I think that the majority of manufacturers do not 'rip-off' Hospitals, but there are a small minority who could be accused of doing that (without naming and shaming - I agree with Dave).

Those that do overcharge, or will not provide technical training - service manuals - spare parts, can be easily identified and when it comes to buying new equipment, you can then (before buying) negotiate better terms, or even 'blacklist' the suppliers that won't play ball, through the buying department (Approved suppliers list).

If the playing field is laid out by both the buyer and the supplier, the relationship can be a co-operative arrangement, a partnership. and both parties benefit.