[HN Gopher] As private equity dominates wheelchair market, users...
       ___________________________________________________________________
        
       As private equity dominates wheelchair market, users wait months
       for repairs
        
       Author : coloneltcb
       Score  : 247 points
       Date   : 2024-05-03 17:25 UTC (5 hours ago)
        
 (HTM) web link (www.statnews.com)
 (TXT) w3m dump (www.statnews.com)
        
       | tonetheman wrote:
       | What you would expect from private equity sadly. Destroyers of
       | value.
        
         | Rinzler89 wrote:
         | But, but...muh free market capitalism always leads to the best
         | products supply for the demand...or so we've been told.
        
           | ElevenLathe wrote:
           | Turns out late hegemonic capitalism has a similar failure
           | mode to late Soviet central planning.
        
             | vundercind wrote:
             | Relaxing various rules on investment and m&a, and allowing
             | unprecedented levels of market power concentration (it's a
             | _lot_ worse in many major industries than what promoted our
             | first big wave of "trust busting") turns out to be less
             | than awesome.
        
           | readyman wrote:
           | Capitalism works perfectly if you just ignore all the
           | inevitable disasterous consequences and outright failures.
        
             | ars wrote:
             | And your better alternative is........... ?
        
               | mistermann wrote:
               | Capitalism moderated by various systems emerging from a
               | genuine, sophisticated democratic system would be my
               | advice.
               | 
               | We have a lot of work to get from here to there though,
               | and much of it is the undoing of mass psychological
               | condition.
        
               | readyman wrote:
               | Capital will simply undermine the democracy _again_. It
               | 's literally that simple. Capitalism and democracy are
               | fundamentally at odds.
        
               | mistermann wrote:
               | This part is important:
               | 
               | > from a genuine, sophisticated democratic system
               | 
               | Do you think something more powerful than capitalism is
               | impossible?
        
               | margalabargala wrote:
               | Capitalism with much stronger consumer-protection
               | regulations?
        
               | kelipso wrote:
               | China is doing pretty well. In before a wall of text
               | about how China is doomed or whatever.
        
               | realusername wrote:
               | China is doing well is a funny take post covid. The
               | argument worked much better 10 years ago when they still
               | had large growth.
               | 
               | "Doomed" I don't know but they seem quite stuck now
               | between a lot of internal problems.
        
               | ausbah wrote:
               | only once they switched to free market principles under
               | deng. iirc as their growth has been slowing it has been
               | due to increasing state clampdown on the economy
        
               | giovannibonetti wrote:
               | I assume you aren't aware of China's housing market
               | bubble [1].
               | 
               | [1] https://en.m.wikipedia.org/wiki/Chinese_property_sect
               | or_cris...
        
               | truckerbill wrote:
               | Social democracy
        
               | atq2119 wrote:
               | Market socialism. Or some in-between that recognizes that
               | wealth and corporate power has a genuine responsibility
               | to society as a whole. Myopic focus on profit as the only
               | metric is the biggest problem, after all.
        
           | mistermann wrote:
           | It is the job of government to regulate and reign in
           | capitalism.
           | 
           | We are also told that democracy is the best form of
           | government, and we are also told that our democracy is
           | genuine, and that it must be protected. For some reason,
           | people are unable to wonder if these various stories are
           | true...perhaps because that skill is not innate, and is not
           | taught in school?
        
           | tomoyoirl wrote:
           | No. It's only efficient when property rights are enforced,
           | barriers to entry are low, and transaction costs are minimal.
           | 
           | Wheelchairs are regulated (barriers to entry), pollution is
           | the nonexistence of property rights, and your take-it-or-
           | leave-it noncompete agreement is a consequence of high
           | transaction costs (job search, legal negotiations).
        
           | Terr_ wrote:
           | > ... or so we've been told.
           | 
           | To expand on this inconsistency, it comes from different
           | people cheer-leading "the free market" with different and
           | conflicting sets of assumptions about what the phrase means.
           | 
           | For example, one economist makes an assumption of "perfect
           | information on prices and transactions", and declares that
           | it's the most _efficient_ thing ever.
           | 
           | But another one assumes actors _are_ free to make secret
           | deals and private transactions, and concludes that the free-
           | market _doesn 't_ have a cartel problem, because individual
           | members will secretly defect and undercut so that it falls
           | apart.
           | 
           | Those two assumptions are in direct contradiction, yet
           | somehow the overlap phrase "the free market" still gets
           | touted as having both of the incompatible features.
        
         | 7thaccount wrote:
         | Private Equity really is a pox on society.
         | 
         | One reason they may not be able to hire is that they paid a ton
         | to buy out all the competition and now have a bunch of
         | investors wanting to see high rates of return. That requires
         | cutting staff and raising prices. I'm all for a free society
         | that allows private parties to make agreements, but PE is by
         | definition all about breaking markets by creating a monopoly
         | where they have large amounts of market power and where no
         | competition can realistically occur. The end result is
         | consumers getting screwed all over.
        
           | ars wrote:
           | > Private Equity really is a pox on society.
           | 
           | Every single non-public business is "Private Equity". How is
           | every single small business in the entire world "a pox on
           | society"?
           | 
           | Perhaps you mean "short term thinking" is a pox on society?
           | Or in, like in this case, a duopoly is the issue? If there
           | were 10 such companies a reputation for slow repair would
           | drive people to other suppliers and things would rapidly get
           | better.
        
             | eesmith wrote:
             | https://en.wikipedia.org/wiki/Private_equity
             | 
             | "In the field of finance, private equity (PE) is capital
             | stock in a private company that does not offer stock to the
             | general public. Private equity is offered instead to
             | specialized investment funds and limited partnerships that
             | take an active role in the management and structuring of
             | the companies. In casual usage, "private equity" can refer
             | to these investment firms rather than the companies that
             | they invest in."
        
             | hx8 wrote:
             | PE is specifically referring to companies not listed on
             | stock exchanges that take money from investors. I agree
             | that we do not want to throw the baby out with the
             | bathwater here, but there is probably merit to limiting the
             | activity of PE funds with lots of investors or lots of
             | money. PE often used as a scheme of raising money and
             | conducting business in a way to avoid the scrutiny of a
             | publicly traded company.
        
             | 7thaccount wrote:
             | I'm referring to the large investor firms that go around
             | buying out companies not listed on the stock exchange to
             | capture entire markets, milk it for all it's worth, and
             | then dump the shriveled corpse. This is very rarely good
             | for the end customers or the employees who get outsourced.
             | The owner gets millions though and it allows the PE firm to
             | sell an asset class to investors.
             | 
             | On the one hand, I don't think it's right to restrict the
             | rights of the business owner. If they have a company with
             | $20M in revenue and PE offers $60M to buy them out...fair
             | game right? On the other hand, it takes perfectly
             | profitable companies providing value, extracts that wealth
             | from happy consumers of the product to people already
             | wealthy and then leaves the consumer with a crappy,
             | expensive, and barely supported product. If this happens
             | just a few times...it sucks, but no big deal. Once it
             | starts happening all over America, then we start running
             | into systemic problems like not being fleeced every time
             | you want to go to a concert. It's not like a competing firm
             | can just pop up either in a lot of cases as there are huge
             | barriers to entry. There is no recourse other than not ever
             | seeing your favorite artist again.
        
         | IncreasePosts wrote:
         | Well, a private equity firm owned the wheelchair company for a
         | decade. It was only when a _different_ PE firm came in that the
         | service allegedly declined.
        
       | ars wrote:
       | "Grau wants more wheelchair users to come into the shop, as
       | repairs happen much faster -- only two week's wait, on average.
       | Wheelchair users are loath to adopt this, as coming into the
       | office can be physically treacherous for them"
       | 
       | vs. a technician fixing the chair in the house.
       | 
       | But how about something in between? A medium-skill employee who
       | takes the chair from their home to the repair facility? They
       | would need to carefully document what's wrong with it, so they
       | need a little skill but not as much as a full skill repair tech.
        
         | giovannibonetti wrote:
         | It seems like a good job for non-profits. Anyone with a
         | suitable car should be able to volunteer and help their
         | community.
        
         | advisedwang wrote:
         | I'm not a wheelchair user, but I can imagine it being a non-
         | starter to have your wheelchair just taken away from you. What
         | if the tech doesn't bring it back? You're just stranded! Even
         | if they do bring it back, there's potentially a lot of time
         | stranded.
        
       | JumpCrisscross wrote:
       | What's the barrier to entry?
        
         | ars wrote:
         | Regulation.
         | 
         | This is one of the market failures caused by excessive
         | regulation.
         | 
         | To make a chair you requires so much paperwork that only a
         | small number of business can do it.
         | 
         | I especially like the regulations that make sure only those who
         | need the chair get it, to reduce medical costs, but in the
         | process all the paperwork dramatically drives up the costs.
        
         | alistairSH wrote:
         | Power wheelchairs are regulated (FDA) as medical devices.
        
           | TechWorld01 wrote:
           | I can buy an electric wheelchair at Walmart for $750. What is
           | the issue?
        
             | mcmcmc wrote:
             | You can also buy pharmaceuticals at Walmart. What is your
             | argument?
        
             | happyopossum wrote:
             | That's a powered scooter, not an electric wheelchair. They
             | may look the same to a layperson, but they're not - one is
             | highly regulated and has a lot of people making a lot of
             | money off them, the other is a scooter.
        
             | deadeye wrote:
             | Some of these wheelchairs are 75k. They're custom made to
             | your body size for maximum comfort and the features are
             | customized to your disability.
             | 
             | These aren't off the shelf mobility products. Each one is
             | assembled to specification.
        
             | alistairSH wrote:
             | As the sibling comments noted, we're talking about bespoke
             | wheelchairs for people with severe mobility disability (MS,
             | ALS, etc). Things like Stephen Hawking's chair.
        
               | Fricken wrote:
               | Still, they shouldn't cost more than a high end Ebike.
        
               | alistairSH wrote:
               | I don't know what the median/average price is for these,
               | only the range.
               | 
               | Bit, a high end e-bike is $12-$15k. Which also seems
               | ridiculous to me. And I'm a cyclist with several nice
               | bikes (none of which were more than $7k).
        
               | mikestew wrote:
               | _And I'm a cyclist with several nice bikes (nine of which
               | were more than $7k)._
               | 
               | "Nine", or did you mean "none"? I'm just checking if it
               | was a typo, or if I should be jealous. :-)
        
               | sokoloff wrote:
               | Anything custom will cost more than a similar complexity
               | mass-produced item.
        
               | JumpCrisscross wrote:
               | Oooh, I missed this distinction.
        
       | nickff wrote:
       | 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.
        
         | tdb7893 wrote:
         | We've seen consolidation across the whole economy (which have
         | vastly different regulation schemes) so I'm skeptical of it
         | being just regulation driven
        
           | JumpCrisscross wrote:
           | > _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.
        
             | kazinator wrote:
             | Then, how would it fix things then if it wasn't private
             | equity dominating that market?
             | 
             | There would still be regulations that would allow public
             | equity wheelchair makers to jack prices.
        
               | JumpCrisscross wrote:
               | > _how would it fix things then if it wasn 't private
               | equity dominating that market?_
               | 
               | I'd start importing them for less than $500 from India
               | [1]. (Versus $1,500 to $6,000 for these jalopies.)
               | 
               | [1] https://www.amazon.in/electric-
               | wheelchair/s?k=electric+wheel...
        
               | MichaelZuo wrote:
               | The regulations don't just disappear to allow for such
               | imports as in your example ...?
        
               | JumpCrisscross wrote:
               | > _regulations don 't just disappear to allow for such
               | imports as in your example_
               | 
               | My point is the regulations are leading to the duopoly,
               | which is the source of the problem. The last private-
               | equity owner seems to have been fine. And the market was
               | competitive before the CMS rules in 2005. I'm not
               | suggesting scrapping the rules. But the rules are clearly
               | well past safety.
        
               | MichaelZuo wrote:
               | Perhaps you've confused which comment I was replying to
               | with one further up, from what I can see you were trying
               | to answer the question, and nothing else is visible:
               | 
               | > how would it fix things then if it wasn't private
               | equity dominating that market?
               | 
               | The visible answer is clearly contingent on some future
               | regulatory landscape coming into existence, otherwise it
               | makes no sense, so I was wondering how does it answer the
               | original question?
        
               | cogman10 wrote:
               | Well, that's the interesting thing. You likely can import
               | and use these wheelchairs, but they can't be sold as
               | medical devices and, subsequently, won't be covered by
               | your insurance.
               | 
               | The dumb thing is these super cheap wheelchairs would
               | likely cost the end users more money than the expensive
               | ones as they will buy them out of pocket vs having their
               | insurance/medicare cover most/all of the cost.
               | 
               | The reason these companies don't sell these wheelchairs
               | in the US is likely because the marketing would run afowl
               | of regulations about selling medical devices. You
               | probably could sell these as bicycles and hobby chairs
               | though.
        
               | charrondev wrote:
               | I mean they could market similar to Not a Wheelchair I
               | guess? https://notawheelchair.com/products/the-rig
        
               | yumraj wrote:
               | The price difference seems to be enough for a person to
               | fly to India and bring one with them.
               | 
               | Can the FDA stop a person from using one by coming to
               | their home and confiscating it?
        
               | dahinds wrote:
               | It would not necessarily fix things if private equity
               | wasn't involved, but private equity is particularly
               | effective at identifying cases where a market or
               | regulatory inefficiency is not being maximally exploited,
               | and jumping in to extract profits from that. So sort of
               | by construction, when private equity enters a particular
               | market, things are likely to get worse for consumers. It
               | doesn't mean that things are golden if private equity is
               | not involved.
        
           | Gormo wrote:
           | Regulation across the whole economy is one of the principle
           | mechanisms of consolidation.
           | 
           | Vested interests sell regulation to the public as a "consumer
           | protection" mechanism, then use regulatory capture as a tool
           | to erect barriers to entry and impose complex rules that
           | supersede common-law jurisdiction while giving them a range
           | of tools to evade liability. The threat of competition is
           | restrained, and a de facto collusive oligopoly can squeeze
           | the market dry.
        
           | akira2501 wrote:
           | 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.
        
         | pdonis wrote:
         | 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 who to buy from and who not to
         | buy from, and customers would see the full cost of the products
         | so they could make meaningful cost-benefit calculations.
         | 
         | In capitalism such as we currently have, none of that is
         | happening. The government aids and abets rich people who want
         | to siphon off even more wealth than they already have by
         | putting regulatory barriers in place that stifle competition,
         | and it removes visibility into actual costs by forcing all
         | medical products and services to be provided through health
         | insurance, even when, as in this case, there is no insurable
         | risk involved--it's an ongoing medical need that is already
         | known (not a risk) and which is predictable (so insurance makes
         | no sense anyway). The result, of course, is that the customers
         | get shafted while rich people get richer.
        
           | kazinator wrote:
           | Capitalism refers to the system of individuals pooling money
           | together (capital) to start a venture that they couldn't if
           | they acted separately. The idea of a company being a person-
           | like legal entity with its own assets and liabilities is
           | capitalistic.
           | 
           | In a free marked that is absent of regulatory hurdles, it is
           | far from guaranteed that costs would be affordable.
           | 
           | Freedom from regulation about how wheelchairs have to be
           | constructed would go hand-in-hand with freedom from
           | regulation against monopolistic practices!!!
           | 
           | In a completely free market, devoid of regulation, wheelchair
           | makers can get together and fix prices. Or buy each other.
        
             | JumpCrisscross wrote:
             | > _idea of a company being a person-like legal entity with
             | its own assets and liabilities is capitalistic_
             | 
             | It independently evolved in Rome and India to provide legal
             | personhood to cities, guilds, public works and later, in
             | the former, the Catholic Church.
        
             | pdonis wrote:
             | _> Capitalism refers to the system of individuals pooling
             | money together (capital) to start a venture that they
             | couldn 't if they acted separately._
             | 
             | That's one aspect of capitalism, yes. But in capitalism as
             | it is currently practiced, most of the people who are
             | accumulating capital aren't people that are trying to start
             | new ventures. They are people that are already rich but
             | think they aren't rich enough, who are _unable_ to start
             | new ventures themselves because they have no actual skills
             | at providing valuable products or services, so instead they
             | find some existing venture and siphon off all its wealth.
             | (This pattern is not new, btw; it 's the same way the
             | "robber barons" in the late 19th century operated.)
             | 
             |  _> In a free marked that is absent of regulatory hurdles,
             | it is far from guaranteed that costs would be affordable._
             | 
             | Nothing is ever "guaranteed". But the article under
             | discussion makes it obvious that _with_ regulations in
             | place, not only are costs not affordable, but even the very
             | _existence_ of products meeting customer needs is not
             | happening. A free market couldn 't possibly do any worse.
             | 
             |  _> In a completely free market, devoid of regulation,
             | wheelchair makers can get together and fix prices. Or buy
             | each other._
             | 
             | This would only happen if it were economically more
             | efficient for wheelchairs to be made by a monopoly. I
             | strongly doubt that is the case. It's not the case for the
             | vast majority of products and services. If it's not
             | economically efficient, the monopoly (or price-fixing
             | cartel) will simply be out-competed in a free market,
             | because it will have no way of keeping other companies from
             | producing at a lower cost.
             | 
             | Historically, virtually all monopolies have been the result
             | of government interference. (The original meaning of the
             | word "monopoly" was a royal grant of the exclusive
             | privilege to sell a particular product or service.) Most
             | large corporations today are not the size they are because
             | that is the most economically efficient way to deliver
             | their products or services, but because it's the best way
             | to buy government favors.
        
               | wesselbindt wrote:
               | > Historically, virtually all monopolies have been the
               | result of government interference
               | 
               | I'm with you on this. In general, the state (by
               | definition) functions to protect the interests of the
               | politically dominant class, which, under capitalism, is
               | the owning class. From the haymarket massacre to Biden's
               | strike breaking shenanigans, this is absolutely beyond
               | dispute. The state will always facilitate monopolies. The
               | only way to get rid of monopolies is for the workers to
               | organize and overthrow the dictatorship of the owning
               | class. Until that happens, it's all Disney, Amazon, and
               | pseudo democracy.
        
           | ausbah wrote:
           | private equity is just exploiting existing regulations that
           | already make it hard for new members to enter the market &
           | add competition no? doesn't seem like many _new_ regulations
           | are being enacted to gain market dominance, working with what
           | exists is enough?
        
             | pdonis wrote:
             | _> existing regulations_
             | 
             | Which were put in place in response to other rich people
             | lobbying the government for regulations that favored them
             | and their companies. Perhaps there haven't been many recent
             | ones put in place specifically in response to lobbying by
             | private equity companies (though I'm not sure that's true).
             | But that doesn't change the main point.
        
           | cyberax wrote:
           | 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 moat.
        
             | bravo22 wrote:
             | 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.
        
               | eropple wrote:
               | _> Liability still exists in a free market_
               | 
               | Only if a wronged party has the resources (time, money,
               | political capital) to pursue it.
               | 
               | Which is but one reason why it is deeply silly to rely on
               | it to make a society go.
        
               | pdonis wrote:
               | _> Only if a wronged party has the resources (time,
               | money, political capital) to pursue it._
               | 
               | In a free market, if there is a market need for more
               | efficient achievement of redress for wronged parties, the
               | market will produce it.
               | 
               |  _> Which is but one reason why it is deeply silly to
               | rely on it to make a society go._
               | 
               | But of course relying on governments to achieve redress
               | for wronged parties works just great. Not.
        
               | AlexandrB wrote:
               | > In a free market, if there is a market need for more
               | efficient achievement of redress for wronged parties, the
               | market will produce it.
               | 
               | In our current market, many companies have worked around
               | redress of wronged parties by mandating arbitration in
               | various contracts.
        
               | wolverine876 wrote:
               | Free markets are not a panacea, nor do ideal free markets
               | ever exist anyway. Also, free markets require regulation
               | to prevent powerful actors from making them non-free.
               | 
               | > the market will produce it.
               | 
               | Only if it's profitable. Feeding poor people, caring for
               | the indigent, etc. isn't profitable.
        
               | randomdata wrote:
               | _> Only if it 's profitable._
               | 
               | Are you confusing markets with business?
               | 
               | To profit means that you accepted a debt instead of
               | getting something in return for your efforts. _Business_
               | seeks profit because the expectation is that it will pass
               | the debt on to the stakeholders who will then call the
               | debt and get something in return for their efforts.
               | 
               | But it is _people_ who participate in the market. If they
               | demand profit continually, therefore not getting anything
               | in return, that just means they 're working for free.
               | People won't feed the poor unless they can do it for
               | free? Methinks that's not what you meant.
        
               | Latty wrote:
               | Liability can't magically undo damage to health.
               | Regulation is vital when the potential damage is
               | irreversible.
        
             | pdonis wrote:
             | _> 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 delude themselves
             | that Big Brother is looking out for them (even though Big
             | Brother is _not_ actually doing that); they know that
             | _they_ have to enforce quality if that 's what they want.
             | That means customers know that it's on _them_ to be savvy
             | enough to be able to evaluate the quality of products and
             | services.
             | 
             |  _> That 's why we have regulation: to establish the
             | minimum standards._
             | 
             | That's what regulators claim, but all history shows that
             | claim to be wrong. The end result of regulations is to
             | _reduce_ the quality and availability of products, not
             | increase them. The wheelchair market described in the
             | article is a classic example: it 's regulated up one side
             | and down the other, yet customers can't get simple things
             | like proper footrests.
             | 
             |  _> 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._
             | 
             | Doesn't this contradict your claim that regulation is the
             | only way to avoid exploding chairs? If you don't do
             | clinical trials, how do you know the chairs won't explode
             | one day after the warranty expires?
             | 
             | Of course the answer to this is that the 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.
             | 
             |  _> All-in-all it 'll cost you around $10m, which is not at
             | all a moat._
             | 
             | So you'll be going into the wheelchair business then? Looks
             | like there's plenty of opportunity to out-compete the
             | current incumbents.
        
               | wolverine876 wrote:
               | 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 idea how to evaluate the safety of an
               | electric wheelchair, and don't have the time to acquire
               | the expertise to learn how to do that with everything I
               | buy. But we all can chip in and pay someone, who has the
               | expertise, to do it once rather than than millions of
               | people doing it redundantly.
        
               | roughly wrote:
               | Eternal September, except it's an Econ 1 class.
        
               | wolverine876 wrote:
               | It seems like quite a rush of it today. Did someone put
               | up the anarcho-libertarian bat signal?
        
             | robertlagrant wrote:
             | We might think we have regulation for minimum standards,
             | but that's not necessarily why regulations are created.
        
             | xcdzvyn wrote:
             | Why would I buy something that kills me the day after the
             | warranty expires?
        
               | Uehreka wrote:
               | Because you don't know that it will. If it's been out for
               | less than a year perhaps no one has been harmed by it
               | yet.
        
           | throwaway48476 wrote:
           | The problem is that the people with money have no incentive
           | go innovate, they already have money. The people without
           | money have reason to innovate but no means to do so. So
           | everything stagnated.
        
         | mhh__ wrote:
         | That some people apparently can't see this strat with AI
         | "safety" laws is genuinely bizarre.
        
           | api wrote:
           | Lots of people see it. It's very clear to me and many others
           | that a lot of the AI safety push is about going straight for
           | regulatory capture and effectively outlawing competition.
        
           | wolverine876 wrote:
           | How do think we should address security around AI, and the
           | public's control over a major impact on their lives, welfare,
           | freedom, prosperity, etc.
        
             | sangnoir wrote:
             | > How do think we should address security around AI
             | 
             | The same way we address security around cars: we don't ban
             | individuals from working on project cars, or driving them
             | on public roads - instead, we have standards for OEMs _and_
             | individuals, and prosecute negligence.
             | 
             | AI safely is similar to GM lobbying for laws making it
             | illegal to tweak your own car or changing your own brake
             | fluid for "public safety".
        
               | wolverine876 wrote:
               | > we don't ban individuals from working on project cars,
               | or driving them on public roads - instead, we have
               | standards for OEMs and individuals, and prosecute
               | negligence
               | 
               | I'm not quite sure what you mean, or what in AI safety
               | you see as analogous.
               | 
               | For other technology, certainly building and using
               | certain things is illegal - you can't make hand grenades,
               | lots of chemicals; I'm pretty sure you can't own certain
               | instruments of crime, counterfeit money, etc. Many things
               | you can do; it's not all or nothing.
        
               | sangnoir wrote:
               | > I'm not quite sure what you mean
               | 
               | IMO, for the general public, current AI models are much
               | closer to cars than they are to anti-personnel weapons,
               | when plotted on risk/benefit axes. FWIW, vehicle
               | regulations are not an all-or-nothing affair either -
               | there are things that remain verboten.
               | 
               | Those who claim AIs are too dangerous to be in the hands
               | of the public have ulterior motives, and/or are far more
               | optimistic than I am on the speed and ease the chasm
               | between LLM and general intelligence will be bridged - if
               | it at all.
        
             | Gormo wrote:
             | 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 for themselves.
             | You can bet that the first casualty of a regulatory regime
             | for AI would be to suppress development of FOSS solutions
             | that would eventually give people the maximal control and
             | benefit from AI, and force them into dependence on third-
             | party solutions offered by organizations that have
             | influence over the regulatory regime itself.
        
               | wolverine876 wrote:
               | > 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.
               | 
               | If AI takes over the world, or others pump lots of GHG
               | into the air and cause climate change, or someone sets
               | off explosives and burns down my neighborhood, or my
               | frozen chicken contains poisonous bacteria, or my
               | bathroom sanitizer doesn't really sanitize - how do I opt
               | out?
               | 
               | Plenty of regulations coexists with FOSS, obviously.
               | 
               | The arguments against all regulation are transparently
               | weak, and the apparent dogmatism discredits everything
               | else. Why be so dogmatically anti-regulation? Dogmatism
               | isn't about finding truth but about serving someone's
               | political interests. If I understand correctly what's
               | happening, whose interests are you serving and why?
        
               | wizzwizz4 wrote:
               | > _If AI takes over the world,_
               | 
               | This is a potential concern, but no currently-existing
               | computer system (that I'm aware of) is any kind of risk
               | for that. Certainly, nothing OpenAI has produced is.
               | 
               | I'd say the currently-real unaligned-agent behaviour of
               | our institutions is a bigger risk than currently-
               | fictional computer-instantiated unaligned
               | superintelligence. And we do have regulation in place to
               | constrain the behaviour of many institutions:
               | governments, corporations, utility operators, and so on.
               | 
               | The unaligned agent problem was not _discovered_ by the
               | AI safety people. They merely named it.
        
               | Terr_ wrote:
               | > 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 didn't tell you the active ingredients
               | and amounts.
        
         | vrc wrote:
         | It's interesting. The regulation ostensibly protects vulnerable
         | classes from exploitation and lets them use reimbursement
         | structures to defray cost. At the same time it causes costs to
         | go up and allows people to buy their way across the moat.
         | 
         | I wonder if regulation that stipulated that a change of
         | ownership of some percentage would require recertification of
         | the entity would stem this a bit. Or restrictions on buying
         | HIPAA covered businesses with patient data. Might pose a
         | problem to folks in the business today, but could slow down the
         | massive acquire-and-merge train in these industries.
        
           | wolverine876 wrote:
           | Not all regulation causes costs to go up. Some causes costs
           | to go down, for example, by correcting inefficiencies created
           | by raw game-theory market competition. Some reduce costs by
           | creating a safer environment for investment, reducing risk.
           | Regulation serves market participants too.
        
             | johngladtj wrote:
             | Regulation always increases costs, it's just that not all
             | costs are easily visible
        
         | burnte wrote:
         | They're huge in healthcare for this very reason.
        
         | wolverine876 wrote:
         | It's impressive that not only has private equity enshittified
         | even nursing homes and wheelchairs, they have persuaded people
         | to empower PE even more by reducting regulations. Do you think
         | PE will suddenly change without regulation?
         | 
         | PE is responsible for PE's actions. If these services and goods
         | decline under PE, with the same regulations as before, then the
         | cause is clear.
        
         | EMCymatics wrote:
         | We should be more vocal in our opposition
        
         | tmaly wrote:
         | 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.
        
           | throwaway48476 wrote:
           | How hard is it for them to leave and start their own
           | business?
        
         | fakedang wrote:
         | The brevity of this statement belies the prescience of it. Back
         | in my former life in PE, businesses with industry moats were
         | actively hunted down and targeted, regardless of location. That
         | obviously led to the three basic necessities of man -
         | healthcare, education and housing - being the most affected
         | sectors.
        
         | esafak wrote:
         | Is there anything that PE doesn't turn to shit?
        
       | throwaway2562 wrote:
       | Dare one say, fuck those motherfuckers. I realise this is not a
       | nuanced take, but I struggle to see any other reasonable
       | response.
        
         | Invictus0 wrote:
         | Don't hate the player, hate the game.
        
           | pseudalopex wrote:
           | Do both.
        
           | wolverine876 wrote:
           | People are responsible for their own behavior. They can't
           | blame the game.
        
           | bcrosby95 wrote:
           | The player also lobbies to keep the game going. So yeah, fuck
           | those motherfuckers.
        
         | kachapopopow wrote:
         | I mean fair, but helping people like that teaches empathy which
         | we're severely lacking in today's world. There is something
         | special we humans experience when helping others for nothing
         | and return and I think that a lot of people are blinded by
         | never experiencing what it means to help others.
         | 
         | A lot of arguments are "imagine if it was you", but I think a
         | fairer argument would be "what if it was somebody you
         | like/love"?
         | 
         | I personally wouldn't mind jumping off a bridge if I became
         | useless, but what about the people who want to continue living
         | who are afraid? And what about the people that like/love me?
        
           | happyopossum wrote:
           | I think you completely misread GP...
        
           | wolverine876 wrote:
           | Humans aren't tools and therefore can't be 'useless'. You
           | matter intrinsically. The most important lesson I've learned
           | in life is the need to know and love myself - in a healthy,
           | compassionate way. It doesn't matter what some other people
           | think, what I do for them. I matter and you matter.
        
       | alistairSH wrote:
       | 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.
        
         | deadeye wrote:
         | Think about it. For many users, they're in these chairs 12+
         | hours a day. They're not cars that get driven for an hour a two
         | a day.
        
           | alistairSH wrote:
           | Sure, but I would have expected them to be modular enough to
           | keep running more than 5 years. More so given they cost as
           | much as a used car.
        
           | s_m_t wrote:
           | And yet my motorcycle has gone 80,000 miles without ever
           | needing _any_ maintenance except for a new chain and new sets
           | of tires. Well, I 've had to replace the headlight and levers
           | and shift peg because I've crashed it off-road multiple times
           | but that's not the motorcycles fault. I bought it for $1000
           | used.
        
       | ryanong wrote:
       | The problem isn't regulation, the problem is that the regulation
       | isn't simple or cheap enough for small companies to get
       | regulated.
        
         | saulrh wrote:
         | Yeah. Don't complain about regulation existing. Complain about
         | regulations being controlled by private equity. Complain about
         | private equity existing. Complain about capitalism. Not about
         | the existence of government.
        
       | JumpCrisscross wrote:
       | "In 2005, CMS announced requirements for testing of electric-
       | powered wheelchairs as part of efforts to modernize coding (5-7).
       | In this century, CMS, in what might be classified by some as an
       | uncharacteristic move, has provided leadership in evidence-based
       | classification of wheelchairs.
       | 
       | Globally, the International Standards Organization (ISO) manages
       | the wheelchair standards. ISO and the RESNA standards committee
       | work collaboratively. ISO and RESNA have often been driven by
       | outside sources to expedite their work and to address needs of
       | consumers and other organizations. In the 1990s, the European
       | Community Medical Device Directive provided impetus to make a
       | number of changes to ISO standards and to create new standards in
       | response to stricter regulation. The European Committee for
       | Standardization (CEN) went its own direction for a while and over
       | time, CEN and ISO standards have begun to merge. American
       | National Standards Institute (ANSI)/RESNA was a driving force for
       | a long time and often had different standards than ISO. However,
       | this has dwindled in the past decade. Concomitantly, the
       | wheelchair industry has exploded over the past 10 years, and the
       | standards have simply not kept pace. There is a clear and present
       | need for change in standards development and support in the
       | United States.
       | 
       | Most of the participants in wheelchair standards development are
       | employed by the wheelchair industry, an inherent conflict.
       | Unfortunately, wheelchair users and clinicians have traditionally
       | not had the financial support to participate in sufficient
       | numbers. Interestingly, the same companies that participate in
       | the standards committees develop internal tests not represented
       | by ISO or RESNA as part of their product development programs to
       | protect them against legal liability. Test laboratories do the
       | same thing, creating a number of tests that differ from or
       | improve on ISO or RESNA standards. None of the existing standards
       | (ISO, CEN, or RESNA) is comprehensive enough to cover all areas
       | of wheelchair evaluation."
       | 
       | [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1929010/ _2006_
        
       | roody15 wrote:
       | Private Equity = we have a bunch of money and use it to control
       | markets and politics.
       | 
       | Almost a new form of feudalism.
       | 
       | Get back to work IT surfs while we continue to extract wealth
       | from your labor.
        
       | hi-v-rocknroll wrote:
       | Vulture capitalism - def. (noun): A strategy applied to a company
       | or multiple companies in a market category whereby profits are
       | maximally extracted without regard to long-term sustainability of
       | customer relationships, brand reputation, or company viability.
       | 
       | Not saying it's not a viable possible strategy for the investor,
       | but that it's perhaps a suboptimal strategy if greater net
       | profits were desired long-term.
        
       | neilv wrote:
       | We frequently hear about "private equity" doing something
       | sociopathic.
       | 
       | We sometimes don't even hear the names of the companies, just
       | "private equity".
       | 
       | Do we need to systematically trace and publish which individuals
       | and institutions benefit from the nasty companies?
        
         | ben_jones wrote:
         | We should publish the b-school, and b-school networking graph
         | through the career of a malicious individual.
         | 
         | People will take action faster if they knew Thaddeus
         | Wrappesalot went straight from lacrosse captain to executive
         | chairmen hiking veterinarian costs.
        
       | throwaway050324 wrote:
       | 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 more frustrating than that? NSM continued sending me
       | phony bills for parts that I _did not_ order. I just trashed them
       | until it went to collections. (Fortunately, the collection agency
       | they use is even more incompetent than they are, and I 've been
       | able to put them off with standard anti-collections form
       | letters.)
       | 
       | I figured I'd go with Numotion when insurance is ready to re-up
       | me for a new chair, but reading this article, it doesn't seem
       | that would be any better.
        
         | stronglikedan wrote:
         | Maybe The Paradox Project (by JerryRigEverything) is for you:
         | https://notawheelchair.com/products/the-paradox-project
        
       | minusLik wrote:
       | 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=eaAj59025Kk
        
         | renewiltord wrote:
         | This is a great project. I didn't realize that FDA Class I
         | regulations were this easy to comply with.
        
           | readyman wrote:
           | > _I didn 't realize that FDA Class I regulations were this
           | easy to comply with._
           | 
           | They definitely won't be once this open source effort shows
           | any sign of success. You can't solve political problems with
           | technical solutions. At best, you may be able to displace
           | them, but even that is rare.
        
             | minusLik wrote:
             | > You can't solve political problems with technical
             | solutions.
             | 
             | Yes, that's what I've been thinking too. Tom Quiter even
             | mentions in the interview that there already have been
             | companies which tried to offer cheap wheelchairs, but the
             | quasi-monopolists had the FDA alter the regulations in a
             | way with which the newbies couldn't comply.
             | 
             | However, since the MIF already attracted suppliers, I hope
             | they can gain some leverage.
        
             | renewiltord wrote:
             | 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 no mobility than having a device that doesn't work
             | properly.
        
               | icegreentea2 wrote:
               | 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.
        
               | readyman wrote:
               | 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.
        
               | HillRat wrote:
               | 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 at night at
               | -10degF because it couldn't handle the cold for long
               | enough. This doesn't mean the incumbents aren't fixing
               | the regulations to ensure they've got a manufacturing
               | moat -- this being healthcare, I assume that's exactly
               | what they're doing -- but the FDA definitely has reasons
               | to make sure these are regulated.
        
               | zmgsabst wrote:
               | 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.
        
             | Der_Einzige wrote:
             | When replicators are invented, most political problems will
             | disappear. Star Trek got it right.
        
               | krapp wrote:
               | 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 of nanotech,but no such technology
               | will ever be so cheap or ubiquitous as to render politics
               | obsolete. 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.
        
               | throwaway11460 wrote:
               | Energy in Star Trek is not free either, just too cheap to
               | meter. They use fusion and matter-antimatter reactors.
               | Once we get there we will also have more than enough
               | energy to power the potential replicator.
               | 
               | Though I agree we probably won't be using it to replicate
               | a cup of Earl Grey for a very long time.
        
         | cogman10 wrote:
         | Really cool that an electric wheelchair costs more than a
         | luxury EV and is somehow less reliable.
        
           | loceng wrote:
           | Reminds me of the military industrial complex.
        
           | VHRanger wrote:
           | 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.
        
             | ptero wrote:
             | I suspect in the US the lack of competition is due to
             | regulation and liability, not VCs.
        
               | makmanalp wrote:
               | Isn't the auto industry notoriously jam packed with
               | regulation?
        
               | TkTech wrote:
               | Weirdly, not really in the US. The regulations are all a
               | little pointless because it's a "self-regulated"
               | industry. Look at the cyber truck - stuck floor pedals
               | and trunk closer that cuts off fingers, or trivial to
               | clone car fobs.
        
               | SllX wrote:
               | 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 equipment would drop into the abyss compared to
               | where they're at now.
        
               | akira2501 wrote:
               | 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.
        
         | tdeck wrote:
         | I was curious what parts they were using in their design but
         | couldn't find any actual open source design content. The
         | website seems to be 100% fundraising copy. The idea seems good,
         | I hope this doesn't turn out to be another piece of accessible
         | tech vaporware.
        
           | seventytwo wrote:
           | How hard would it be to do a project like the voron printer
           | project where it's just the plans and BOM?
        
         | ashton314 wrote:
         | > usual electric wheelchair costs about $65,000
         | 
         | This puts the Bluey episode "Granny Mobile" in context, where
         | the grouchy granny wants to buy the used wheelchair for a mere
         | $100. $1,200 is still an incredible deal.
        
         | somethoughts wrote:
         | 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 pocket
         | the purchase and there was decent quality/repairability/safety.
         | 
         | There do seem to be a fair number that are approaching "geez I
         | might as well just buy an over the counter version" (i.e.
         | sub-$2000) instead of going through the paperwork hassle of
         | getting a free Medicare "prescription" for one.
        
           | heyoni wrote:
           | 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 one with the
           | software on its own.
           | 
           | If you want to know who's causing waste, look to the ones who
           | stand to benefit from it.
        
         | floxy wrote:
         | >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?
        
           | lagniappe wrote:
           | Some folks in europe have a hard time knowing when to use a
           | or an because there are so many exceptions, (a before
           | consonant, an before open vowel sound) particularly in areas
           | that pronounce it as oo-sual and not you-shual.
        
           | tyingq wrote:
           | It's a complex set of sub-markets. Like, for example, if your
           | kid has one...it has to be NHSTA crash test certified to put
           | on a school bus.
           | 
           | Or, for people with very limited mobility, they need very
           | special cushioning to avoid bedsore type problems.
           | 
           | Just 2 examples, there are many more. Though $65k still
           | strikes me as unusual.
        
         | carabiner wrote:
         | Should be "a usual" because "usual" starts with a consonant
         | sound. Otherwise could sound like "unusual."
        
       | sskates wrote:
       | Public company CEO here. One of my rules that has served me well
       | is "don't ever be on the other side of a transaction from private
       | equity". They have blatantly anticompetitive playbooks where they
       | buy up all the competition in a market and then raise prices as a
       | cartel. Mostly recently, the DOJ has opened a criminal probe into
       | RealPage for price fixing in real estate. What a scourge on
       | capitalism.
        
       | RecycledEle wrote:
       | 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 that wheelchair users are disabled. As an
       | able-bodied nerd with a socket set and a few wrenches, I can
       | repair an electric wheelchair. A disabled person usually can not
       | do that. They can not even follow the (good) advice to use an
       | external charger instead of the (garbage) charger built into most
       | wheelchairs; they physically can not get to the relevant parts.
       | 
       | Home oxygen companies send people out on short notice to debug,
       | repair, or replace home oxygen equipment. If you want insurance
       | to cover electric wheelchairs, then rent them instead of selling
       | them and include service visits.
       | 
       | The problem with shipping an electric wheelchair back for service
       | is that this thing weighs almost 100 pounds without batteries and
       | is a very odd shape. Before anyone complains, you want it to be
       | heavy so it will not tip over when the human (who is high up)
       | leans over, takes a corner, or drives sideways on a slope.
       | 
       | If you want a less-insurance-intensive solution, pass a right-to-
       | repair law that (1) requires all electric wheelchair parts to be
       | marked with a manufacturer and part number, and (2) requires all
       | electric wheelchair makers to sell parts for a decade or two
       | after they stop selling the chairs. If they use industry-standard
       | parts, and mark the parts as such, they should be relieved of the
       | obligation to carry the parts for 20 years. Here's an example:
       | Include a label on the chair saying that all bolts are either
       | m6x60mm or m4x25mm and that all red and black electrical
       | connectors are PP75 series Anderson Power Poles.
       | 
       | Here is a case that drove me nuts: I was dealing with an electric
       | wheelchair that had some odd version of Anderson PowerPoles
       | connecting the batteries and motors. These connectors had been
       | knock-offs, and the reseller of these (Chinese-made) connectors
       | lost a patent lawsuit to Anderson (before their patent expired.)
       | 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.
        
         | sokoloff wrote:
         | I've worked on cars and other mechanical things for most of 3
         | decades. I've never needed a sticker telling me what size
         | standard bolts were.
         | 
         | On the broken, ruled as patent-infringing part, what do you
         | want to happen that would comply with patent law? If it was
         | compatible with Anderson, you'd just buy that. Since it wasn't
         | and the original company isn't allowed to keep making them...
        
         | xnyan wrote:
         | > One connector broke and was impossible to replace.
         | 
         | This is not a solution that would help the wheelchair user, but
         | if you have a set of inexpensive ($10 bought in the US, less
         | from china) 3" digital calipers, you could likely measure the
         | socket and get it 3D printed. I've done it for obsolete
         | electrical connectors in cars and while it takes time and some
         | effort, it's very doable.
        
       | azinman2 wrote:
       | Banning private equity (not sure how) is necessary to prevent
       | enshitification of all health care and related services.
        
       | neocritter wrote:
       | A good comic on the difference between what most people think
       | when they hear wheelchair vs what wheelchair users need to be
       | independent: https://www.tumblr.com/calvin-
       | arium/184341867538/its-here-th...
        
       | jmyeet wrote:
       | Private equity is great for exposing the flaws in our economic
       | system. The consequences are of course awful and it would be
       | better that they didn't happen. But since they are happening,
       | hopefully more people will start to realize it. When exposed to
       | this kind of thing you can generally have one of two reactions:
       | 
       | The first is that you say that this kind of thing is good. It's
       | all part of capitalism. The market will work it out. People will
       | say this kind of thing with a straight face.
       | 
       | The second is to say that it is bad. But why is it bad?
       | 
       | The first stage is you believe that there are bad apples. Private
       | equity is simply a few bad actors who may or may not need to be
       | dealth with by way of legislation, regulation and/or prosecution.
       | Lots of people believe this because they still fundamentally
       | believe in our current economic system.
       | 
       | The second stage is you realize that private equity isn't an
       | outlier and isn't a few bad apples. It is exactly what our system
       | is designed to produce: to financialize and rent-seek in every
       | aspect of our lives as a means of extracting wealth from the poor
       | to the already vastly wealthy.
       | 
       | Private equity is taking over every aspect of your life by buying
       | up homes, mobile home parks, vets, medical practices, hospitals,
       | etc. There probably isn't a single aspect of our lives that
       | hasn't been tainted by private equity.
       | 
       | And the playbook is exactly the same:
       | 
       | 1. Jack up the prices, usually by cornering a market by either
       | buying up all the competition or through legislatively creating
       | enclosures;
       | 
       | 2. Cut costs. Use noncompete agreements and and the like to
       | suppress wages; and
       | 
       | 3. Load up the entity with exploding debt and sell it to the
       | market before the debt explodes.
       | 
       | This is capitalism working as intended. No more, no less.
       | 
       | On wheelchairs in particular, it's truly disgusting what we as a
       | society put wheelchair users through. One of the most egeregious
       | examples is how airlines will routinely destroy wheelchairs.
       | 
       | We are steadily marching towrads a future where almost all of us
       | will be a permanent underclass devoid of any kind of security.
       | Every aspect of our lives will be at the mercy of our overlords.
       | Capitalism inevitably leads to neofeudalism.
        
       | Ozzie_osman wrote:
       | If you want to hear more about the negative impact of private
       | equity on various industries, like retirement homes etc, I'd
       | recommend the book Plunder. Eye-opening stuff.
        
       | 48864w6ui wrote:
       | Is private equity this century's equivalent of the LBO?
       | https://www.latimes.com/archives/la-xpm-1990-03-23-me-521-st...
        
       ___________________________________________________________________
       (page generated 2024-05-03 23:00 UTC)