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As private equity dominates wheelchair market, users wait months for repairs

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Re: As private equity dominates wheelchair market, users wait months for repairs

#161

Post by akira2501 »

ptero wrote: post #144
VHRanger wrote: post #129

Earlier quoted context omitted.

Wheelchair users have no bargaining power against wheelchair makers. Car buyers have leverage. Normally this exorbitant price would incentivize competition in a healthy market, but the private equity players presumably make that difficult. There might also be barriers to entry in the market.

I suspect in the US the lack of competition is due to regulation and liability, not VCs.

There have been a lot of acquisitions and rollups in this space. We have regulations against this, but they are not enforced, and the VCs have the money to push through this layer anyways.

It's both.

The US lacks serious competition in _most_ of it's industries right now.

Re: As private equity dominates wheelchair market, users wait months for repairs

#162

Post by akira2501 »

tdb7893 wrote: post #18
nickff wrote: post #10

Private equity discovered that regulations, compliance requirements, & other similar barriers to entry are the most effective 'moats' which allow businesses to raise prices and have little impact on demand; they are now exploiting this 'hack' ruthlessly.

We've seen consolidation across the whole economy (which have vastly different regulation schemes) so I'm skeptical of it being just regulation driven

The regulation is what drives the ratio, here, though. Consolidation often brings price increases and worse service for customers, but in a regulated industry, you can push this practice quite a bit further than you might consider doing in any other one.

Re: As private equity dominates wheelchair market, users wait months for repairs

#163

Post by zmgsabst »

HillRat wrote: post #139
renewiltord wrote: post #110

Earlier quoted context omitted.

I only just noticed that the wheelchair https://libertymemesfoundation.org/donations/endurance-the-o... is actually a Class 2 device. That sounds really hard to get past the FDA. I think it's pretty cool still because folks with the knowhow could make their own, but the disabled are probably SOL because you can't really make these for sale without that. I suppose the FDA's reasoning is that they're better off having…

Without commenting on the specific standards and regulations, the parade of horribles that could go wrong with a powered wheelchair is pretty extensive, when realizing that when a wheelchair goes wrong the user cannot move away from it . Consider the risks of a battery fire you can't escape, a drivetrain that could grab loose clothing around a pair of immobile legs, or a user whose wheelchair dies on an empty street…

Do they?

I don’t think the FDA is in a position to asses whether those risks versus the benefits of mobility are an appropriate trade off for any individual.

The FDA is deciding that some people should have no mobility so that others have… what, exactly?

The people who bought $65,000 chairs still could — and they’d be equally reliable. But because one person needs to use it in Alaska, all people need to pay a premium… even if they live somewhere that cold rating is completely irrelevant and adding a needless $5000-10000 to the price.

While there’s a reason to regulate for truth in advertising and basic safety, eg, not catching fire on its own, the actual regulations extend far beyond that into adjudicating personal risk management without clear benefit.

I’m not a fan of technocracy — I think people themselves know what’s best for them.

Re: As private equity dominates wheelchair market, users wait months for repairs

#164

Post by paulddraper »

minusLik wrote: post #67

What the article does not seem to mention is that an usual electric wheelchair costs about $65,000 (and is intended to be replaced every six years or so). This and the non-availability of replacement parts is why some wheelchair users started a project to open-source a wheelchair from standard parts: https://themif.org/ Louis Rossmann interviewed the founder of the project here: https://www.youtube.com/watch?v=eaAj59…

> a usual electric wheelchair costs about $65,000

A usual one?!?

The MSRP of a 2024 Tesla Model S is $72,990.

---

EDIT: Do you have a source?

Re: As private equity dominates wheelchair market, users wait months for repairs

#165

Post by akira2501 »

RecycledEle wrote: post #85

I deal with wheelchairs, electric wheelchairs, oxygen systems, CPAPs, spirometry, and more every day. Electric wheelchairs are built to be very rugged and dirt simple. There are 2 problems: The first problem is insurance. People expect their insurance to cover everything. If they need a new set of 35 AH SLA batteries, they will throw their old chair away and ask for a new chair on insurance. The second problem is tha…

> If they need a new set of 35 AH SLA batteries, they will throw their old chair away and ask for a new chair on insurance.

> One connector broke and was impossible to replace. I would gladly pay $100 for a single connector, but they do not exist. Before someone says to replace both ends of the connector, this is a connector mounted in a custom bracket with almost zero clearance as the chair's seat fits right on top of the bracket, connectors, and wires.

So.. which is more prevalent.. users throw away their chairs because they expect to live high on the hog off insurance, or users throw away their chairs because any form of replacement is often met with these arbitrary and senseless complications?

Re: As private equity dominates wheelchair market, users wait months for repairs

#166

Post by serf »

floxy wrote: post #141
minusLik wrote: post #67

What the article does not seem to mention is that an usual electric wheelchair costs about $65,000 (and is intended to be replaced every six years or so). This and the non-availability of replacement parts is why some wheelchair users started a project to open-source a wheelchair from standard parts: https://themif.org/ Louis Rossmann interviewed the founder of the project here: https://www.youtube.com/watch?v=eaAj59…

>an usual electric wheelchair costs about $65,000 Can you go into what that statement means? I'm having a hard time parsing "an usual". Seems like there are some electric wheelchairs for ~$2,000: https://www.forbes.com/health/accessibility/best-electric-wh... ...maybe some specialized wheelchairs cost considerably more?

none of those chairs in that article is realistically a full-time use electric chair; they're more akin to 'adult scooters' than that. The purpose of most of the chairs in the article linked is to make ease of travel easier; that's why they mostly all fold.

Here's an example of a real full-time use electric chair. [0] It's front wheel drive, has standard attachment points for medical devices, a standardized controller interface that can be adapted to just about anyone, false bogey-arm suspension for stability sake, and all the certs.

It starts around 8k-ish out of pocket. I don't use electric chairs myself, so i'm unfamiliar with what insurance/medicare costs would be.

I pay ~2-4k out of pocket for a manual wheelchairs 20% co-pay through medicare, to give an example of the costs of things. Electric full-time use chairs are astronomically more expensive.

[0]: https://rehab.invacare.com/Power-Mobility/Invacare-AVIVA-FX-...

Re: As private equity dominates wheelchair market, users wait months for repairs

#167

Post by serf »

krapp wrote: post #142
Der_Einzige wrote: post #133

Earlier quoted context omitted.

When replicators are invented, most political problems will disappear. Star Trek got it right.

Star Trek style replicators can't be invented. The laws of physics won't allow it. It will always cost more energy and be vastly less efficient to assemble a cup of coffee atom by atom than it would to just grow the beans, have them picked, packaged and shipped, and make it yourself, and unlike in Star Trek, energy in the real world isn't free. You might say we could come close with advanced 3D printing and some kind…

>History is replete with advancements and inventions which were supposed to usher in utopia, and all they have ever done is further the means by which the powerful enslave and control us. Technology cannot solve human nature.

humans are more sovereign than ever before in most calculable metrics.

Re: As private equity dominates wheelchair market, users wait months for repairs

#168

Post by photonthug »

cyberax wrote: post #32
pdonis wrote: post #21

Earlier quoted context omitted.

This is a good illustration of the difference between capitalism and a free market. In a free market, "moats" like regulatory capture would not exist . In a market like this, where the customers--wheelchair users--are generally pretty savvy about what they need, a free market would have no trouble providing products that met customer needs at an affordable cost, because customers would have meaningful choices about w…

In free market it's also OK to cut costs as much as possible, making chair that explode and kill the user one day after the warranty expires. That's why we have regulation: to establish the minimum standards. Simple medical devices like wheelchairs (Class I or Class II) are also not super over-regulated, you don't need to do clinical trials to certify them. All-in-all it'll cost you around $10m, which is not at all a…

> All-in-all it'll cost you around $10m, which is not at all a moat.

Ok, I know we’re assuming electric wheel chairs, we don’t want fires or stuck accelerators, but really? This is still fairly close to literally reinventing the wheel, or adding complexity, a RC car.

It’s pretty sad to think this level of almost Stone Age technology only needs a 10 million dollar investment to bootstrap.

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