I'm guessing that management wasn't one of the functions selected for offshoring - funny how the Indians are always better at every function except that.

Yes one part is definitely pushing people past natural limits and then drugging them to try and extend their limits.

I think another is a privileged perspective - to a tenured university researcher with a low stress life, or a wealthy doctor, they may feel that "the program" has worked fine for them. So they can't imagine how the program has led another to a life of misery.