6 ms·

I'd like to point out that the price difference is most likely to do with the marked conditions of the health care in general, and has nothing to do with the qu

I'd like to point out that the price difference is most likely to do with the marked conditions of the health care in general, and has nothing to do with the quality of the operation itself. There is a big problem with health care in most countries that I've been living into for extended periods of time (France, Italy and to a lesser extent Germany). Anything sorrounding "medical" and/or "health care" has a 10x-100x price blowup, for absolutely no reason. I'm not even speaking about surgery, I can start by phisiotherapy consumables, such as elastic bands. Elastic bands are used in phisical rehab. They are dirt cheap, usually, if you buy them inside a child play store. But behold, if you buy the same stuff from "Thera Band", which is officially sold to hospitals and clinics, a couple of meters of the stuff will cost you 20-30 times more. I worked as an assistant in a phisical rehab clinic for several years, and this kind of bullshit is amazing, because it goes for everything (air balls, plastic rods for balancing excercises, and so on). The price inflation goes even higher with actual machines. There is a machine which is called "Rehab 3xxxx" (produced by a clinic around here which I helped develop, so I won't disclose the details), which is just a linear actuator which moves back and forth. Literally, nothing more. There is an embedded controller which allows to tune the extension limits, and a couple of ABS plastic accessories that hold to the knee, wrist, etc. The idea is just to move the articulation, and/or rotate it, over and over. You would think that there is something "fancy" about it, to name a few details which I wished this machine had: * force feedback to stop the motion (right now the machine will just twist your arm as configured, no matter the force) * speed regulation (who needs it? just one speed is good enough) * some sort of patient-id so that you don't need to reconfigure it each time But not really. Like I said, this is just a dumb linear actuator, with incredibly cheap ABS plastic accessories and a fancy name. Price? 30k euros in the basic kit. The funny part: for anything medical, you have to demonstrate that this machine is effective somehow. So we had a trial in an hospital, wrote an article about the effectiveness (or lack thereof) and did some paperwork. The idea is that you just have to demonstrate that it doesn't hurt. Of course, a physiotherapist will be twice as effective, but it's more expensive on an hourly basis, so that's why clinics love to buy the machine and just let patients sit on it. I'm literally disgusted, but I can see everything around "medical" equipment having the same issues. All the economy surrounding hospitals, doctors and equipment is essentially broken, because there's essentially no competition, assured money (by the state in this case) and a lot of corruption going on within the clinics and medical companies (unfortunately). edit: english.

kokey 13y ago
What you describe sounds a lot like the problems the developed when supplying to government in general, whether it be IT, military, transport, etc. That said to me the US system sounds like it's so rigged that it has developed many of the same problems you encounter with government inflicted monopolies.
- bluedino 13y ago
  I wonder how many medical offices with a staff of 3 have a Cisco 3950 in the closet...
toble 13y ago
Medical equipment has to meet more rigorous standards. This reminds me of the news story where breast implants were being sold with low grade silicone in Europe: http://www.bbc.co.uk/news/health-16391522 http://www.bbc.co.uk/news/health-16391522 I realise that suppliers are probably taking advantage due to limited competition, but at the same time, I hope the regulation helps to protect us from sub-standard products.
jfoster 13y ago
Are you sure you're looking at the whole picture? I imagine liability, lawyers, and a much greater interaction with customers will be driving up costs very substantially when selling widgets as medical devices.
- tenfingers 13y ago
  Absolutely, but unfortunately all of this only aggravates the problem. For instance, we needed lawyers and the "study" just to be able to sell the machine at all. But then again, lawyers and the testing itself contributed absolutely nothing really, while being incredibly expensive (both in terms of money, and time). Yes, medical devices need to be tested, but all the testing/layers and related processes only inflate the cost without actually contributing to the product. The problem is that the process/testing/lawyers for a "medical" device are essentially the same as the testing you would do for something non-medical but that has regulated safety features (such as a children toy at least in EU), yet the "medical" testing is simply more expensive. We can speak about the rubber in those "Thera Bands" strips. We used bands made for children (which, by definition in EU should be toxic-free and bla bla), and we found absolutely no difference compared to TheraBand (even material wise). Sure, TheraBand had to pay for "testing" indeed, which again contributed nothing to the real product, inflated the cost, and still doesn't justify the 20x price inflation for a piece of elastic rubber. But still, that's not really it. By working closely with hospitals, I also know several people in the loop. I had second-hand knowledge (from people that I consider reliable) that offers and prices from big MRI machines from Siemens and similar companies are rigged. And that happens because there's very little competition and no real market (only hospitals will buy such machines). When all the market is inflated, you can justify high prices for almost every product in it. And that's exactly what's happening. Plus people need medical assistance, which means that in emergency situations will simply pay for it at any price.

kokey 13y ago

What you describe sounds a lot like the problems the developed when supplying to government in general, whether it be IT, military, transport, etc. That said to me the US system sounds like it's so rigged that it has developed many of the same problems you encounter with government inflicted monopolies.

bluedino 13y ago
I wonder how many medical offices with a staff of 3 have a Cisco 3950 in the closet...

toble 13y ago

Medical equipment has to meet more rigorous standards. This reminds me of the news story where breast implants were being sold with low grade silicone in Europe: http://www.bbc.co.uk/news/health-16391522 http://www.bbc.co.uk/news/health-16391522 I realise that suppliers are probably taking advantage due to limited competition, but at the same time, I hope the regulation helps to protect us from sub-standard products.

jfoster 13y ago

Are you sure you're looking at the whole picture? I imagine liability, lawyers, and a much greater interaction with customers will be driving up costs very substantially when selling widgets as medical devices.

tenfingers 13y ago
Absolutely, but unfortunately all of this only aggravates the problem. For instance, we needed lawyers and the "study" just to be able to sell the machine at all. But then again, lawyers and the testing itself contributed absolutely nothing really, while being incredibly expensive (both in terms of money, and time). Yes, medical devices need to be tested, but all the testing/layers and related processes only inflate the cost without actually contributing to the product. The problem is that the process/testing/lawyers for a "medical" device are essentially the same as the testing you would do for something non-medical but that has regulated safety features (such as a children toy at least in EU), yet the "medical" testing is simply more expensive. We can speak about the rubber in those "Thera Bands" strips. We used bands made for children (which, by definition in EU should be toxic-free and bla bla), and we found absolutely no difference compared to TheraBand (even material wise). Sure, TheraBand had to pay for "testing" indeed, which again contributed nothing to the real product, inflated the cost, and still doesn't justify the 20x price inflation for a piece of elastic rubber. But still, that's not really it. By working closely with hospitals, I also know several people in the loop. I had second-hand knowledge (from people that I consider reliable) that offers and prices from big MRI machines from Siemens and similar companies are rigged. And that happens because there's very little competition and no real market (only hospitals will buy such machines). When all the market is inflated, you can justify high prices for almost every product in it. And that's exactly what's happening. Plus people need medical assistance, which means that in emergency situations will simply pay for it at any price.