Why Are Medical Ultrasound Systems So Inexpensive?

It would be nice to have cheaper ultrasound devices, and yes, it can't be that hard to develop something which is useful to a certain hobbyist niche.

Especially with pet breeders, I could see a use for devices around a couple hundred Dollars, though there may not be enough demand to warrant commercial development, especially not from players interested in selling more expensive, over-engineered (for this purpose) devices to the same market.

It's clearly not easy to break into the market for USI, both at the low and the high end. But with patents expiring, and electronics becoming cheaper, more customizeable, more performant, the bigger players may have another think coming.

My point was that it might be better to accept a risk of scalding if it saves lives. A really cheap ultrasound could have all sorts of bad attributes -- and still be worth it to the people who are using it. It could make an incredible positive difference in people's lives. There is no universal set of standards. It varies a lot depending on particular circumstances.

This is a great post, thanks for writing and sharing.

I'm a biomedical engineer and found both posts interesting.

There are really exciting things happening right now where the murky area between expensive, slow medtech and fast-moving, lower cost consumer products are being explored.

There have been some specatular implosions of approaches straying to far towards the consumer tech-startup approach.

Like most things, the best path is probably somewhere in between. Medicine and health is hard because the systems involved are complex and non-linear. There is a higher burden for doing things right than other industries. That said, people also suffer from innovation being slowed by red tape and leading to increased costs.

One great but unlikely solution would be for an improved market for used equipment, where the device loses its certification for medical use and obsolete software becomes open source. Little incentive for manufacturers to do this, but would be great for hobbiests, more 'wellness' rather than medical applications, and improved use in developing countries (where used medical devices like ultrasound machines often are donated but aren't used, because they can't be adapted to local needs).

If risk of scalding means the price can be reduced to a point to where every ambulance or high-speed paramedic car can have one, then it is worth it. If it means that every back-water third-world doctor can have one, great. Sometimes knowing if a patient has internal bleeding, and where, is worth the risk.

The fallacy this author makes in his response is unfortunately very symptomatic of our society's poor grasp of fundamental economic principles. Worth noting that despite failing to see some of the larger forces at work that the previous post mentioned the author nevertheless acts condescendingly towards that other post, which is also very similar to how society-at-large operates.

The one factor the author completely fails to engage in is the fact that the state-of-the-art of ultrasound production and the resources devoted to its development is entirely endogenous to the regulatory and market structure around it. He spends a great deal of time justifying the price based on the technical challenges involved in building the device, but this completely misses the point. The market doesn't reward innovators or companies because their product is "complex."

The matter-of-fact is that we have crazy regulations in the medical space that sharply distort both the demand and supply of these machines. On the demand side, there's bat-shit crazy things like the fact that in order to open up a new hospital, in certain regions the existing hospitals in the area have to all agree that they are okay with that. Imagine what the technology landscape would look like if every time Apple wanted to open a store it would have to seek approval of the Best Buys that had already been there.

We also rarely pay directly for our own medical treatments. The fake prices we see in medicine (I was once hospitalized for $40k; a juice-box in an itemized hospital list could cost $12, etc.) are a great indication of the lack of competitiveness in that space. The truth is these fake prices reveal the fact that no one actually pays them, and instead are like that so insurance companies can negotiate individually with treatment providers. Now, given all of this, who could possibly enter this space and try to sell you on the idea that they could make an ultrasound that is 10% cheaper?

10% cheaper, that is, on top of an already highly-inflated price. Elsewhere in medicine, the INCREDIBLY high cost of FDA drug approval is extremely well documented, costing in the billions of dollars to bring a new drug to market. I hope it wouldn't shock the author of the post to learn that, with that incredibly high cost to play ball, the default scenario is for young medical startups to quickly sell to pharmaceutical giants, as that is really the only way to bring drugs to market. At a smaller scale, this too happens in the ultrasound arena, thus also making their price artificially high.

Speaking more broadly, the author's post is symptomatic of a view of much of our society which ends up treating prices as exogenous things. "College is expensive," "medicine is expensive." are things you hear all the time, and said with the intent that this reveals some fundamental truth about these things. That's garbage. College is expensive simply and only because colleges have been charging that much and people have been paying for it. Full-stop. In fact, the "free college" would be wise to understand that much of the increase in the price tag can be explained by the artificially low rates that you can borrow to attend them in the first place. I lived overseas for many years, and despite having Harvard Medical School-trained doctors and frequenting world class hospitals there, the actual, full cost of those treatments -- which I paid individually -- were a fraction of what they would have cost me in the U.S.