It sounds like he's talking about a different problem. This is a problem with certification and regulation. What you're talking about is, "I'm bleeding and d

It sounds like he's talking about a different problem. This is a problem with certification and regulation. What you're talking about is, "I'm bleeding and don't have time to drive to the next city over because it's cheaper." When that hospital purchased its gauze, sutures, and other equipment it wasn't under duress and theoretically could switch suppliers at any time. Being intended for use on or inside a human body, we have higher expectations in quality and consistency. Unfortunately, these certifications can make the barrier to entry too high for good competition. Or they're locked into a supplier for whatever reason.