How the medical supply industry blocks device startups from selling to hospitals • Hacker News Board

Re: How the medical supply industry blocks device startups from selling to hospitals

#51

Post by gusfoo » Wed, Apr 25, 2012, 6:16 PM UTC

chaostheory wrote: post #33

wisty wrote: post #24

Earlier quoted context omitted.

On the other hand, here's another quote from the article: "Without a GPO contract, it doesn’t matter how good your product is. Even if I could wave this wand over your body and cure you from cancer, chances are I couldn’t sell it to hospitals" The core problem is, big manufacturers offer discounts (or bigger kickbacks) for bundling. A niche product is unlikely to succeed, even if it's obviously better. A product that…

"The core problem is, big manufacturers offer discounts (or bigger kickbacks) for bundling. " Yeah someone can correct me, but to add to the point: hospitals have razor thin margins. If I remember correctly, it's 10% or less.

10% is hardly "razor thin", it's quite respectable in a lot of industries.

Re: How the medical supply industry blocks device startups from selling to hospitals

#52

Post by dan_yall » Wed, Apr 25, 2012, 6:18 PM UTC

chaostheory wrote: post #33

wisty wrote: post #24

Earlier quoted context omitted.

On the other hand, here's another quote from the article: "Without a GPO contract, it doesn’t matter how good your product is. Even if I could wave this wand over your body and cure you from cancer, chances are I couldn’t sell it to hospitals" The core problem is, big manufacturers offer discounts (or bigger kickbacks) for bundling. A niche product is unlikely to succeed, even if it's obviously better. A product that…

"The core problem is, big manufacturers offer discounts (or bigger kickbacks) for bundling. " Yeah someone can correct me, but to add to the point: hospitals have razor thin margins. If I remember correctly, it's 10% or less.

Try 3%.

Re: How the medical supply industry blocks device startups from selling to hospitals

#53

Post by garrettkuhlmann » Wed, Apr 25, 2012, 6:18 PM UTC

robomartin wrote: post #40

As an entrepreneur I have dedicated most of the last 25 years to doing hardware (read: manufacturing) ventures. Manufacturing in the US is hard, if not impossible, save cases where the ecosystem or nature of the market can support it. Problems one could face include: ip (patents) mine field, government regulations, liability issues, lack of localized supply chains, high labor costs, high insurance costs, high taxes a…

"The solution is evolved rapidly until the right approach surfaces"

Government solutions to real-world problems are the EXACT opposite of this

Re: How the medical supply industry blocks device startups from selling to hospitals

#54

Post by Symmetry » Wed, Apr 25, 2012, 6:18 PM UTC

tyree732 wrote: post #47

ChuckMcM wrote: post #11

When I think of the federal government 'fixing' health care, this is the sort of thing I think they can fix. Not single payer, not mandatory coverage, just good enforcement of anti-competitive practices, ways to enable innovation with patient consent Etc.

Are you so sure about that? excuse-me's comment, right above yours in my view, talks about how the government has anti-competitive arrangements with big military contractors. How would the situation be different with healthcare?

I think the fix in this case would be removing the laws that encourage anti-competitive arrangements.

Re: How the medical supply industry blocks device startups from selling to hospitals

#55

Post by jrockway » Wed, Apr 25, 2012, 6:32 PM UTC

saturdaysaint wrote: post #49

God I hate the healthcare industry. This was on my mind this morning because my girlfriend isn't rich and relies on Lunesta to sleep (I'll leave the fact that her doctor is advising her to take this indefinitely for another day). It's extortionately priced - something like $6 a pill - enough to gouge insurance companies thoroughly and enough to wreck havoc on the finances of someone that's not rich and lacks insuranc…

Why can't she take the generic drug?

Also, $180/month is not really what people mean by "high healthcare costs". They mean something like a $50,000/day hospital stay. $180 is a lot if you don't have a lot of money, but it's hardly backbreaking.

Re: How the medical supply industry blocks device startups from selling to hospitals

#56

Post by ChuckMcM » Wed, Apr 25, 2012, 6:38 PM UTC

tyree732 wrote: post #47

ChuckMcM wrote: post #11

When I think of the federal government 'fixing' health care, this is the sort of thing I think they can fix. Not single payer, not mandatory coverage, just good enforcement of anti-competitive practices, ways to enable innovation with patient consent Etc.

Are you so sure about that? excuse-me's comment, right above yours in my view, talks about how the government has anti-competitive arrangements with big military contractors. How would the situation be different with healthcare?

Yes. I am sure that Congress could propose laws that prevented anti-competitive market practices with regard to health-care and that this would mitigate some of the problems we currently have with the health care system. I claim that doing so is a more effective way, or at least more efficient in terms of relative improvement, of improving health care. This claim is of course made relative to the existing efforts in the US of trying to regulate the insurance industry around health care.

Re: How the medical supply industry blocks device startups from selling to hospitals

#57

Post by Symmetry » Wed, Apr 25, 2012, 6:41 PM UTC

robomartin wrote: post #40

As an entrepreneur I have dedicated most of the last 25 years to doing hardware (read: manufacturing) ventures. Manufacturing in the US is hard, if not impossible, save cases where the ecosystem or nature of the market can support it. Problems one could face include: ip (patents) mine field, government regulations, liability issues, lack of localized supply chains, high labor costs, high insurance costs, high taxes a…

I don't think that politicians having real jobs for part of the year would help, particularly. They'd still only have one job, which wouldn't be nearly enough to get the expertise needed to legislate on all the topics that they make laws on.

I could talk about how any organization tends to become less tolerant of risk over time. Failures happen and when they do the tendency is to make sure that they are prevented from happening again. And when they happen again (they will) the tendency to add more laws which, since the resources devoted to enforcing laws won't be increased, causes all laws to be enforced less well.

I remember a while ago The Economist had a feature one issue on the Dodd-Frank Financial bill that was pretty critical. Dodd and Frank then wrote in the next issue with letters that I though were, frankly, rather illuminating.

One gave the "Something had to be done, this was something, we did it" syllogism nearly perfectly. The other talked about all the hard work that went into the bill, how he'd talked with all sorts of professionals working in the financial industry and added all sorts of special cases so that the currently existing set of businesses weren't unduly inconvenienced.

Re: How the medical supply industry blocks device startups from selling to hospitals

#58

Post by jeremyarussell » Wed, Apr 25, 2012, 6:44 PM UTC

byandyphillips wrote: post #35

Wow, I love reading a book on the web. Either cut your copy down by 1/2 (no one is going to read the whole thing) or place a disclaimer at the top on the average it will take to read the whole article.

Or ya know, as an beings who can keep track of things like how fast we read, you could simply scroll through the article like i did, go, okay that's about ten minutes. Then decide if you want to keep going. Saying no one would read the whole thing is a bit much to, considering I read every word, and I'm sure others did to.

Re: How the medical supply industry blocks device startups from selling to hospitals

#59

Post by tel » Wed, Apr 25, 2012, 6:51 PM UTC

robomartin wrote: post #40

As an entrepreneur I have dedicated most of the last 25 years to doing hardware (read: manufacturing) ventures. Manufacturing in the US is hard, if not impossible, save cases where the ecosystem or nature of the market can support it. Problems one could face include: ip (patents) mine field, government regulations, liability issues, lack of localized supply chains, high labor costs, high insurance costs, high taxes a…

And, when it comes to the medical field, might even result in people dying.

No, it does with a great deal of certainty. HIPAA protects patient privacy, but often prohibits healthcare research, certainly increases the cost of health IT by orders of magnitude, and certainly destroys the opportunity to make good decisions about how to run a hospital or treat a patient.

The original plan was for the "P" in HIPAA to mean "Portability" but those parts of the bill were delayed and eventually dropped.

Re: How the medical supply industry blocks device startups from selling to hospitals

#60

Post by gamble » Wed, Apr 25, 2012, 6:56 PM UTC

robomartin wrote: post #40

As an entrepreneur I have dedicated most of the last 25 years to doing hardware (read: manufacturing) ventures. Manufacturing in the US is hard, if not impossible, save cases where the ecosystem or nature of the market can support it. Problems one could face include: ip (patents) mine field, government regulations, liability issues, lack of localized supply chains, high labor costs, high insurance costs, high taxes a…

I'm not seeing how the government was an issue in this case. The article is about how private companies use kickbacks and cartel behaviour to restrict what products are available to hospitals. It seems like a lack of government action is the problem here.