Example: My wife is in surgery, and has told me how surgical tools often come billed as a set. Rather than being able to bill for a single tool, if an operation requires another duplicate of the same tool the surgeon will often just open an entire new set.

Another example: In college I build a tDCS machine [1] for about $20. I knew a doctor from the VA who was working in the area who showed me one with essentially the same circuit which sold for $80,000 - essentially for the stamp of approval from the FDA to use it in a clinical research setting.

There are reasonable-sounding explanations for both things I guess, but the obvious consequence is that the number of people able to receive care is dramatically lower. I feel like there are probably similar analogies in technology, but maybe they are more easily disrupted because of lower regulatory barriers.

[1] https://www.hopkinsmedicine.org/psychiatry/specialty_areas/b...