Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

statnews.com

Post reply on HN
Print view View original

211–220 of 330 posts

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

#211

Post by WalterBright »

SllX wrote: post #159
ptero wrote: post #144

Earlier quoted context omitted.

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

It’s more the divorce between the receiver, the seller and the buyer. Sellers are not selling to the people using the wheelchairs, they’re selling to insurance companies and the government. Both types of entities have a proclivity for overpaying. This is also true for most drugs. If we removed private insurance companies, Medicare and Medicaid in their totality from the equation, the market rate for drugs and medical…

Consider the public schools. You have the customer (the students), the buyers (the taxpayers) and the service provider (the teachers), which are accountable to neither.

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

#212

Post by WorkerBee28474 »

VHRanger wrote: post #129
cogman10 wrote: post #97

Earlier quoted context omitted.

Really cool that an electric wheelchair costs more than a luxury EV and is somehow less reliable.

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.

> but the private equity players presumably make that difficult

There's no reason to think this is true. Unless the barrier to market entry is access to huge amounts of capital, it should be no different than if the entire space owned by mom and pop shops.

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

#213

Post by manquer »

homefree wrote: post #209
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 better wheelchair seems like a fun project and if the costs are that extreme probably not so hard to do better (unless the costs are extreme because regulation prohibits a good market). It’d be fun to take advancements in electric mobility devices to wheelchairs.

there are some projects which are there doing it for fun.

This one from Youtuber Jerry Rig Everything https://notawheelchair.com/products/the-rig

He usually reviews mobile phone durability etc, there are videos on his channel about the chair, this started as project for his wife who was paralyzed in riding accident very young.

Akin to the flamethrower that Musk was selling a while back as long you don’t call it a medical device there isn’t much regulations (hard to differentiate say a Walmart scooter style device from a actual wheelchair)

Of course if it’s not a medical device it won’t qualify for insurance or Medicare , but you can still sell it for reasonable prices

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

#214

Post by WalterBright »

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…

> energy in the real world isn't free.

That's because we haven't figured out how to harness it.

For example, 99.9999% of the sun's energy just disappears off into space.

We sit on a hot planet, all that's needed to drive our energy needs is to drill a hole through the mantle. But nobody has figured out how to do that yet.

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

#215

Post by jjk166 »

wolverine876 wrote: post #81
pdonis wrote: post #41

Earlier quoted context omitted.

> 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. No, it isn't, because nobody will buy chairs from a company that does that. In a free market, no company can use the get out of jail free card of "but I was following all the regulations". Businesses have to actually meet customer needs. And in a free market, customers can't…

It's all theoretical. Do you see it actually working out this way? When and where? > regulators just, you know, look at the design of the chairs to evaluate them for certification. But customers could do the same thing for themselves, at less cost (what, you think those government regulators work for free?). So the regulations are actually adding zero value. But they're certainly not adding zero cost. I have little i…

Then you can choose to pay that premium for a wheelchair, or any other good or service, evaluated by a third party of your choosing. But others, with potentially different requirements, should be able to choose different third parties who evaluate by different criteria. At the very least, you should be able to disregard a third party's evaluation of safety for a wheelchair. The idea that there should be one master evaluation and all other evaluations are redundant holds no water.

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

#216

Post by WalterBright »

krapp wrote: post #187
serf wrote: post #167

Earlier quoted context omitted.

>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.

What "calculable metrics?" By what definition of "sovereign?" Objectively, this is a meaningless statement to me.

Which countries force you where to live and what job to work at?

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

#217

Post by fzeroracer »

JumpCrisscross wrote: post #27
tdb7893 wrote: post #18

Earlier quoted context omitted.

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

> I'm skeptical of it being just regulation driven It seems to be blatantly obviously regulation in this case. There are electric wheelchairs in other countries. What's stopping them from being imported are the regulations.

What exactly do you mean 'blatantly obvious'? Because to me, the issue that is blatantly obvious is that we don't have enough regulations on PE.

Let's say in this scenario you do import an electric wheelchair. You fork out a few thousand dollars on the expensive costs of said purchases. It breaks. No one in America can repair it. Or if they can repair it, you have to go through the PE-owned wheelchair market, whom charge a premium. Your options are fork out the money for repairs, import another wheelchair, or send it abroad for repairs.

Assuming that instead you create a company designed around importing said wheelchairs, PE buys you out and then sells imported wheelchairs at monopolistic prices.

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

#218

Post by fzeroracer »

bravo22 wrote: post #36
cyberax wrote: post #32

Earlier quoted context omitted.

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…

Liability still exists in a free market. Regulations are government's way of giving you immunity from liability laws, or not enacting them, in exchange for doing things a very specific ways. This creates moates.

Is liability not a regulation? See: All of the arguments/debates about how to regulate self-driving cars in cases where the car injures someone.

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

#219

Post by wolverine876 »

jjk166 wrote: post #215
wolverine876 wrote: post #81

Earlier quoted context omitted.

It's all theoretical. Do you see it actually working out this way? When and where? > regulators just, you know, look at the design of the chairs to evaluate them for certification. But customers could do the same thing for themselves, at less cost (what, you think those government regulators work for free?). So the regulations are actually adding zero value. But they're certainly not adding zero cost. I have little i…

Then you can choose to pay that premium for a wheelchair, or any other good or service, evaluated by a third party of your choosing. But others, with potentially different requirements, should be able to choose different third parties who evaluate by different criteria. At the very least, you should be able to disregard a third party's evaluation of safety for a wheelchair. The idea that there should be one master ev…

What if the wheelchair malfunctions and injures someone else? What if my car malfunctions and causes an accident?

Also, I don't want to live in world of frauds and scams and other crimes, trying to navigate it, for obvious reasons. It's also an economic disaster.

You're doing an awful lot of work to empower already powerful people by removing democratic power over our society.

Post reply on HN