This is similar to the joke about someone running a lottery for $1, with a chance of winning a live donkey. 1000 people buy tickets, and the winner comes to cl

This is similar to the joke about someone running a lottery for $1, with a chance of winning a live donkey. 1000 people buy tickets, and the winner comes to claim their prize, and discovers a dead donkey instead. So he complains, and the lottery runner give him back his $1. The key is to fine them for every patient, not just the patients that complain, because every patient is being defrauded, not just the ones who complain. Then 1.5x will actually be meaningful.