Hospitals are extremely risk adverse, any billing/invoicing is quite complicated and getting pre-certified hardware you don't have to certify yourself is expensive and challenging.
Maybe it's time we reconsider some of these regulations.
Medical billing sucks across the board (ask most doctors or any patient), and $5 aspirin is borderline criminal negligence.
Because it's a business. The purpose is revenue across the chain, not health.
e.g. they could be just plain bad, or they could be poorly written, etc.