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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

#271

Earlier quoted context omitted.

To be honest - it actually seems like a risky Private Equity play as I bet the $65000 sticker price is due to the fact that Medicare is footing the bill. Medicare is likely what is requiring a regulation grade wheel chair, not the users themselves. I bet a huge segment of the user base could easily self purchase a mobility scooter and achieve the same quality of life if the price point was such that they could out of…

You can buy mobility scooters for under £2000. e.g. https://www.mobilitypower.co.uk/product/fastest/ $65k is an obvious rip-off. > Medicare is likely what is requiring a regulation grade wheel chair, not the users themselves. It's a shame Medicare can't just give the users cash and allow them to choose their own wheelchair; both Medicare and the users would win.

Are you serious? Wheelchairs are not mobility scooters. I don't know much about them, but I can point out some obvious likely differences:

1)The chair has to be comfortable enough to be in almost constantly - for someone whose body may not be shaped the same as most other people's. It may need to be designed in a way that makes it easier for the user to get in and out of, unassisted. That means a substantial part of it is customized to each user, probably in consultation with medical professionals. It may need to carry medical devices/equipment.

2)The chair has to be navigable in indoor spaces with a fine degree of control, by someone who may have lower motor skills and range of motion than others. So it may need customizable response time, input smoothing, and acceleration.

3)The chair cannot, under any circumstances, make an un-commanded motion - which could easily kill the occupant (ie going into traffic, or down a steep hill, or off into water.) That has implications for the physical controls, the electronic controls, and mechanical drives (I'm guessing many chairs have electrical locking, and can use the motors for braking.) Similarly, the chair has to be very reliable, or that could kill the occupant (say, a fire or other emergency where they are) or otherwise be a major inconvenience. If you're unable to move much from your chair and, say, your cell phone is in another room - you're varying levels of screwed.

4)It has to be designed such that fire would be a very low risk.

Are they probably more expensive than they need to be? Yeah. But I'm sure it's nowhere near an order of magnitude, and your comment is pretty ignorant.

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

#272

Sigh. I dealt with NSM a few years ago to get a new manual wheelchair. The tech who fitted me for it, and delivered it, was great, but very obviously always in a rush. The chair itself was not made to spec, so it was just not useable for me as-is. After many months of trying (and failing) to get NSM to help me mod it and get it as close to spec as possible, I gave up and just continued using my old chair. But even mo…

Maybe The Paradox Project (by JerryRigEverything) is for you: https://notawheelchair.com/products/the-paradox-project

Thank you - definitely always nice to see people trying new things in this space. It might be a bit risky to rely on a wheelchair that doesn't have a good support ecosystem, though, unfortunately.

This actually touches on something that seems to have changed in the past 10-15 years: in my experience, shops now absolutely refuse to touch wheelchairs that they did not themselves provide. I'm lucky that I can generally do my own maintenance, because even something simple like a deep cleaning is met with worries of voided warranties, etc. etc. I'm not sure when this changed, but throughout the aughts I was able to get service at shops in multiple different cities without any issues.

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

#273

Earlier quoted context omitted.

It’s similar to defence procurement. If the customer is government with endless budget, inflate costs, and use regulatory capture to maintain the cash flow.

some senator just held up a bag on bushings for use on fighter jets suring a speech..the cost for a sandwich bag full...$90k

Well no wonder, he keeps sneaking in with baggies and stealing them.

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

#274
post #257
post #83

Earlier quoted context omitted.

It is not just wheelchairs and nursing homes. My eye doctor office got bought out. They pay the doctors as little as possible and maximize the number of appointments per day.

That sounds great for the consumers of optometry services in your area.

Sure if you like mistakes.

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

#275

Our whole economy is feeling increasingly Soviet. Somehow our business leaders have decided that the best business is one that does not serve its customers, and that providing a good or service efficiently and effectively is poor management because it is "leaking value" to counterparties. I guess the next phase is going to be you need to know people if you want your medical device delivered, your car repaired, or for…

My brother in Christ you are witnessing the consequences of capitalism

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

#276
post #92

Earlier quoted context omitted.

The first step is to stop thinking of "the public" as a monolithic entity whose interests are pursued by the government, and instead recognize that control over things that have a major impact on the lives, welfare, freedom, and prosperity need to be things they can effectively control or opt-out of as individuals . Regulatory intervention makes it harder, not easier, for individuals to take charge of these matters f…

How does that work for things that can only be effectively controlled or opted out of collectively? There's not really a way for an individual to opt out of a corporation using AI in a way that negatively effects them.

> How does that work for things that can only be effectively controlled or opted out of collectively?

I can't think of many such things. Do you have any examples?

> There's not really a way for an individual to opt out of a corporation using AI in a way that negatively effects them.

Refrain from doing business with that corporation? If they are transgressing against your person or property, that's where the law comes into play.

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

#277
post #132
post #92

Earlier quoted context omitted.

The first step is to stop thinking of "the public" as a monolithic entity whose interests are pursued by the government, and instead recognize that control over things that have a major impact on the lives, welfare, freedom, and prosperity need to be things they can effectively control or opt-out of as individuals . Regulatory intervention makes it harder, not easier, for individuals to take charge of these matters f…

> Regulatory intervention makes it harder, not easier, for individuals to take charge of these matters for themselves. That strongly depends on the details. In particular, regulation that compel clear disclosure of information to individuals. Imagine how impossible it would be to "take charge for yourself" if none of the food in the grocery store had any ingredient/nutrition/allergen information, and bottles of pills…

I don't really have a problem with laws that require accurate disclosure of those details. I do have a major problem with laws that usurp decision-making agency away from individuals.

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

#278
post #151

Earlier quoted context omitted.

In my experience, the chairs and how they’re built aren’t what adds to the price tag; the fact that an insurance company is paying is what is. My daughter literally just got approved for a talking device that would otherwise cost us $4000. It’s a Samsung tablet with $300 software and an attached speaker and comes with some sort of repair agreement. I can buy and break 20 iPads for that price…and we did end up buying…

It’s similar to defence procurement. If the customer is government with endless budget, inflate costs, and use regulatory capture to maintain the cash flow.

People assume this serves no-one, but a well heeled public servant with good insurance (or some other member of our new moral rulers) might think it's a fair deal, especially if R&D is amorised by having poor people also forced to pay. They would pay a bit more for the extra safety.

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

#279

Almost as troubling, from the article "Customized wheelchairs typically last five years, but most chairs need a major repair or two during that time." What the actual fuck? Power wheelchairs run the spectrum for a few thousand USD to ten thousand plus. And they only last ~5 years, and even then with several major repairs in that period? That sounds like an absolutely atrocious durability/reliability record.

This is a function of CMS/Medicare paying for a new wheelchair every 5 years. Functionally my wheelchairs have lasted longer. I still use my 8 year old chair with thousands of miles on it as a backup chair when I travel.

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

#280

Earlier quoted context omitted.

I don't think powered wheelchairs should be Class II, but we should be a bit kinder to the FDA. The FDA is not comparing no mobility and simply an inoperable device, the FDA is comparing no mobility vs the possible outcomes of an malfunctioning device. Like perhaps what happens if the throttle gets stuck on forward.

The FDA serves many compromised purposes that, in sum, prioritize the interests of the capitalists who predominately control it. The same can be said for the entire US government.

I can assure you that the FDA does no such thing, as I have been through a very difficult 510k at a previous employer.
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