR article about recent deaths on Mt. Everest:


Nepal's government doesn't put a specific limit on permits.  This year 381 people were permitted to climb--a number the AP says is the highest ever.  Foreign climbers must pay a fee of $11,000 for a spring summit of Everest and provide a doctor's note attesting to their fitness.


OK, government permit and fees.  Check.  Doctor's statement of fitness.  Check?  What's missing?


The article makes a big deal that there is no limit on the number of permits, and that's fair, but what strikes me as particularly important is that the article does not describe any requirement for climbing ability, or a requirement that one must have summited a few great peaks before-hand. 


Now certainly a reputable guide would insist, say, that applicants must have summited some of the other great peaks--Denali, Kilimanjaro, whatever--but it's terrifying for me to consider the probability that some of the death toll is people who should have been told "try some of Colorado's 14'ers before you go to where you need oxygen."  That, or people assisting people who should have proven themselves on those 14'ers first.