I would call this a false choice argument. The two choices are not sell for the cost of materials or for an exorbitant amount. That is why you can buy an iPad for less than a couple of medical screws.
Anything related to the medical industry is involved with multiple layers of sterile handling and record keeping to prove chain of custody and sterility. (Add $). Your iPod/iPad/iPhone doesn't care if it's exposed to a few drops of rain on the package, or is packed in an environment that has just any old ambient humidity in some dirty Chinese warehouse or number of human hairs falling into the package.
Anything related to the medical industry is always involved with the potential of lawsuits. (Add $). True, if it's pure titanium that has been approved by the FDA for human implants, they have a good defense...but it's a given that ALL lawyers will go after the "deep pockets" theory, and sue EVERYONE that has an ability to pay, not just a doctor that messes up an operation. And even if no one is at fault, the medical device manufacturer will either settle for some money to put the litigation to rest and move on to save legal fees, or pay the legal fees to defend themselves in court and have to increase their cost of production for those legal fees.
Anything that does not have high volume will, of course, have higher marginal production costs, compared to a higher volume product. (Add $). Note: all of your subcontractors that make these small screws must have a separate machine in a sterile environment for this production. They also must factor in the lawsuit item that I mention below, as well. So that's a double Add $. No one's going to sell a screw for $5 that cost them $4.50 to make, if they get sued 1 time and have to settle for $100,000 in partial liability. Just $100,000 for 1 settlement means you have to sell a hell of a lot of screws just to break even!
Anything with a relatively smaller volume will also have, on a unit basis, a higher overhead/distribution cost per item, with various levels of management and sales reps. (Add $).
Anything that is an FDA approved impact must go through various FDA tests, perhaps even clinical trials. (Add $)
Anything that is sold must have some design and R&D in order to get to the finished product. (Add $)
Anything that is sold usually has additional future R&D to make the product even better, and/or to meet other competitors' advances when they bring competing products that might be even better to the market. (Add $)
Odds are, whatever you have as the finished product could easily have had several other competing designs from the company that was shelved because it didn't work, and that R&D cost and other costs associated with that development were lost forever. (Add $).
Add up all of those - and more factors! - and you suddenly have a product that must have quite a bit of money added to every unit sold in order to produce profits to the company. Many of the above factors are either not present at all, or not present to the same high degree (like lawsuits) as in nearly any other industry.
Of course - if you think that cost is extreme, there's no one holding a gun to your head saying that you HAVE to have a titanium implant put into your body. You can go through life with a destroyed hip joint, or wrist, or knee, or shoulder, and live with the pain of not being able to use it, and/or confined to a wheelchair. Or fly to some other country to have the implant installed there.
(yes, there are some people that have reactions or don't like their implants...but overall, the # of people that have kept them obviously must be greater, or there wouldn't be a market for these devices after a while....)
Do I think some aspects of the healthcare system are overbloated and could be more efficient (including medical implants)? Of course. But to simply make blanket statements comparing a product's raw material cost to the finished product (especially for a medical implant) is preposterous.
