I think you're spot on with certifications.
I was stupid a few times and needed orthopedic equipment. Each time, the price flabbergasted me. But it didn't matter since the health insurance fully refunded it.
In a regulated market, if you can influence the cap, the item will cost exactly that, no less. And if the market is small enough to not allow any disruption, then it will stay that way forever.
I need to talk to my girlfriend who's a physiotherapist about it. But for now I'm hoping his YouTube fame would start a snowball effect.
Thinking he could do with the wheelchairs what Elon is pretending to do with EVs is truly exciting.