Earlier quoted context omitted.
As heartless as this sounds: the patient isn't the only person in the equation. There are investors that fund the medical research, a company has employees to pay, the hospital wants the best pacemaker available, etc.
Sure - why not ask patient for paid subscription for privilege of using pacemaker? Somebody please think of the investors...
I mean, I get the business incentives involved, but I also think it's high time to realize they're getting insane and should be altered.