Imagine a little kingdom with a quaint custom: when a man likes a woman, he offers her a tulip; if she accepts, they are married shortly thereafter.
A couple who marries sans tulip is considered to be living in sin; no other form of proposal is appropriate or accepted.
Meanwhile, across the river is another little kingdom that had the same tulip-related marriage custom.
One day, a Dutch trader comes to the little kingdom.
He explains that his homeland also has a quaint custom involving tulips: they speculate on them, bidding the price up to stratospheric levels.
Why, in the Netherlands, a tulip can go for ten times more than the average worker earns in a year!
The trader is pleased to find a new source of bulbs, and offers the people of the kingdom a few guilders per tulip, which they happily accept.
We took one look at that problem and said “You know, let’s make doctors pay an extra $200,000 for no reason.” And to paraphrase Dirkson, $200,000 here, $200,000 there, and pretty soon it adds up to real money.