A dose of Tylenol provides a good example. In order to take medications in a hospital, even over-the-counter medicines, they must be prescribed by a doctor (a little bit of cost for the doctor), that order gets transmitted to the pharmacy (a little more cost), the order gets filled by a pharmacist or pharmacy tech who retrieves just one Tylenol pill and individually packages that one pill (still more cost), the pill gets transported from the pharmacy to the nursing unit where the patient resides (a little more cost), then the pill is retrieved by a registered nurse who personally gives the pill to the patient and then must document the administration of that pill in the patient medication administration record (a little more cost). All of this process to give a patient a single dose of Tylenol in a hospital bed is regulated by agencies that accredit hospitals – a condition of participation in the Medicare program. In other words, this is what hospitals must do to administer a pill in compliance with all pertaining regulations (a little more cost).Apparently this was not written as an intentional parody. At least I don't think so. It's always possible that they're putting us on. But maybe not. Maybe they really have conducted thorough internal audits on the costs of "transporting the pill from the pharmacy to nursing unit" and "individually packaging a single pill". Bureaucracies have been known to do worse.
It's like when you get sucked into going to Applebee's and everything on the shit menu is $13.99 or more and you ask the waitress, why the hell does boxed pasta noodles with pesto sauce from a can cost so seemingly much? And the overly enthusiastic waitress, the kind who intermittently widens her eyes while talking, to emphasize particular points, to connect with you or whatever, probably while squatting down by your table so she's at eye level because some corporate higher up read somewhere that levelling the eye contact playing field makes the customer feel more in control and better about himself-- she, while chomping some sort of fluorescent aqua gum flavor, squats beside you and says, "well hun, you see, someone has to open that box of rotini (a little cost) and pour it into a boiling pot of water (stove usage cost!), while another guy in the back has to retrieve the pre-cooked chicken chunks from the walk in cooler (doesn't cool itself for free, ya know!) and then a pre-determined volume of sauce has to be measured out (still a bit more cost, copyright charges on the recipe) and then once it all gets whipped together someone has to arrange it on your plate (cost!) and transfer said plate to the larger tray where similar orders for your wife and children have already been arranged (costs, hun!) and then I get notice and so I grab the nearest expediter to help me transport a not inconsequentially heavy order all the way from the kitchen to your table (costs indeed!). So, ya know, it's like $13.99 is sort of a good deal, once you break it all down". She smiles a ghastly smile, whips her head to the side to wink at my terrified daughter. And then she is gone.