$42,000 Prosthetic Hand Outperformed By $50 3D Printed Hand

An anonymous reader writes "A man named Jose Delgado was so used to using a $42,000 myoelectric prosthetic hand for the last year that he didn't realize that there were other options out there. Although Delgado, born without a left hand, was able to obtain the hand via his insurance, he found that a 3D printed 'Cyborg Beast,' an open source hand which costs just $50 to print, actually was more comfortable and performed better than the device which costs 840 times as much money."

Comments

and also reading machines for the blind

[Anonymous Coward]

cutting down on the absurb prices for 'prosthetic' devices is great, but someone who is blind has to pay $1000-$2000 for a "Reading Machine" and that's not so great, especially since in the USA this is not covered by Medicare, howoever www.topocr.com has a $5.00 program that does the same job with a $60 scanner or a $95 document camera, I have to say that I'm a happy customer, I wish more people would develop low cost technology that provides an alternative to the big ticket items that "medical" companies charge, mainly to people who can't afford it.

Re:and also reading machines for the blind

[Anonymous Coward]

Are you sure this isn't covered by Medicare? I had an aunt who had one of the multi-thousand dollar machines. It was like a microfilm/fiche reader, but with different parameters. With the cost of tablets, one tablet mounted at a fixed distance would be cheaper than a document camera, and liked to a second reading tablet would get better performance for less cost. But new things are not applicable as medical devices. No idea why. Interestingly, being diagnosed as blind doesn't void one's drivers license. She had a "valid" license, when she would have trouble finding the driver's seat without help.

Re:and also reading machines for the blind

[Zargs]

People who need prosthetics are already operating at a disadvantage, why disadvantage them even more by saddling them with debt?

Re: and also reading machines for the blind

[Anonymous Coward]

my wife is very low vision. I would like to hear more about the program, scanner/ document camera

Sunk Costs

[ObsessiveMathsFreak]

The additional $41,950 is allocated towards sunk costs including

• - Cosmetic designs of a hand like-prosthetic to prevent adults staring uncomfortably and children exclaiming "cool"!
• - Insurance/class action insurance for when the prosthetic ends up injuring/irritating one or more users or people, or things, or otherwise perishable or damageable entities the hand interacts with.
• - Robustness to last through more than, say, 10,000 cycles before snapping into brittle plastic shards.
• - Salaries and children's college funds for the scientists, designers, and MBAs running the prosthesis companies
• - Salaries and children's college funds for the academic and medical researchers involved in prosthetic studies, both mechanical, psychological, and sociological

Meanwhile, the 3D prosthetic hand has only the following sunk costs to cover.

• - ~$10,000 investment in quality 3D printer
• - The time taken find and to add the most saccharinly kitch music to 3D printing application videos on Youtube.

It's important to remember to keep the background details out of perspective... or in perspective, depending on whichever context you'd prefer to hock.

Re:Sunk Costs

[rolfwind]

Cosmetic designs of a hand like-prosthetic to prevent adults staring uncomfortably and children exclaiming "cool"!

Idk about you, but I'd think an obvious robot hand would be easier to deal with than a fake looking piece of plastic mimicking a human hand.

Re:Sunk Costs

[ColdWetDog]

- and since it is a commercial product, a couple of million dollars getting it approved by the FDA.

It all adds up.

Re:Sunk Costs

[im_thatoneguy]

Well, not only that but most people don't know how to operate a 3D printer, nor how to customize the hand to fit the individual. So while the $42,000 hand includes the professional services involved with fitting the device, the 3D printed one depends on a charitable donation from the 3D printing operator to do the work. It won't be much but it's all probably going to be significantly higher ($400-$1,000) for the human being to operate and configure the 3D model for the individual.

I bet there are only $100 worth of aluminum, gold, silicon and acrylic in the $42,000 hand too.

This drives me crazy when people don't include the costs of labor. It would be like someone getting a car donated to them and saying "Wow cars only cost $200 for a title and registration! Why do people pay thousands of dollars for a car!?" Because someone gave you one for free!

I work in film production. I have a $50k camera that I rent out. On most productions your total rental per day will be about $2,000 a day. Now you could say that you could shoot a TV commercial for "only $2,000 in rentals!" But that ignores the fact that cameras don't operate on their own, lights don't just place themselves, actors should be paid for their skills, assistant directors need to keep production on schedule, locations need to be paid for the rights to use their property etc. So yeah it "only costs $2,000" as long as you ignore the $20,000 per day in crew costs for a small production.

People who say a film only costs $20,000 to make are either productions that somehow shot and finished in 1 day or else they're saying that their crew's time was worth nothing.

If I spent $10,000 on a 3D printer. I couldn't just open the box and push the "Give me a 3D Prosthetic Hand" button. I would either need to spend a good week or so learning how to print ($100 an hour * 40 hours = $4,000) or else spend $1,000 on a professional to setup and configure the scene/hand for me specifically. /Rant.

Re:Sunk Costs

[Anonymous Coward]

I worked with a guy for years, though I only met with him every few weeks at most. Turns out he only had one arm the entire time I knew him, but it was a long time before I realized it, and I wasn't sure about that for quite a few meetings since his prosthetic was so good. Someone later just happened to mention that he'd lost it in a traffic accident years before.

Being initially inconspicuous might matter to some people.

If I lost a hand I'd definitely go for the robot look though.

Re:Sunk Costs

[JanneM]

Idk about you, but I'd think an obvious robot hand would be easier to deal with than a fake looking piece of plastic mimicking a human hand.

It's probably impossible to know until you are actually in the same situation. There have been highly functional, highly useful hand prosthesis long before robotics - the classical hook is just one example - but the vast majority of patients have always preferred a hand mimic, even when it is completely nonfunctional and even when the mimiry is far from perfect.

Not getting stared at, and fitting in, is critically important to people, in this case as in others. Should'nt be too surprising when you think about it in such terms.

Re:Sunk Costs

[CodeBuster]

To be fair, some of these costs would exist in any business. There are always capital equipment costs, employee costs, administration costs and in some cases research and development costs. However, you are on the right track with your criticism of artificially high medical device costs. Indeed, these high costs can be seen not just in prosthetic hands or limbs but also in more mundane devices such as hearing aids and prescription eyeglasses. In my estimation there are two main reasons for this:

First, the devices are sold through specialized middlemen who bill your insurance company which in turn bills you and perhaps your employer for premiums. This is the classic third party payer problem that exists throughout the healthcare industry here in the United States and is in no small part responsible for the high costs which are ultimately borne by the consumer in the form of higher premiums and higher out of pocket costs.

Second, and related to the first point, the market for FDA approved medical devices here in the United States is highly regulated and therefore high cost. There is a great deal of regulatory rigmarole and ceremony required to bring a product to market. This imposes costs of course, but it also results in delays while the product winds it's way through the circuitous approval processes. By the time something is approved for sale as a medical device it's not only expensive but often obsolete or at least several generations behind the state of the art technology.

Finally, it ought to be remembered that medical devices are now assessed an additional tax under Obamacare, on top of any previous expenses. It's hard to see how this will lower costs, especially for those who find themselves in need of a medical device. Although, I suppose that "reform" is in the eye, or the hand in this case, of the beholder.

Re:Sunk Costs

[Anonymous Coward]

If I lost a hand I'd definitely go for the robot look though.

Hasta la vista, baby.

Re:Sunk Costs

[The123king]

This. I've got a birth defect that's left me with only 2 deformed fingers on my left hand. It doesn't bother me, i've never hunted out prosthetics (i like having feeling in my hand!) and no-one really notices. It took my english teacher many months to notice, and i think she's the only teacher to ever pick up on it. Many of my friends don't notice until i point it out too.

Re:Sunk Costs

[The123king]

Not getting stared at, and fitting in, is critically important to people, in this case as in others. Should'nt be too surprising when you think about it in such terms.

Being that self-conscious about things that have happened or are out of your control is a waste of time, and that's coming from someone with a birth defect. If you're getting a prosthetic for extra freedom and usefulness, great, but getting a fake hand for the sake of a fake hand is just being vain IMHO.

Re:Sunk Costs

[WinstonWolfIT]

True. But from a practical point of view, 3d has brought to market a simpler device that works better, and has far less technology -- with its associated costs -- behind it. In scale, I can see this technology easily approaching 10% of the cost.

Re:Sunk Costs

[Anonymous Coward]

10k for a quality 3d printer, are you joking? I'm not sure you could do it on a printrbot simple (build area question), but a normal 200x200mm bed, such as a Mendel (or variants) will be able to print that. So from somewhere between $300 and $1000, roughly. I've got 3 printers in my field of view, and if it cost $2000 for all 3 I would be surprised. (Mind you, one of them is a simple.)

If you are paying ten thousand dollars for that, you are being ripped off. Mind you, if you've looked at Stratysis, their FDM (tm) printers are pretty crappy compared to Reprap printers, and within that price range. (Though they have some nifty powder printers.) Hell, even Makerbots, are under 3k, and they are IMO, a bit expensive.

Re:Sunk Costs

[Anonymous Coward]

Does that explain why your post lacks capitalization of I?

Re:Sunk Costs

[Anonymous Coward]

Let's not forget, so long as a prosthetic hand costs $41,950, you more or less need to buy insurance to get one. So long as all medical costs are outrageously high, you mor or less need insurance to get medical treatment. Hence, the insurance company has little interest in trying to push down the actual cost of such devices or medicine in general. Sure, they pay through the nose themselves to fund all the procedures and such, but at least they're there as a middle man just like the RIAA is.

Of course, having said all that, no doubt the actual cost is a good bit more than the $50 even if you amortize the cost of obtaining a 3D printer and using it for most the rest of your life and the low actual labor cost to you to learn how to use it--suggesting like others that a week working at it equates to $100/hour * 40 hours is insane because most people don't make $100/hour and the opportunity cost for most people during those hours is incredibly low given (1) they wouldn't avail themselves of earning extra money regardless and (2) most places aren't going to hire you to work at your leisure whenever you like as a second job and those that do tend to have horrible effective pay rates even if you effectively make it a second full time job. But, that's still no where near $41,950 and honestly if 3D printers were to start showing up at Lowe's or whatever, well, no doubt doctors could just prescribe a blueprint and directions to go there (along with a note to buy a couple replacements for when the first breaks).

*shrug*

Re:Sunk Costs

[itzdandy]

This is really the point. The $40K+ prosthetic is simply over engineered. It's a poor argument saying that we should support engineers, their families, their companies, etc so that they can charge a disabled person $40K when we could have a single developer make a much simpler product that can be produced at a local 3D fab shop or in the garage of an enterprising neighbor.

Clearly this is an early version, though fully functional. Improving aesthetics can certainly be an optional component. Today, a black or clear acrylic prosthetic would be of very little concern to many people and I only see that as becoming more of a non-issue.

The other interesting part of this is that someone in need of such a device could invest in the tech to customize and produce a device specific to their needs. maybe they have a palm, or less to work with. Customizing the device to suit them at their own pace with rapid prototyping changes their disability. The thriving makers movement can facilitate the sharing of schematics so you might find a near-ready model that you can alter to fit. maybe even spawn a boutique prosthetic shop in your town.

   

Re:Sunk Costs

[JanneM]

[...] but getting a fake hand for the sake of a fake hand is just being vain IMHO.

People are vain. People do care what other people think of them, and people do want to make a good impression on others. And it's completely rational; we are being judged by how we look, what we wear, how we behave. What we think of that is besides the point.

So yes, it turns out most people care about what their prostheses look like as much or more than how well they function. Any maker that disregards that is setting themselves up to become a niche within a niche; and most likely a long-term failure.

Re:Sunk Costs

[misexistentialist]

If I spent $10,000 on a 3D printer. I couldn't just open the box and push the "Give me a 3D Prosthetic Hand" button

No shit, you need to print the button first.

Re:Sunk Costs

[laird]

Interestingly, kids LOVE 3D printed hands. If you go to http://enablingthefuture.org/ there are tons of pictures of thrilled kids. It's cool to be like Iron Man!

Re:Sunk Costs

[jxander]

There's also the concept of "Price the Market will bear," which gets convoluted in the mire of health insurance companies. No one really knows what the market will bear, cuz it's always just payed whatever price was asked.

$42,000 for a prosthetic hand? Sure, if that's what it costs.
$1000 for an MRI? OK, if you say so.
$500 per pill to treat my hypochondria? Seems reasonable... etc.

Right now, the market will bear a 42,000 hand. And these guys could probably sell their $50 version for 45,000 on the claims that it performs better and feels more comfortable. The real costs of medical stuff (operations, hardware, medication, etc) has long since been lost to the bureaucrats.

Re:Sunk Costs

[artor3]

Great, go tell that to the people who lost a hand. I'm sure it will make them feel better.

Hurr, stupid idiots, having emotion! Why don't they just stop feeling things!?

Re:Sunk Costs

[laird]

You're coming very much from the prospective of a wealthy American/European, where a $42K prosthetic is an option.

But if you're not covered by very good insurance, which is the case for the majority of humanity, an affordable 3D printed hand is much better than nothing.

And a free/open innovative community working on prosthetics can move much faster than the commercial options, and perhaps innovate past them the way home 3D printing exploded past the commercial 3D printing companies. The commercial guys were too concerned with the expensive/subtle issues, when what people may well care more about is being able to cheaply and easily solve their problem.

You're right that the $42K prosthetic isn't the same as the $50 one. A major difference, which you missed, is that it's myoelectric and active, while the $50 one is mechanical. It turns out that for this patient, the simple, mechanical solution worked better than the sophisticated, computerized one. So it's fundamentally a cheaper, simpler solution.

The rest of the costs pretty much come down to the traditional business model vs. FOSS. If you want to buy a product from a company that you can sue, with MBAs and lawyers and on-staff researchers, etc., you get to pay the big bucks for the product. If you don't have the money for that, or you prefer free/open source solutions for other reasons (such as the ability to modify the designs to suit your personal needs), you can go the Free Open Source Software route, and print your own.

Yes, this relies on volunteer labor to do the printing, assembly, fitting, etc. There are 600+ people registered at http://enablingthefuture.org/ (mainly in the Google+ group). That's the point - by empowering people with FOSS designs and documentation, they can help each other, at much lower cost than paying professionals with all of the overhead that you mention. And it turns out that many of the volunteers work professionally in the field - this is just a new way for them to apply their skills to help patients.

And I'll also point out that your comments reveal some misunderstandings of how rapidly 3D printing has progressed.

- It doesn't cost $10K for a quality 3D printer. You can get a fine 3D printer for $1K, or a cheap one for $300, and the most expensive home 3D printer is $3K. There are some great industrial printers, but it would be stupid to buy an industrial printer to print one thing - there are plenty of people and Maker spaces who already have 3D printers. See http://enablingthefuture.org/c... and register if you're interested. And of course there are service bureaus such as ShapeWays if you really want a high-end printed version.
- The materials aren't as fragile as you think. There are 100+ people happily using ABS prosthetics now, and we're finding that printing in Nylon is amazingly durable. You can hammer on Nylon, and just bounces back. Amazing stuff. Hospitals and medical researchers are using 3D printed Nylon now, so using it for prosthetics is pretty reasonable.
- If you can print a replacement for the raw cost of materials, that changes the economics. If you can print your own replacements for $1, it doesn't make sense to spend $millions in R&D, and spend vastly more for the prosthetic's materials, because the cost of avoiding breakage far outstrips the cost of the breakage.

All of the designs are published, and open source. So there's nothing being hidden in the video - you can download the models and inspect them to your heart's desire.

If you don't like the music that someone selected, feel free to make a better video!

Re:Sunk Costs

[PopeRatzo]

I had an uncle with a wooden leg and I thought it was a big deal until I found out my aunt had a cedar chest.

Re:Sunk Costs

[laird]

The Cyborg Beast is assembled from parts, each of which can fit in a small build area.

Re:Sunk Costs

[Anonymous Coward]

You are right, so the true costs are $10,050, with a recurring $50 fee every 6 months or so. If you wish to change models of the prosthetic it will cost you that $50 all over again. Well that and you probably have to reprint the hand every 6 months or so from wear and tear... so in 300 years or so we will see who had the better investment!

Re:Sunk Costs

[gl4ss]

make it 1000 for the printer.

10 000$ bucks printer(mojo) doesn't print in taulman nylon(which is what he is now printing another version in for him). ..part of the reason why the commercial hand option is so high is that the person isn't expected to pay from his own money at all, but from insurance.

Re:Sunk Costs

[MrBigInThePants]

And you are all missing (surprinsingly) the ability to add things such as 3d printed guns, knives, hooks, crossbows, dildos to your hand.

Why settle for just a boring old hand when you can become inspector gadget?!

Re:Sunk Costs

[TaoPhoenix]

"And you are all missing (surprinsingly) the ability to add things such as 3d printed guns, knives, hooks, crossbows, dildos to your hand.
Why settle for just a boring old hand when you can become inspector gadget?!"

Yours is the most general comment I've seen, so I'll reply to you.

Slashdot comment chains run in themes, so once about five themes get going plus some flamebait, that's about where the discussion centers.

But for you, I'll remark that a couple of science fiction writers did stories on 3d printing. For a while that stayed science fiction rather longer than some of the other candidates such as cell phones. But now here we are - a few stories down again today, the 3d gun topic came up. So it's really going to be thrashed out heavily now for the next six years.

Re:Sunk Costs

[stenvar]

"Sunk costs"... you're not using it right. Perhaps you mean "hidden costs" or "unaccounted for costs".

Re:Sunk Costs

[ruir]

This comments are rather naive. The prosthetic costs 40K+ because the system is designed to rip off insurance companies, and inflate the bill 3 or 5 times more when dealing with insurance claims. The same as with a car accident... someone hit my car a couple of years ago, signed a term of responsibility and neither did she not care to deal with me in human terms, nor she replied to my emails. So down the line, two months were gone, and by the time I had it being repaired, her insurance company received a bill of $4000 USD something, and told her the monthly payments would be going through the roof. She called me, and said, cant we solve it out of the system? I said no way lady, you did not deal with me during two months, and my car is already being repaired. The point is out of the system, the bill would have been probably between $400-$800 I suspect. The sad part of it, is at the end of the day we pay higher insurance costs because of this bullshit.

Re:Sunk Costs

[Anonymous Coward]

Nobody cares except you. This ought to be obvious.

Re:Sunk Costs

[Anonymous Coward]

are your friends made of straw too, like your arguments.

i'm glad you're an expert on telling people how they should feel.

that kind of attitude makes me doubt you really have a defect that makes it hard for you to "fit in", and are instead just being privileged prick.

Re:Sunk Costs

[sjames]

So what you're saying is that the conventional prosthetic is made by a horribly inefficient company that should have been washed out by the market but the market failed (as is typical for anything vaguely medical).

The 3D printed prosthetic had to be designed as well and apparently it was designed better. It could probably be stronger and even cheaper if it was mass produced.

Re:Sunk Costs

[sjames]

Well, he did say a few posts up that he has a deformed left hand. He's not exactly asking people to go where he hasn't been.

Re:Sunk Costs

[sjames]

Getting from $50 to $42,000 would be a lot of labor. Are you saying it takes 5 months or so full time per hand? Let's be generous and say instead that the labor is $1000. Now to account for the other $41,000

More likely it's the same MBA math that claims going from the $0.10 part to the more durable but otherwise identical $0.20 part absolutely must add $10 in hard costs to the end product, just because.

Re:Sunk Costs

[sjames]

It's more that it's poorly regulated than that it is highly regulated. The FDA has no concept of risk assessment. Medicine is highly regulated everywhere in the 1st world, but it is vastly more expensive in the U.S.

Re:Sunk Costs

[Sarius64]

Well hell! Your insight has just destroyed the entire multi-billion dollar cosmetics industry! Cad!

Re:Sunk Costs

[mwvdlee]

That's the exact thought I had when I saw the video.
The "human-like" hand is dead in the middle of the uncanny valley.
In fact, the 3D printed hand had motion which looked far more "natural", despite looking nothing like a natural object.

IMHO, trying to make a prostethic look human is like saying "I'm ashamed of not having a hand".
Adults will stare uncomfortably at both. With the printed hand I think most people will just think "well, he doesn't have a problem with it, why should I?".
And children will be exclaiming "cool" because... well... it is cool. Guy doesn't have a hand but he's got a machine as a hand. What's not cool about that? You'd rather children be exclaiming "creepy"?

Re:Sunk Costs

[mwvdlee]

Mod parent "+1 attention whoring crybaby".

Re:Sunk Costs

[Anonymous Coward]

Yet he managed to type the totally unnecessary "This." at the beginning of his post.

Re:Sunk Costs

[MrBigInThePants]

I feel sooo special now.

Go go gadget sarcasm!

And I selected the examples from other stories on purpose with a graduated theme from sensible/real to ridiculous. Pop culture references tie your comedy to the familiar so that the hyperbolic nature of your statement and/or surprise endings gave more impact.

My genius operates on many levels. Don't feel bad you cannot fathom it.

Which makes your elitist comment ironic (real definition of this word) and amusing.

Re:Sunk Costs

[Hognoxious]

No, but he is imposing his values on others.

He might not care about appearances. That's good, it's how it should be.

But it isn't how it is - some people do care. Some of those people might be potential employers who wouldn't want a "wierdo" or a "flid" around because it might disturb colleagues and customers.

Re:Sunk Costs

[Jack Griffin]

Also known as the uncanny valley effect

Re:Sunk Costs

[Hognoxious]

50$ is a rip-off. Elon Musk could make it for two bucks fifty.

Re:Sunk Costs

[Jack Griffin]

And the simple fact that a fake hand will always look like a poorer version of a real hand, whereas a robot hand can be made to look cool and superior to a human hand. Remember when Oscar Pistorius made the Olympics, he generated buzz because was cooler than regular old sprinters with human feet. Some silly fake looking legs/feet wouldn't have had the same effect as the blades. Of course murdering his girlfriend ruined all the goodwill he had, but that's another story...

Re:Sunk Costs

[drinkypoo]

This drives me crazy when people don't include the costs of labor.

That's intentional, because the design was given away. This is the future, and it's why 3d printing has corporations pissing themselves. If someone will give away a design for a product better than what they're selling, what chance do they have to continue to exist? Answer, none, and it's about damned time. Of course, this raises some serious questions about how we're going to distribute wealth when we don't need a bunch of slaves to stamp out widgets, and therefore we don't need slave-owners to crack whips over them. Instead of giving the wealth to the slave-owners, we might have to share it.

Re:Sunk Costs

[Trepidity]

The real costs of medical stuff (operations, hardware, medication, etc) has long since been lost to the bureaucrats.

I think that's how it should be, having medical services delivered in accordance with their needs rather than in accordance with market mechanisms and profits. But you need an actually compete system of health bureaucracy that is aiming to maximize outcomes for the country's citizens given the available budget. Not, as the U.S. seems to have, bureaucrats looking to profiteer for some insurance companies and biomed labs.

Here in the Nordic countries medical devices do not cost nearly as much as they do in the U.S., and that's because we have more and better bureaucracy, not because we have a free-market health system (in fact providing private healthcare is illegal).

Re:Sunk Costs

[gatkinso]

Not the mention of the years of extensive R&D, human factors, and usability trials... which I am sure the home brew folks didn't refer to at all when developing their hand.

Re:Sunk Costs

[usuallylost]

In the video that is attached to the article the guy says that in addition to the 3D printed components there are "various bits of hardware, Velcro, padding etc". All of which requires some know how and some assembly. So unless somebody came out with very good instructions or perhaps a kit with all the additional parts I doubt the average person is going to make this at home.

The other thing that is not really touched on there is that the $42,000 hand hooks onto the entire forearm. It uses the muscles in the forearm to control the actuator. Where the 3D printed hand hooks over the stump of the guy's left hand and uses the muscles in his palm to control movement and to provide the actual strength. A lot of people with missing arms don't have the palm of their hands left to provide that strength and control. For those people the 42K version is going to continue to provide utility where as they wouldn't be able to use the $50 version at all. For this particular type of case the $50 outperforms the 42K version. If you took 500 people with various levels of amputation I suspect that the 42k version would help a lot more of them than the $50 version.

What is shows me is that there is a tendency in the prosthetic industry to try and go for a one size fits all solution. Where it is clear that for some patients you could use a less expensive solution. It might bare some research to see just how many people are being fitted with 42k prosthetic when much cheaper solutions might work better for them.

Re:Sunk Costs

[Anonymous Coward]

Got that in carbon fibre?

(it's pretty much as easy as fibreglass to work with)

Re:Sunk Costs

[Anonymous Coward]

That's a valid point, but is that mimicry worth $42,000? I could buy my last two vehicles with $42,000, with change to spare, and I bought relatively nice vehicles(nice compared to the junker I had at 16). Am I supposed to believe one prosthetic arm is worth more than two almost-new vehicles?

Re:Sunk Costs

[pnutjam]

My friend had a wooden eye. He was really embarrassed about it, but his family could not afford a glass eye. He was a quiet, shy guy who had trouble approaching women. One time, at a school dance I convinced him to approach this cute girl who had some sort of leg problem that caused her to limp. He worked up his courage and asked her, "Would you like to dance?"
She jumped up and exclaimed, "Would I!"
He yelled, "Harelip!", and ran away.

Re:Sunk Costs

[Anonymous Coward]

I used to know a guy with 2 wooden legs and real feet.

Re:Sunk Costs

[Anonymous Coward]

Looks like your fellow autistics modded you to +4

Re:Sunk Costs

[Anonymous Coward]

Second, and related to the first point, the market for FDA approved medical devices here in the United States is highly regulated and therefore high cost. There is a great deal of regulatory rigmarole and ceremony required to bring a product to market. This imposes costs of course, but it also results in delays while the product winds it's way through the circuitous approval processes. By the time something is approved for sale as a medical device it's not only expensive but often obsolete or at least several generations behind the state of the art technology.

To be fair, just imagine the uproar if it turned out that 3D printed prosthetic limbs ended up causing serious birth defects!

Re:Sunk Costs

[Richy_T]

Is there some kind of meta-joke going on there?

Re:Sunk Costs

[scamper_22]

You're absolutely right about the cost of labor.

However., I think there is a general trend line out there where medical products are significantly overpriced relative to the actual cost of production or use. A lot of the industry is based on keeping the medical professionals and companies filled with decent money.

Things like 3d printers, scanners, generic parts will reduce the cost significantly. It is definitely an area where automation and computing could reduce costs significantly. And yes, perhaps for a while, there will still be some optimization that could be provided for by the super skilled labor. However, there is always a trade off between cost and quality.

If you could get 95% of the quality for 1/20th the cost, it's probably a good idea for most of the population.

Not everyone needs a professional camera person. Sometimes most people can do quite well with a simply point and click of their own. And yes, healthcare is no different in that respect.

Re:Sunk Costs

[sjames]

OK, let's see it, then we'll talk.

Re:Sunk Costs

[Anonymous Coward]

GREAT reply with many good points, thank you for your contribution...

Re:Sunk Costs

[Anonymous Coward]

Yes there are instructions and a kit! $50 includes the price of all the hardware.

Re:Sunk Costs

[luther349]

and the oss community did the same thing with better performance for 50$. just goes to show how out of control medical cost are.

Re:Sunk Costs

[luther349]

that's the nice thing with 3d printing it can make all the measurements etc and make one far cheaper.

Re:Sunk Costs

[pnutjam]

would I!, wood eye....

Re:Sunk Costs

[Anonymous Coward]

http://www.makexyz.com/printer/dsrobey?printer=b3794e4c679639b6a8a0061270d3df2b&frm=srp
$50 an hour for 3d design and $0.50 / cm for printing

Re:Sunk Costs

[AK Marc]

People who say a film only costs $20,000 to make are either productions that somehow shot and finished in 1 day or else they're saying that their crew's time was worth nothing.

Or they get people to trade working on a film for working on a film (they get to be in credits and such, so some think it a good thing to get the experience, even if unpaid). According to the IRS, donated time is worthless.

Re:Sunk Costs

[Hognoxious]

Benighted moron. Have you read the story here about batteries?

His mere presence will bring costs down by an order of magnitude. He can do an ERP implementation in three and a half minutes.

Shun the unbeliever! Shun! Shun!

Re:Sunk Costs

[laird]

There are some people doing interesting work with carbon fiber and 3D printing. One approach, which I think is clever, is to 3D print parts, then wrap and glue the carbon fiber tape around the part along the stress lines. This lets you make things like 3D printed pulleys that are amazingly strong.

At least one company is doing 3D printing with carbon fiber running in the filament. That's pretty trickily to pull off, but if it works (and they claim they're going to be selling the printers soon) it should be extremely strong because the carbon fiber will run everywhere the filament runs. So no inter-layer filaments, but it should be very strong on the X/Y plane, which should work well for many applications.

Re:Sunk Costs

[Richy_T]

How does a hair-lip relate to the limp?

Re:Sunk Costs

[Anonymous Coward]

People who say a film only costs $20,000 to make are either productions that somehow shot and finished in 1 day or else they're saying that their crew's time was worth nothing.

the nigerian film-industry has been making more films yearly then hollywood for years now (hollywood is currently number 4 after india, china an nigeria), the average cost for a movie production in nigeria is 23k, that includes the wage of the professionals making it.

of course 1 hollywood A-list actor gets payed 50 million per movie, there's no need for that. There are plenty of actors waiting tables or cleaning houses to make ends meet who would be thrilled to do acting work at even mininum wage.

While that would still make it more expensive then nigeria, the current practice is insane. You can employ 20 people fulltime for 1 year at a wage of 50k a year for 1 million.

Re:Sunk Costs

[pnutjam]

good catch, I mixed up my jokes, meant to say "gimp"

Re:Sunk Costs

[Richy_T]

I noticed cause the first time I heard the joke, the punchline went something along the lines of "Oh, wouldn' I?" , "Oh, wooden leg"

Re:Sunk Costs

[RyoShin]

I'm reminded of a cousin's girlfriend (who caused him no small amount of grief, but that's another story) who had a few birth defects, one of which was Amelia (or something similar) on her left arm. Her mother, who sounded like a rather nasty individual, apparently tormented her over the arm and so she learned to hide it as much as possible.

She was rather good, too; while I didn't interact with her too much, I had seen her off and on for about two months before someone clued me into her uniqueness. Only after that did I notice it; she makes it seem as though she just keeps one arm tucked in somewhere (her pocket or purse or whatever) and freely uses the other one, which doesn't seem odd if you only see her now and then.

Re:Sunk Costs

[laird]

Thanks!

They are the patent trolls of the future

[Anonymous Coward]

They are the patent trolls of the future

The fight against 3D printing is right around the corner.

A different beast

[Sarten-X]

I'm no expert in prothetics, but it seems the printed Cyborg Beast hand is a completely passive device, relying on wrist movements to control the fingers. On the other hand, the $42,000 device was a "myoelectric prosthetic device, which took signals from the muscle fibers in his forearm, translated those signal, and then used them to mechanically move the fingers of the prosthetic, which looks pretty close to an actual hand."

This guy prefers the less-realistic device. Good for him. A direct comparison is somewhat unreasonable, though.

Re:A different beast

[im_thatoneguy]

More importantly it ignores labor costs. Simply listing the price of the materials isn't an apples to apples comparison to the robotic hand which needs someone to setup the 3D printer, and then actually assemble the hand (Probably takes someone with a working hand to perform the threading of the cables etc.)

Re:A different beast

[laird]

Typically the first one is assembled by the volunteer working with the family, as a training session, and after that they can print replacements and do the assembly themselves.

this approach does require a parent/relative/friend with some dedicated to get started. There's a map of volunteers http://enablingthefuture.org/c... . If you don't have anyone around that wants to help, you'd better have insurance to cover paying a professional to help you out.

Stack Overflow

[Anonymous Coward]

The article references a message board, which contains one post referencing the article.....my head hurts.

Re:Stack Overflow

[laird]

The group has a web site http://enablingthefuture.org/ which links to a map of participants, and a very active Google+ community.

More money does not always buy better things.

[Anonymous Coward]

We need more examples of this decoupling of the price from how good something is. A $30 aeropress coffee maker is as good as a $5000 espresso machine. A double edge safety shaver that uses 20 cent blades is far superior to any expensive disposable shaver system, even the ones with 5 blades. A $150 Formica counter top fulfills all the duties of a $3000 granite counter top. And yet we are constantly told by marketing and advertising that better equals more expensive. It shouldn't be a surprise at all that something could be better and also cheaper.

Re:More money does not always buy better things.

[turbidostato]

"A $30 aeropress coffee maker is as good as a $5000 espresso machine"

Haven't tested a $5000 one so I can't say. I tested espresso machines at any bar at, say, Venetia, and I can attest that no, your $30 aeropress coffe maker is no challenge for them.

"A double edge safety shaver that uses 20 cent blades is far superior to any expensive disposable shaver system, even the ones with 5 blades."

I use them and I agree.

"A $150 Formica counter top fulfills all the duties of a $3000 granite counter top."

The $150 Formica counter top at my rented flat and my mother's 30-year-old granite one beg to differ.

"And yet we are constantly told by marketing and advertising that better equals more expensive."

Yes, marketing (publishing, to better say) is quite clever in using bad rationals to push sells.

Better equals more expensive and that's right more times than not. The point is that more expensive doesn't equate better (see? even you fall on bad rationale).

Re:More money does not always buy better things.

[InsultsByThePound]

A $30 aeropress coffee maker is as good as a $5000 espresso machine.

As an owner of an expensive automatic machine, not quite $5000 but up there, I like the convenience it offers and it makes great coffee for an automatic. I have to clean it very seldomly. The aeropress looks good for what it is although I don't trust plastic and hot water together.

A double edge safety shaver that uses 20 cent blades is far superior to any expensive disposable shaver system, even the ones with 5 blades.

Agree. Companies moved on from DE to proprietary cartridges for profit.

$150 Formica counter top fulfills all the duties of a $3000 granite counter top.

Not quite. I had formica crack under a hot pot, stain, scratch, and chip. The first I haven't seen my granite countertop of 10 years do, and the latter 2 were much, much reduced to nil. Might not be worth it to everyone though, I can see that.

Re:More money does not always buy better things.

[blueg3]

An Aeropress doesn't make espresso. It makes a good drink, and it does it decently well, but you're comparing different coffee beverages. (Could the beverage made by a $30 Aeropress satisfy many people just as well as espresso. Sure!)

Formica doesn't have anywhere near the mechanical and chemical properties of granite or other high-end countertops. If all you want is something that will hold up cutting boards and room-temperature objects, they do the same thing, yes. But a granite countertop is practically indestructible.

Re:More money does not always buy better things.

[jklovanc]

A $30 aeropress coffee maker is as good as a $5000 espresso machine.

Things aeropress can not do;
- Heat the water
- control temperature
- steam milk
- foam milk
- Make a shot in under ten seconds
- . grind the beans
- operate by pressing a button.
The $5000 espresso machine is generally used for commercial shops and is much more versatile that an aeropress. An aeropress is similar to a $5000 espresso machine in the same way a sewing needle is similar to an industrial sewing machine.

A $150 Formica counter top fulfills all the duties of a $3000 granite counter top.

Formica is not as resistant to burns/stains/scratches as granite and does not have the look of granite. Why not make all flooring thin vinyl. It covers the floor.

Just because two things have a similar function does not make them similar in value or price.

Re:More money does not always buy better things.

[Anonymous Coward]

http://aerobie.com/Products/Details/AeroPressMaterialsDescription.htm

Re:More money does not always buy better things.

[Anonymous Coward]

An aeropress gets thoroughly pwned by a ~$200 2nd hand semi-automatic espresso machine. Not that the aeropress can make espresso or milk-based espresso drinks like lattés or cappuccinos. It's really not the same thing at all, and saying it rivals $5000-ish machines like a La Marzocco GS/3 is ignorance. Sure, it's better than keurig, tassimo and that sort of stuff. It tastes about as good as coffee from a $30 french press really.

More money doesn't always mean better, but there's LOTS of times when you also get what you pay for!

Re:More money does not always buy better things.

[Anonymous Coward]

Exactly. OP chose some bad examples. Formica counter top... Everyone knows the best is corrian or quartz. Granite is permeable and needs to be resealed.

Re:More money does not always buy better things.

[Anonymous Coward]

>>>> A double edge safety shaver that uses 20 cent blades is far superior to any expensive disposable shaver system, even the ones with 5 blades.
>> Agree. Companies moved on from DE to proprietary cartridges for profit.

I have used a DE razor (and a straight razor) for many, many years, and they give a fantastic shave. However, I keep some 5-bladed Gilette Proglides on hand too.

Why? I can get a terrific shave (with and then against the grain) from the latter in about 60 seconds when the need arises. If I tried that with either the DE or the straight razor, someone would stumble across my blood-drained body days later.

Mostly marketing, not all. :-)

Re:More money does not always buy better things.

[serviscope_minor]

"A double edge safety shaver that uses 20 cent blades is far superior to any expensive disposable shaver system, even the ones with 5 blades." I use them and

I agree.

Those T-shaped ones which use bare metal blades?

I own one, since they're excellent if your stubble has got a bit longer, and are great for triming sideburns etc. I also own one of those braded 5 blade razors with crazy-expensive blades. I still fork out for the latter since for regular shaving they are way better. My guess is that the optimal type of razor depends strongly on the type of beard and skin you have.

The $150 Formica counter top at my rented flat and my mother's 30-year-old granite one beg to differ.

You have to try hard to bust up a proper formica counter top: the cheap ones are not as high temperature resistant. That said, a very hot frying pan placed on the top will cause it to burn. Granite obviously won't. On the other hand, the previous owners of my place managed to knock a chnuk out of the solid granite counter top. That's impressive in its own way.

Better equals more expensive and that's right more times than not. The point is that more expensive doesn't equate better.

Yep.

Re:More money does not always buy better things.

[hankwang]

"The $150 Formica counter top at my rented flat and my mother's 30-year-old granite one beg to differ."

Last time I was looking into kitchen hardware, the salesman warned me that natural granite is a bit porous and tends to get stained irreversibly from, say, wine spills, and that you have to re-impregnate it regularly. Not something I want in my kitchen. On the other hand, all synthetic counter tops, including granite-look composites, are not guaranteed to handle hot pans. I ended up not buying a new kitchen...

Re:More money does not always buy better things.

[pruss]

As I recall from looking at the Consumer Reports reviews of countertop materials, laminate (e.g., Formica) and quartz provide what looked to me to be on balance the best functionality (at least for my mental weighting of the categories). Laminate looked better than granite to me. Quartz was a little better than laminate functionally, but laminate is quite a bit less expensive. I can't remember the specific ratings for the categories.

As for heat resistance, here is some anecdotal information. We lived in a house that was scheduled to be demolished right after we moved out, so for the last couple of months I did not take any precautions with the laminate countertops, since they'd all be smashed up soon. I would take a pot straight off the stove and put it right on the countertop (it felt wrong!). Visible results: none. I don't know the variety of laminate, I am afraid.

Re:More money does not always buy better things.

[jklovanc]

Laminate looked better than granite to me.

That is personal preference. Many would not agree. To most people laminate looks cheap.

As for heat resistance, here is some anecdotal information.

There is a reason it is called anecdotal. Here are some questions. How hot was the pot? how many times did it happen? When you so it several times the polymers in the plastic break down. Over time the area will become soft, rough, and easily scratched. I live in an apartment and the previous tenants were not very careful. There is a spot right next to the stove that is starting to deteriorate. It is darkened, scratched and sucks up stains easily. That process does not happen in granite. I am not talking about burns but the chemical breakdown of the material.

Ever try to polish out a scratch in laminate? You can do the in granite and it scratched much less.

Re:More money does not always buy better things.

[Richy_T]

A pot with liquids in it will probably not be far off 100C, particularly if there are a few seconds between getting it from the stove to the top. A frying pan would be more likely to cause damage (I have scorched a top with one before).

Re:More money does not always buy better things.

[turbidostato]

the salesman warned me that natural granite is a bit "porous and tends to get stained irreversibly"

The salesman wanted to sell you a composite. First you need to know that in the market, any kind of counter top stone will be called granite in the business. Then, while it's true that ligth-coloured mostly quarz and feldspar are somehow porous (but less than, say, marble, and you'll find, even white marble, covering floors) and can be stained, then try just "standard" Spain Grain or Swedish Absolute Black and let me know if you manage to, while technically porous, stain it at all even without any caresness.

Insurance, lol

[Anonymous Coward]

The 3D printed hand probably sucked a lot more than they showed. Build that bastard out of titanium, refine the system a little bit. You'd have a kick ass 20k system. If insurance wants to get the other 20k back after you sell off the old system, tell them to pull it from your cold dead hand.

Re:Insurance, lol

[Richy_T]

Imagine if you could build a 3D printed hand with a built-in 3D printer.

We all know the medical cartel...

[Anonymous Coward]

artificially pushes prices up with their protected monopoly. The only surprising thing here is the 84,000% profit margin.

Re:We all know the medical cartel...

[Anonymous Coward]

As someone paying more than $1k per day for a drug that you can buy in India for less than $20, I have to agree.

Correction to headline

[wonkey_monkey]

$50 3D printed hand preferred over $42,000 prosthetic hand by particular guy

This is great news for this particular guy, but it doesn't necessarily follow that the 3D printed hand is therefore objectively better than the other.

One word answer: Liability

[Theovon]

When you buy a medical prosthetic from a medical company, almost none of the sticker price covers materials or basic engineering. Most of the money is split between liability insurance and extra R&D and testing overhead to make damn sure that someone won’t misuse the device, thereby generating a law suit. In Law, products liability is a huge area; big companies have deep pockets and often lose in suits where the user of their product was clearly doing something really stupid. (Chain saw instructions: Do not use hands to stop chain!) The fact is, people are sue-happy, and that’s the primary reason why all medical devices cost so damn much.

If someone is selling 3D printed prosthetics, they are GOING to get sued, and they’ll get put out of business very quickly by some moron who found a way to hurt themselves in a heretofor never conceived of manner. It’s just inevitable.

If someone were to make open source designs avaiable for prosthetics so that people could print them themselves, you’d think that the user would be taking all the liabilty into their own hands right? Ha! When something goes wrong, the maker of the 3D printer will get sued. And no matter what kind of disclaimer they put on it, the maker of the 3D schematics will get sued too. All because people find amazing ways to hurt themselves and sue over it. Especially with medical devices.

Why do you think airline food is so damn expensive? When something goes wrong with a plane, everyone gets named in the suit. The airline, the airplane manufacturer, all subcontractors of said manufacturer, including the company that made the rivets, the supplyer of the airline food, the pilot, you name it.

medical industry = rent seeking

[buybuydandavis]

This shouldn't come as a big surprise.

You'll routinely pay 10x or 100x markup for all that lovely FDA "protection". If only the mafia were providing health care, I'm sure their "protection" wouldn't be quite so pricey.

Medicine is all about information technology and customization. The prices of these things have been coming done exponentially, but medical prices still go up. Why? Because fuck you, that's why. Because they can. Because with medicine, the link between your money and your life is more direct than usual, therefore those with the guns can rob you like any mugger would, taking every last penny in your pocket. Would you rather be dead? No? Then you'll fork over whatever they say. They make competition with the government approved rent seekers illegal, then say "pay up or die". It's a great racket.

Re:medical industry = rent seeking

[hyades1]

What kind of idiot fails to understand that all those nasty government regulations came about because people were getting fleeced left right and centre by quacks, confidence men, grifters, Republicans and other thieves.?

Re:medical industry = rent seeking

[buybuydandavis]

"all those nasty government regulations came about because people were getting fleeced..."

Are you really enough of a buffoon to believe that?

I'd note that if the concern were really about getting fleeced, fraud has been both criminally and civilly actionable for a long long time.

Re:medical industry = rent seeking

[Anonymous Coward]

Look up p values and null hypothesis.

Re:medical industry = rent seeking

[stenvar]

What kind of idiot fails to understand that all those nasty government regulations came about because people were getting fleeced left right and centre by quacks, confidence men, grifters, Republicans and other thieves.?

Quite right, that's why they came about. And now, instead of just a small number of stupid people getting fleeced because they believed some snake oil salesman, the entire nation gets fleeced, and it gets fleeced by many of the same companies. And the irony is: the regulations don't even work. That's what Democrats do: they make getting fleeced by corporations mandatory.

Re:medical industry = rent seeking

[ThatsMyNick]

You forgot Democrats and the Independents. Include them, and I partly agree with you.

Re:medical industry = rent seeking

[Anonymous Coward]

Another libertarian gimp who thinks any victim of anything can make the world right via the courts.

Re:medical industry = rent seeking

[Trepidity]

I think the particular problem with the U.S. is those con-men haven't been put out of business: there is still a whole slew of private companies getting their grubby hands into healthcare. And they are still profiteering from misleading people, providing substandard service, advertising things people don't need and/or that are quack bullshit, etc. There is regulation but the regulation has you dealing with insurance companies, for-profit health clinics, all sorts of nonsense.

I agree that an unregulated laissez-faire health market would be ridiculous, but the U.S.'s system is only slightly less ridiculous. I think we did it right in Scandinavia by just taking an axe to the whole sector of privatized medical care, replacing it with an efficient and much less complex state-run system.

Re:medical industry = rent seeking

[hyades1]

Very nicely said! I agree with you 100%.

Re:medical industry = rent seeking

[hyades1]

What a ridiculous lie! The US is in the grip of Corporate America, and its people are paying for it. The best that could be done under the circumstances is the flawed legislation President Obama managed to force past the utterly-recalcitrant Republican Party, who are still flopping about like gutted trout in a doomed effort to repeal "Obamacare" before taxpayers realize how much better it is than what they had before. It's the legislative version of bridge technology like compact fluorescent bulbs and hybrid vehicles, and a useful first step down the road to universal health care.

Those of us who live in civilized countries can't help but laugh at the ridiculous cost paid into the US health care system by taxpayers who often got no benefit from it in return. For example, in spite of being much larger and colder than the US, and having only a tenth the population as a tax base, your neighbour to the north manages to put two dollars (either US or Canadian) into actual health care instead of paper-shuffling for every dollar you pathetic losers manage. And although it's far better than the US system, Canada's health care isn't anywhere near the best.

The only fleecing going on is perpetrated upon slack-jawed, pig-ignorant conservatives by their intellectual superiors (which is, let's face it, just about anybody with a three-figure IQ).

Re:medical industry = rent seeking

[stenvar]

The US is in the grip of Corporate America, and its people are paying for it.

Quite right.

The best that could be done under the circumstances is the flawed legislation President Obama managed to force past the utterly-recalcitrant Republican Party

No. Obama's health care act is a gigantic handout to the insurance industry. Mind you, the Republicans are also in bed with corporate American, but Obama has really taken this to new heights.

The only fleecing going on is perpetrated upon slack-jawed, pig-ignorant conservatives by their intellectual superiors

Yes, totally agreed: the high-IQ Obama and his high-IQ political and corporate buddies are ripping off the country. They don't call that kind of governing class the "intelligentsia" for nothing.

Those of us who live in civilized countries

If Europe or Canada are "civilized", I prefer not to be civilized, thank you very much.

Large corporations beware

[EmperorOfCanada]

One of the big advantages that big corporations bring to bare is the ability to finance big long term product development all the way through to manufacturing and distribution. One of the ways they do this is through shear scale of infrastructure. So if a washing machine company comes up with a new washing machine it is easy for them to put it in front of the consumer; easy that is compared to your average schmoe. But what happens in a world where either some guy tinkering in his basement in Northern Manitoba can come up with something cool, and either you can print it at home or have some local printing company print the device? While that guy might not have the marketing might to blast out his new invention; marketing is usually what is needed when one product is largely the same as the others. But if that guy comes up with something genuinely cool, viral marketing ought to go pretty far.

Now in some cases the big old corporation will just make the guy an offer or try to beat him up with their legal department, but in many cases people will just put out their designs as CC0 or some other open license and that is that. It will be Pandora's box ever day of the year.

I look around my house at all the badly designed crap and marvel at why it isn't better. I even think about things that are well designed like my swiss army knife and wish to make changes.

I'll give an example of where the large corporations are simply not giving a crap and just sell us the same old same old as long as they can. My example is cordless telephones. My cordless telephones are absolute crap. Compare the typical cordless phone to my 10 year old Motorola Razr. That old phone runs circles around my 1 year old cordless phone. So when I go to Best Buy and look at their selection of cordless phones they are all basically the same crap. I am willing to bet that the unit cost is under $10. I am also willing to bet that the marketing, shipping, and other administrative costs are potentially greater than the materials and manufacturing cost. The only real function of my cordless phone is to make some shareholders richer.

So now picture a future where I can 3D print my new cordless phone(yes I know that circuitry printing is a ways off and that by the time it comes around cordless phones will be a dead technology) what the heck kind of cordless phones will people be printing. I am seeing tiny little things with massive ranges and ungodly battery lives. I am also seeing something that interacts with my computer.

So now run around your house and think what could I 3D print where the materials cost was a tiny faction of what I paid. I am thinking all the hardware around my house like doorknobs, locks, hinges, drawer sliders, etc. Those things are all way overpriced. Then think about your bikes, lawnmowers, rakes, shovels, etc. Things that are built like crap and break all the time. When I lived somewhere really snowy I would guess that we went through around 2-3 Canadian Tire shovels a winter. They all broke in the same place. And so on.

So basically I don't believe anything that comes out of old media and thus don't read/watch it; so I am very hard to market at. So I can see a future where more and more of what I own will be designed by "some guy" and then printed either by me or by some local specialist in 3D printing. I also see a future where that 3D printer was 3D printed from an open design as well. Ideally it even gets to a point where the materials that I print are largely recycled locally or completely a commodity product. Thus there is no room for rent seeking in my 3D printing.

I'll even give you my uber dream. My house is 3D printed, all the hardware inside is 3D printed, the furniture assembled from locally produced wood and 3D crafted I will unlock(3D Printed) the door and step over the threshold in 3D printed shoes.

Re:Large corporations beware

[Anonymous Coward]

and this is something you typed out on easter sunday
  GG bro

living life to the hilt.

Re:Large corporations beware

[silas_moeckel]

3D printing right now tends to scratch an itch for somebody. Recently the GF had a part break on a brand new lamp. Nothing fancy just a utility light for her crafting room. 30 seconds of searching on thingverse to find that multiple people have come up with a better replacement. Mind you I'm a wood guy a few minutes with a scrap of hardwood and a shop full of tools would be my normal response but had a new toy to try out.

Re:Large corporations beware

[EmperorOfCanada]

My belief is that 3D printing is going to bubble along with all kinds of articles saying how great it is while the bulk of the world simply don't use it. Then suddenly 3D printers will be Time's man of the year. I think the key will be that someone comes up with a Netflix for 3D printing combined with an aggressive business model that drives costs down even more. Another critical thing is that 3D metal printing becomes the norm.

One thing that I have thought would be interesting would be 3D wood printing. Either you put in some boards and it cuts them up into ready to assemble lego furniture. Or you put in wood pulp and it forms it into a final piece.

The wood business model would not be for someone to sell furniture, but for them to sell more wood. The idea is that some local lumber mill would get a 3D cutting system and would then take orders to cut up the wood into interesting shapes (think that swedish brand) and people would come and pick them up. But from an economic model the idea is that people are effectively buying wood with a bit of a markup. With furniture often the price of the wood has little to do with the final price. This would upend a huge amount of the furniture business. This way you are truly buying local.

Re:Large corporations beware

[silas_moeckel]

There are plenty of 2D laser cutters pumping out wood bits mostly out of plywood. Making quality furniture out of wood is a lot more then just cutting out an assembling things like book matching, inlays, etc become an art and it's rather specific to the individual piece being used. The hard part is local very very little wood is, the US is pretty much regulated itself out of the furnature grade wood market. OSB and MDF can easily be made locally along with veneers getting imported that is a big chunk of the market.

Re:Large corporations beware

[EmperorOfCanada]

You are correct. But what I was talking about was more than plywood.

Basically I was thinking that the 3D printer/carver is done when it can do this: https://upload.wikimedia.org/w...

But more likely to be something like: http://www.alzohawoodwork.com/...

Think of a lumber mill that could buy a $100,000 machine that could turn out at least the second type of design by just selecting from a menu. The price differential from the same chair that had to go through the usual logistics chain would be massive. Plus if the robot is carving the thing then it could do it in the style of a technically difficult wood worker instead of the simplistic techniques of an assembly line. So for way less money you could get way more chair. The lumber mill could then sell way more wood. They don't care if it is a 2x4 or a bunch of chair parts, especially if they can charge a bit more for the chair parts.

Re:Large corporations beware

[silas_moeckel]

Your looking at a couple different machines to do something like the first (the second would not come up for me). I'm not sure how much savings you would see, those local lumber mills are at the far end of a supply chain there cost of raw materials is far higher (and those lumber mills that have survived home depot and Loews far and few in-between) than using that same machine in asia and sending the completed part for less.

prosthetic human outperforms

[turkeydance]

49% of the population.

Re:And the developer of the 3D printer is relying

[Anonymous Coward]

>> .... being able to steal the IP that others spent time and money designing, testing and getting approved.

You're an idiot, if not else, to think we are idiots, too.

a) These things have been made since eons (it's on Wikipedia);
b) if you worked and put a lot of money on research and someone bests you with $50, you're a lousy entrepreneur: deal with it;
c) IP doesn't exist; you can't own ideas; in case you legally can, in your backward country, the world is set to correct your and your laws way of thinking;
d) it follows nobody can steal what you don't own, so basically fsck off.

You can lie to everyone saying you need to pay salaries, school for children, clothes, expensive patent registrations or FDA analysis but, in the end, it's not what you want -- it's what people can afford. Upfront, I'd say that should cost 1,000 bucks, tops. If insurance won't accept it to drive a truck, well that's another story. If you're going to charge $10,000 for that, you don't know how to do it and no amount of research will make it less expensive. It's not your expertise and by lobbying to acquire a monopoly you'll be doing everyone a major disservice.

Stick to what you know and do it (well, except if you're a lobbyist).

> Unfortunately people actually ignorant enough to believe that a part is going to magically design itself in a 3D printer.

Yes, it will. This is the main idea bout open source: things appear magically because some good soul did without compensation. We've been already there and that discussion is over: free lunches do exist. The future has arrived... welcome!

I saw one in a movie many years ago...

[toonces33]

As I recall, it was Dr Strangelove. But the ones they had back then had glitches that caused the hand to attempt to strangle the person to whom it was attached. I am sure that they have this problem corrected by now..

People are great at ignoring labour

[Sycraft-fu]

I see that all the time in IT with people wanting to cowboy up solutions cobbled together from a bunch of random shit. Yes, you can do that, and it can be made to work. However how much time will it take to do and support? Because unless your time is free, you need to factor that in.

Labour is a big part of the cost of pretty much anything you buy. Software is the ultimate example. The materials and distribution cost of software is minimal even if done on physical media. However that doesn't mean it is free to produce. It takes a lot of labour, in the form of programmers writing the code, QA testers reviewing things, support staff, and so on, to make the product happen.

Physical devices are no different, they just have higher materials costs. However all the labour cost is there. People had to design, build, test, etc, etc, that product and they all need to be paid since they all like to eat, have a place to live, and all that jazz.

Re:People are great at ignoring labour

[Handover Phist]

There are plenty of talented people willing to put time into labour and support. There are a ton of people working for free in their spare time outside of their full time time jobs doing stuff that counts. Designers design when their not at work. Carpenters shape wood into what they or someone else wants when they're on free time. There is a market outside of money where talented folks just help each other out. They do it for fun or for a favor returned. It's a part of "all that jazz".

Re:People are great at ignoring labour

[Sycraft-fu]

None of that changes the fact that when you buy a product, it is part of the cost. I mean I suppose you can decide that it should all be free... but then you have the small issue of how those people are going to make money.

Re:People are great at ignoring labour

[sjames]

And people who overcharge are great at exaggerating the cost of labor.

Re:People are great at ignoring labour

[Richy_T]

When you buy product X, you are paying for the labor of all the people who worked on product X and when someone else buys product Y then you are paying for the labor of all the people who worked on product Y.

The thing is, the people who worked on product X often duplicated the labor of those who worked on product Y. That's wasteful.

Now, I'm certainly not decrying competition and commercialism but if someone wants to work on something (and get paid for it or not) and then the fruits of that work can be shared with everyone, that's a good thing and more resources can be put towards things that are beneficial.

Re:People are great at ignoring labour

[laird]

And if people are willing to do the work for free and give the results away, is that so bad?

Re:obamacare says "no way"

[DrLang21]

One word. Co-pay.

Show me the books

[Anonymous Coward]

The additional $41,950 is allocated towards sunk costs including

• - Cosmetic designs of a hand like-prosthetic to prevent adults staring uncomfortably and children exclaiming "cool"!
• - Insurance/class action insurance for when the prosthetic ends up injuring/irritating one or more users or people, or things, or otherwise perishable or damageable entities the hand interacts with.
• - Robustness to last through more than, say, 10,000 cycles before snapping into brittle plastic shards.
• - Salaries and children's college funds for the scientists, designers, and MBAs running the prosthesis companies
• - Salaries and children's college funds for the academic and medical researchers involved in prosthetic studies, both mechanical, psychological, and sociological

When I see the actual books - not what the PR people say or what is reported to the SEC* - then I'll believe it.

The CEO class - actually they are MDs in the medical industry sometimes with a MBA on top of that - usually gets the spoils.

And the insurance on the lawsuits is exaggerated.

*They don't have to nor do they volunteer to report the most of the above costs. All you will see is overall insurance costs, R&D, and lump sums of ALL the salaries. To get an actual product cost (indirect and direct) is impossible outside of the company. So unless the parent happens to be the CFO or in accounting of one of these companies, the parent's post is speculation - at best. And let's keep in mind that ALL businesses cry about their costs, government regulation, and all those unwarranted lawsuits to justify their obscene profits; when the truth is they could make a fraction of their profits and still do quite well - as we can see with companies in the same business who make a very nice living in countries other than the US that have civilized medical costs and single payer systems.

I actually worked in a dental device company. The part was made for $5 out the door - including government shit and lawsuits/insurance, it ws then marked up to $25 - because we could; the distributor marked it up to about $100 - because they could; and the dentist charged the patient $200 - because he could on top of his labor.

A $5 hunk of metal cost us $200.

No good to me

[fustakrakich]

Unless it has a gun built into the index finger

Rather than compare...

[Rick in China]

I see them as having different purposes. Rather than go into details about the hands and their obvious/not so obvious differences or the minutia of when which performs better and how to define PKI for those metrics, it can bes implified into: At least poorer people have options now, that is ALL that matters.

Re:Rather than compare...

[laird]

Exactly! Thanks for getting to the heart of the matter.

Re:obamacare says "no way"

[laird]

Several reasons:
1) Many people don't have insurance, or have insurance that doesn't cover prosthetics. 3D printing prosthetics is a huge enabler for people in the third world, for example. And even in the US, there are plenty of people that the insurance companies don't or won't cover.
2) The ability to make your own, and to customize it to your needs, is very powerful. If you watch the video, the patient was happier with his $50 printed prosthetic than a $40k prosthetic, because it worked better for him. In part this movement is driven by people's desire to make something better than the commercial options.

bisnis

[Anonymous Coward]

sangat bermanfaat sekali,..
www.winarshop.com
www.stepsepatu.com

Re:One word answer: Liability

[laird]

The designs are open source, and freely shared, very specifically with no warranty or guarantee. Just like open source software. People who release open source software don't get sued over the software, because they're not selling and supporting it, they're giving it away specifically with no guarantees or support.

I've worked in the airplane business. As screwed up as liability law is, there still has to be actual liability to award damages. So unless someone can prove that food was a cause of a crash, I don't think that the airline food companies are at risk of paying out over a lawsuit over a crash. And more relevant to the 3D printed prosthetics, if you build your own airplane (e.g. any kit plane) you can't sue the manufacturer. That's why in the US kit plates are relatively popular, because they're vastly less expensive than commercially sold airplanes.

And if you download an open source program/design and use it, and it's not suitable for your purposes, you don't get to sue anyone over it. It's been tried a few times, and went nowhere. If you want someone to sue, you have to go the commercial route, and pay more.

I make prosthetics for a living.

[joeshmoo]

I am a prosthetist, and I regularly fit and bill for these devices as a result. Sure it sounds great that this particular patient can get a hand made for $50, but it’s not a fair comparison and doesn’t necessarily apply for every amputee. Also, as several others have pointed out, that does not take into account the labor or other overhead costs. (Cost estimates that follow are just some ballpark figures)

First off, the patient has part of his hand, and has opposition capabilities at his wrist. If his amputation level was directly through the wrist, or higher, the 3D-printed hand would need a harness or some other element to provide the body power. He’s also lucky enough that he can get away without having an extensive socket to suspend the 3D printed hand on his arm as a result.

Based on the myoelectric prosthesis shown, the $42,000 cost is likely “Usual and Customary” cost. At a contracted rate with insurance on a device like this, you’re probably best case looking at about $16,000 actually being billed to the insurance company. Looks like a Sensorhand Speed (or similar) hand being used, which has a parts cost upwards of $4000 from the manufacturer. The electrodes, battery unit, and custom made socket probably cost an additional $3000 in parts. The billed amount to the insurance company includes the prosthetist’s evaluation, casting, manufacturing, fitting, and subsequent follow-up and adjustment appointments for 6 months.

All that said, the patient probably shouldn’t have been fit with the system shown; most of the benefits he’s stating (such as holding a box at work) are more related to him having a proper limb length with the 3D printed hand! The myoelectric prosthesis shown has thrown off the alignment of the hands for performing bimanual tasks, placing his prosthetic hand way further from his elbow than his sound side hand. He would probably benefit from an M-finger prosthesis which would probably have only run about $5,000 to the insurance company, even being custom made to match the patient. Probably $1500 in parts.

.... but if they said a $1500 prosthetic hand was outperformed by $50 3D printed hand, people wouldn’t get as hyped up.

Re:I make prosthetics for a living.

[laird]

Wow, nice to see someone with an informed post. The amusing thing to me is that we've got tons of videos, and this is the one that made Slashdot. But we're happy with any of the patent's stories. They're pretty cool, actually - patients talking about their prosthetics, shot by either the patients, their parents, or the "maker", and a few videos of people giving presentations (e.g. at TED). Check out http://enablingthefuture.org/m... .

We're not claiming that 3D printed prosthetics are better than commercial prosthetics, just that they're more accessible. Particularly outside of the US and Europe, the cost is a huge barrier, and we're excited that we are producing designs, documentation, etc., empowering people to help each other if they don't have a viable commercial option.

Re:I make prosthetics for a living.

[ThomasBHardy]

-sigh- bad day not to have any mod points

Thanks for posting an informed, reasonable response.

Re:I make prosthetics for a living.

[Anonymous Coward]

There's something else you're forgetting here. This patient was intimately involved in crafting this particular prosthesis. It's "his" in a way that no commercial device, fitted by a prosthetist (no matter how empathic) who is going about his job can ever be. Even with the parts printed, and maybe customized, by a volunteer, he's seen the thing from start to finish, he's been involved the whole way.

I agree the $42k - $50 comparison is silly. I thought the most telling difference in performance of the two devices was holding the car steering wheel, and he may well be overstating his satisfaction with the 3-d printed device while he is talking with the guy who volunteered his time to build it. But I also think the active engagement of the patient is a big deal, and if you can engage a particular patient better by getting him more involved in the device fabrication, then that's a huge win.

Re:I make prosthetics for a living.

[Anonymous Coward]

No one cares that it might cost 1500 in parts or 5000 to the insurance company. They only care how much it costs to the actual person using it.

Your 1500 in parts hand that the insurance company pays 5000 for probably still costs the guy wanting a hand 15k and that's the whole point/problem with the situation.

Re:I make prosthetics for a living.

[ogdenk]

.... but if they said a $1500 prosthetic hand was outperformed by $50 3D printed hand, people wouldn’t get as hyped up.

Still pretty awesome. My question is who's patents he stepped on and when he can expect a team of lawyers to buttrape him with an 18" prosthetic penis?

Re:One word answer: Liability

[Anonymous Coward]

You have no idea what you're talking about. We're dealing with a medical device in this situation, not some open source piece of software that jerks off Linux penguins. You cannot simply release specifications for a medical device and think that because you made them free and said you're not liable that you won't get pounded into the ground by a lawyer who is much, much smarter than you. Grow up and face the real world some time.

The reason medical devices are expensive

[kheldan]

If it's any sort of 'medical device' then the FDA must approve it before allowing you to sell it in the U.S., and in order for it to be approved by them you must do testing the FDA mandates. The testing is complicated and very often expensive, and if your device can't pass the testing then you have to go back to the drawing board and fix whatever it is that causes it to fail the test. Additionally the FDA demands certain manufacturing standards. They can come in and inspect your production facilities, personnel, methods, procedures, tools used, etc. If they don't like the way the communal kitchen looks or whether the communal refrigerator is clean enough for them, or any number of other nit-picky things, they can prevent you from selling or even producing your device; they can shut your company down completely. Sometimes the cost of all the testing and jumping through the hoops the FDA requires you to jump through will cost more than your device costs to produce. The end result is the costs are all tacked on to the final price of the device being manufactured. The 3D-printed prosthetic obviously wasn't FDA approved and couldn't be mass-produced and sold without going through the same process that everyone else has to. Since 3D-printing is relatively new and there hasn't been much if any legislation to govern it's use, what will likely happen at some point in the future is that anyone offering the CAD/CAM files to produce something like this prosthetic hand on a 3D-printer will be jumped on by the FDA and required to do the requisite testing of the finished product or face legal action against them. Furthermore I wouldn't put it past the FDA to require only 'authorized' 3D-printers to produce such things. Of course if it's all open-source and people are building their own 3D printers then the FDA can more or less go fuck themselves, but there'll be a shitstorm over the whole subject, guaranteed.

Source of my information: Personal experience from working for a medical device manufacturer for 5 years.

Re:The reason medical devices are expensive

[laird]

Luckily http://www.accessdata.fda.gov/...

Luckily "External limb prosthetic component, Class I" aren't regulated as tightly.

Re:The reason medical devices are expensive

[Lumpy]

And it will create a black market of 3d printing files for people to still get what they need at an affordable and reasonable price while circumventing the stupidity of the government and rampant greed of the medical industry.

Re:The reason medical devices are expensive

[der_pinchy]

I call bullshit!
A lot of places have to go through the same rigmarole you mention but don't have sky high prices.
Take a restaurant for example. You don't seem meals costing 20,000 dollars do you?

Re:The reason medical devices are expensive

[kheldan]

Go troll somewhere else, you're really terrible at it.

Re:And the developer of the 3D printer is relying

[laird]

"steal the IP that others spent time and money designing, testing and getting approved"

The designs of the 3D printed prosthetics are substantially different from modern commercial prosthetics, because the manufacturing process is utterly different. And mechanical prosthetics have been around for a very, very long time. So there's no "stealing of IP". Really, do some research before accusing people of theft.

"people actually ignorant enough to believe that a part is going to magically design itself in a 3D printer"

So far what's happening is that people with design skills and a 3D printer are making designs to help themselves or others in their area. Then they share the results with people who can then adapt and print the files. So what's "magically" happening is that people are sharing their work freely, to everyone's benefit. Because they need the problem solved so they solved it, but they don't want to be in the prosthetics business so they gave the design away.

You know, like Free Open Source Software. Which has worked out pretty well so far.

Not "the craw"...THE CRAW!

[PopeRatzo]

Do you think you can use adamantium in a 3D printer?

Asking for a friend.

Re:Not "the craw"...THE CRAW!

[PopeRatzo]

OK, I realize I may skew a little older than many Slashdot readers, so here. Consider this your Easter gift:

http://youtu.be/ftgAG3Vnif8

Re:Not "the craw"...THE CRAW!

[hyades1]

I never have a mod point when I desperately need one.

Re:Obamacare exists because...

[Anonymous Coward]

I hope you are not implying that the poor are the only ones not paying their hospital bills.

Re:Obamacare exists because...

[NoKaOi]

Obamacare exists because the poor can't be bothered to pay $90 for a doctors visit...losers that don't pay

Can't be bothered? If you have a medical issue that requires several $90 office visits, and the choice is between paying that or feeding your family (or possibly buying gas to get to your minimum wage job so you don't lose it), how is that "can't be bothered?" Oh, and then you call them losers. So which is it, they can afford to pay but can't be bothered, or they are losers who would rather sit on the sidewalk than get a job? It seems you only see those two options, which pretty much means you are completely unfamiliar, yet pass judgement on a part of our society that comprises a pretty significant portion of the US population.

Re:One word answer: Liability

[laird]

As I said, I used to work in the airplane business. And if you bought a kit for an airplane and built it yourself, you can't sue the company that sold you the kit because you assumed the liability. That's why most innovation in airplanes in the US is in kit planes - commercial manufactures fall under liability, which complicates their lives quite a bit, which (perversely) discourages innovation, so many people are flying airplanes with engine designs from the 1950s.

Hand prosthetics are "prosthetic devices class I, non-significant risk devices" by the FDA.

http://www.accessdata.fda.gov/... .

Re:Obamacare exists because...

[oic0]

$90? lol. That IS what your insurance company pays them. A person paying cash however pays 200-300 at the door and is billed for the rest. Usually another 200-300. Last time I visited the doctor without insurance it cost me $500. Most people would only need major medical if doctors weren't a bunch of greedy pricks who charge insurance companies a fair rate and rape anyone who tries to pay in cash. If a doctor were on fire I would ask for his wallet before pissing on him.

Re:One word answer: Liability

[Anonymous Coward]

It's less likely. With a company there is actual money to be had. With an individual by the time you win they're all out of money. Now if you go aginst that persons insurance company (ie car, house, etc)... that changes things a bit. Whose policy would you go after for someone who releases source in this case? Most people I know would be broke before the trial started. Good luck getting money out of someone who doesn't have any.

And WHO creates and protects the monopoly?

[Anonymous Coward]

BIG government, that's who. The only reason that prices on medical devices have to be so high is that government gets involved. Government is there with the crazy over-broad tolerance to extravagant lawsuits on anything medical .... which drives up the liability insurance rates for manufacturers. Government then steps-in with "reforms" that offer limited liability protections to manufacturers who comply with certain standards (and the big firms already successful in the marketplace happily lobby (bribe politicians) for those standards and rules they can comply with easily, but that any new upstart will not be likely to afford) and ...... SHAZAM! a new monopoly on "medical devices" is born. Got a great idea for a new medical device? Have you got $10 million dollars to spend clearing government regulatory hurdles before you can even manufacture your first sellable device? If not, then drop your idea and consider working in another field.

Same thing with airplanes. If you have a cool idea for a new single-seat propeller-driven airplane, the current estimate if $50 Million dollars to clear the FAA hurdles before you can make and sell the first plane; if you plan to make and sell 1000 copies of that plane, that's $50K dollars added to the price of each and every one. Now you know why you will never have a flying car or a jetpack.... (even if somebody clears the hurdle with a pile of up-front investor cash, the retail price of the product is massively inflated by government). Note: the early guys to enter the field never face the hurdles. When the wright brothers built their planes there WERE no government regulations. When William Boeing founded Boeing aircraft in 1910, he faced no regulations. When the Loughead brouthers founded the Loughead Aircraft Manufacturing Company (later renamed to Lockheed) in 1912 THEY faced no regulations. When Glenn L. Martin founded HIS aviation company in 1912 he faced no regulations..... of course Lockheed and Martin are now merged as Lockheed Martin. When Leroy Grumman founded Grumman in 1929 he faced a very limited regulatory environment, as did Jack Northrop who founded his company in 1939. Here we are a century later with Boeing, Lockheed-Martin, and Northrop-Grumman as our three massive, in-bed-with-big-government aerospace firms. They're all just FINE with huge piles of regulations... they have whole departments of lawyers and paper-pushers (funded by taxpayer-provided defense contracts) to help them clear each and every regulatory hurdle. As a side-effect, they're hardly displeased that those same regulations make sure no upstarts are likely to arise and challenge them in the airplane business. When Burt Rutan's team got a little too interesting, Northrop simply bought them. Space-X is getting in there in the rocket business (sorta snuck-in under their radar - after all, who seriously expected somebody to got straight to rockets without doing jet planes first? and the big guys never considered that an internet billionaire might try to clear the hurdles... their eyes were on their own industry) but did ya notice how quickly the big boys convinced their government friend to lock-in a massive contract for their high-priced EELV rockets? Space-X will be "allowed" the crumbs.... they'll have to FIGHT for more.

When any industry becomes an established thing and starts making lots of money, several things happen:

1. politicians see it as a source of campaign money; they go to the people in the industry and say "I'd really like to help you succeed and avoid any terrible new regulations, but I might not be able to protect you if I lose my next election to that other guy..."

2. government gets comfortable with the industry; the regulators and bureaucrats get used to dealing with certain people and businesses and they'd just prefer not to have to break-in any "new people" (i.e. have to do any extra work to meet, learn about, and oversee new competitors)

3. the members of the industry who got in early and bec

Re:And WHO creates and protects the monopoly?

[John.Banister]

If you have a good new idea for a product people could build for themselves, perhaps there's an alternate route to getting some money for it.

Build a prototype.
Advertise it's virtues.
Have a Kickstarter for releasing the details of your design to the world under Creative Commons.

You don't get regulated as your investors are clearly speculating, and you don't produce an actual product, just the design of your prototype. They don't get regulated because they're building a one-off for their own use. Of course, it wouldn't work for cars or some kinds of planes, but it might work ok for lots of other things.

Re:And WHO creates and protects the monopoly?

[laird]

Sure. That worked for Barbie 3D Printed Armor!

Re:Obamacare exists because...

[ProfBooty]

What did you pay $500 for?

My inlaws are visiting from overseas so no insurance but:

$40 for a check up
$80 for x-rays
$20 for anti-biotics

All in cash.

Later we found out that we could have gotten it all for free via the county health department. I guess it depends on what you are getting treated for.

Re:Obamacare exists because...

[cheater512]

Some of us in Australia are even luckier.
I live near a walk in clinic which bulk bills. Never paid them a dime - its all covered by medicare.
I actually don't think they have any cash/eftpos at all.

It is possible to know

[SuperKendall]

It's probably impossible to know until you are actually in the same situation.

It's possible to know because you know how it is from the side of people noticing things. I find artificial hands immediately obvious, as much so as a robotic hand would be.

I think either would fare just as well in terms of not attracting notice when covered by a glove. Why not, then you would just look a little odd in summer...

the reason

[slashmydots]

Well, $41,950 of that $42,000 is government medical approval, licensing, paperwork, other assorted lawyer and FDA crap, etc.

Re:the reason

[Lumpy]

No, $30K is profits and markup.

Re:Obamacare exists because...

[Bryan Ischo]

It would be more accurate to say that when the service is free, as it more or less is for poor people, then the service is used by those people without consideration for the cost of providing that service.

My wife is a doctor, and has worked in the Bronx and also in low income areas of San Jose. In the Bronx it was not uncommon for people to call an ambulance when they had a cold and wanted to see a doctor to get some cough medicine prescribed, because they didn't have to pay for the ambulance and it was a free ride to a free doctor's visit for a condition that doesn't need an ambulance or a doctor.

In San Jose, she sees tons of drunks and drug users who end up returning to the hospital over and over again because it's the easiest way to milk the system for some attention (I suppose drunks don't get much out of it, but drug users can often badger the system into providing some pills; when presented with a persistent patient with unverifiable claims of pain, after a while the doctors have to prescribe something just to get the person out of the way so that patients with real needs can be seen.

Making everyone pay a nominal amount for every visit is not possible because hospitals cannot refuse anyone, even if they can't pay. But forcing people to get insurance, so that they pay ahead of time, seems like the next best thing.

Also virtually nobody in the USA chooses between a $90 doctor's visit and feeding their family. The choice is usually between a $90 doctor's visit and a $90 cable or cell phone bill.

Re:Obamacare exists because...

[Anonymous Coward]

The problem with Obamacare is that when Nirvana meets Reality, Reality always wins. And, in this case, on average all US citizens will be worse off as a result.

Re:$10,000 investment in quality 3D printer

[TaoPhoenix]

Yeah, but not since the original days of Libraries has there been a chance for Library/Staples option to "rent a 3d printer".

That could bring down the price to print something to say $100 + materials and Bring Your Own Design.

Re:No escape from the tea party nomenklatura.

[Anonymous Coward]

So... you have herpes? I avoided them by not sleeping with people who have herpes. PEBKAC

Re:Obamacare exists because...

[Anonymous Coward]

No, the problem is that you'll always hear from the losers more than the winners. My brother in law was finally convinced to buy health insurance on the exchange. Two months later ... he was in a terrible accident that would have bankrupt him had he not had insurance. Win for him, but you won't find him on the evening news.

Re:Obamacare exists because...

[Anonymous Coward]

Well it's not that simple and as an addict I know this very well and you obviously have no clue how hardcore withdrawals fucks with your mind. You'll do just about anything once they peak and you start feeling like the word is collapsing in on you followed by extreme mood swings, amplified senses, shitting yourself to death, extreme paranoia, body tremors, cold sweats, extreme nausea, depression, high blood pressure, erratic pulse, distorted time where minuets feel like hours, and that's just to name a few.

The shock from withdrawals from harsher narcotics can kill you and like it or not junkies need help at that point. Luckily for me there is a methadone clinic 1.5 hours away 3 "some people there drive 4 hours one way" hour round trip every day for a long time but now it's once a month. It's the only thing that has let me live a somewhat normal life.

For junkies very few options exist and if you don't believe me go out and buy a few Fentanyl patches and some Heroin and bang that shit for a few months then try stopping.

Plastic is better

[Jumunquo]

Why would you want to do that? That's going to get him p0wned by the guy with metal helmet again.

The jobs that prosthetic hand vs printed hand do

[Anonymous Coward]

Hand Jobs.

Re:One word answer: Liability

[stenvar]

Yeah, face the real world: in the real world, we have things like books and libraries. They are full of ways describing how to build things you can use to hurt yourself. If you build those things and hurt yourself, it's your problem.

Re:Obamacare exists because...

[jonwil]

What is needed is a law or regulation that requires medical care (anything from a visit to a doctor to a prosthetic hand to an MRI to major surgery to a pair of prescription sunglasses) to cost exactly the same amount no matter how it is paid for.

Shouldn't matter whether its being paid for by a government program, by an insurance company, by a corporate health plan or by an individual with cash, it should cost the same amount for the same service.

Re:Obamacare exists because...

[Anonymous Coward]

you are an idiot.

Re:Obamacare exists because...

[jonwil]

Anyone who chooses to pay for cable TV, internet access or cellphone service instead of paying for necessary medical care is an idiot IMO (the exceptions being if not paying for the service will cost more in termination charges than paying for it would or if having the service is essential for the job that person is in or for finding a job for that person)

Re:Obamacare exists because...

[Anonymous Coward]

except that the "union" in this case quotes it's prices assuming that there is no discounted cost and everyone still pays more.

Re:Obamacare exists because...

[fremsley471]

In the Bronx it was not uncommon for people to call an ambulance when they had a cold and wanted to see a doctor to get some cough medicine prescribed

Could you define "not uncommon" please? Daily? Monthly? She saw this herself, or 'heard about it'? And the ambulance crews just waved them onboard, like wide-eyed innocents who could be duped that way? Yeah, ok. Did your wife enquire further, or just write it off as the feckless poor?

In San Jose, she sees tons of drunks and drug users... after a while the doctors have to prescribe something just to get the person out of the way so that patients with real needs can be seen.

In San Jose, they need to have their alcohol and drug addiction services massively improved. Addicts should know that they will be referred to specialists. Why isn't your wife tackling this, rather than just handing out the pills?

Also virtually nobody in the USA chooses between a $90 doctor's visit and feeding their family.

I'm guessing your circle of family and friends includes a wide number > 21 yrs old on minimum wage? Thanks for the perspective on what someone in the top 1% thinks of the bottom 10%.

Re:One word answer: Liability

[Anonymous Coward]

Manufacturer takes the liability, if you print your own prosthetic using open source designs that makes you the manufacturer and that makes you yourself liable for your own prosthetic arm. Sue yourself if you want to.
You think nobody has used open source software in medical devices? Or tried to sue writers of such software when device failed?

Re:One word answer: Liability

[Rick in China]

What, are they afraid someone may use it wrong and... lose their hand? Ok, that's terrible.

Re:obamacare says "no way"

[Maritz]

why should people care about low cost health care items?

Just quoting that one sentence, because it puts the rest of what you say in context.

If it still isn't clear to you, try to imagine if there could be any connection between what these things cost and what insurance premiums cost.

Re:Obamacare exists because...

[sjames]

Now if it was just $90. It's $90 for the visit, a few hundred for unnecessary tests, anywhere from $4 to $400 in prescriptions and then another $90 for the inevitable followup visit.

All inclusive, we pay about double what the UK does for healthcare.

If the nominal amount was actually nominal, it might actually work.

I don't know what hospitals are like in the Bronx, but if they're anything like they are in Atlanta, it's a 6 hour wait in the ER for non life threatening conditions. If there are people waiting that long for cough syrup, there's more to the story. Personally, I just use the OTC stuff or do without.

It may be related to the way the medical profession recommends seeing a doctor for every sniffle, bump, or bruise.

Part of it is other social issues being dumped on the hospitals. If the drunks had somewhere other than the hospital to go where they could sleep it off without being rolled or arrested, they would probably go there.

Re:Obamacare exists because...

[Anonymous Coward]

er, are your friends made of straw too, like your anecdotes?

Re:Obamacare exists because...

[techno-vampire]

...forcing people to get insurance, so that they pay ahead of time, seems like the next best thing.

So tell me, now, how you're going to force people who are living on what they can dig out of the dumpsters behind markets because they don't have any money to buy food to buy health insurance?

Re:Obamacare exists because...

[Anonymous Coward]

Obamacare exists because the poor can't be bothered to pay $90 for a doctors visit. Instead they rack up a $900 bill at the local hospital (because hospitals are required to see you, doctors aren't) and they never pay it.

this makes no sense. so, does the doctor's visit cost $90 or $900?

Re:No escape from the tea party nomenklatura.

[Sique]

I got herpes already at birth. Pray tell me, o wise Anonymous Coward, how I could have possibly avoided it. (Herpes is a STD in just the same sense that the Common Cold is a STD. It can also be transmitted through sexual contact, but this is not their main infection vector.)

Re:Obamacare exists because...

[Cochonou]

I don't know how it really works in the U.S., but in France, if you called an ambulance for a cold, for sure it would be free, but you would end up in the emergency room of the hospital waiting for hours and hours because your condition is not critical... who would do that when you have much better ways to spend a day, especially when you have a cold ?

Three words

[benjfowler]

Medical device racket.

Re:Obamacare exists because...

[Anonymous Coward]

Prices should be available at time of service by law.

Re:Obamacare exists because...

[Anonymous Coward]

Some of us in Australia are even luckier.
I live near a walk in clinic which bulk bills. Never paid them a dime - its all covered by medicare.
I actually don't think they have any cash/eftpos at all.

The only way you "never paid a dime" is if you've also never paid taxes. There is not such a thing as "free health care", somebody else is just footing the bill for you.

Re:Obamacare exists because...

[silanea]

Could you define "not uncommon" please? Daily? Monthly? She saw this herself, or 'heard about it'? And the ambulance crews just waved them onboard, like wide-eyed innocents who could be duped that way? [...]

Some input from a medic from Munich, southern Germany. Depending on which part of town you get assigned to you the number of frequent flyers varies considerably. From experience - no statistics to back that up, sorry - our gold card members are most frequent

1. in the poorest quarters where half the calls turn out to be drunks, junkies (who usually did not intend to see us) and socially isolated, but not necessarily homeless people looking for someone to talk to, and
2. in the older, still not so fully urbanized incorporated villages where elderly people of modest wealth abound who cannot properly care for themselves anymore, whose children have moved too far away to provide constant care but who are too proud to move into a dedicated care facility.

What keeps amazing me is that in spite of my - and other medics' - prediction after the banking crisis and the ensuing wave of unemployment the number of FFs type a seems to be more or less constant but type b has been climbing steadily. So this is only partly an issue of poverty. It has more to do with social isolation, with the increasing difficulty of maintaining a robust social network (not Facebook, the family-and-friends variety) that can catch people when they face difficult phases in their life so that they do not hit rock bottom.

Medical care has long transitioned into social care that along the way can also give you a pill or sew up a cut.

And as to whether the medics are duped: Someone wants to see a doctor, you take them to a doctor. That is what the law says. That is what our job description says. We try to avoid it, believe me. We sweet-talk, we bribe, we threaten. But if the patient is adamant, there is no way we are going to assume the legal risk of refusing transportation. The ER staff is not naive, they know their devoted customers. They will make them go through hell, put them through every annoying and time-consuming test they can think of. But guess what: Because of this practice with increasing regularity they actually find a legitimate medical issue that had gone undiagnosed by doctors who just saw the addict or the annoying elderly or the lonesome hypochondriac and treated that instead of the complaints and symptoms.

In medicine there is no easy answer, no magical solution.

Re:Obamacare exists because...

[nbauman]

In the Bronx it was not uncommon for people to call an ambulance when they had a cold and wanted to see a doctor to get some cough medicine prescribed

Could you define "not uncommon" please? Daily? Monthly? She saw this herself, or 'heard about it'? And the ambulance crews just waved them onboard, like wide-eyed innocents who could be duped that way? Yeah, ok. Did your wife enquire further, or just write it off as the feckless poor?

I am also skeptical of this story, which is at best second hand and at worst an urban legend.

Even assuming it is true, it would point to a transportation problem in the Bronx. I became more aware of this (in Manhattan) when I developed arthritis in my knees and once was unable to walk for a week. In order to get to the doctor, I had to take a cab, which cost me about $40 round trip. What if I didn't have $40? Sometimes there's no public transportation to the hospital even if you can walk. (BTW, according to Michael Moore's movie Sicko, the British hospitals reimburse patients for cab fare.)

Is the City paying thousands of dollars in ambulance fees that they could have avoided by paying $40 in taxi fares? Or $20 for car service?

Another reason I'm skeptical about this story is that I heard a talk by Lewis Goldfrank, director of the Bellevue Hospital Emergency Department, who said that because of budget cuts, they were forced to stop giving out a lot of drugs from the hospital pharmacy, including over-the-counter drugs. So are hospitals in the Bronx giving out OTC cough medicines that Bellevue is no longer giving out? Would the City save thousands of dollars in ambulance fees by giving people on Medicaid money to buy OTC drugs in their local drug store?

In San Jose, she sees tons of drunks and drug users... after a while the doctors have to prescribe something just to get the person out of the way so that patients with real needs can be seen.

In San Jose, they need to have their alcohol and drug addiction services massively improved. Addicts should know that they will be referred to specialists. Why isn't your wife tackling this, rather than just handing out the pills?

That's right. For a doctor to complain about drunks and drug users in the ED is like a sailor complaining about the ocean. Did she know when she went into medicine that a lot of people are sick because of drug and alcohol problems? Did they ever teach her how to deal with patients with drug and alcohol problems?

Goldfrank once asked one of his residents what cases were left, and the resident said, "Just some human garbage." Goldfrank told him, "Anybody who refers to patients as human garbage doesn't belong in this hospital."

It doesn't sound like your wife should be caring for this patient population. Perhaps she should go into a specialty with patients in her own social class, like cosmetic surgery. You can make more money running a hair transplant clinic than you can make by saving a diabetic woman's leg from amputation.

Also virtually nobody in the USA chooses between a $90 doctor's visit and feeding their family.

I'm guessing your circle of family and friends includes a wide number > 21 yrs old on minimum wage? Thanks for the perspective on what someone in the top 1% thinks of the bottom 10%.

I've talked to doctors who were fucking idiots. One doctor said that poor people could afford health insurance if they just spent the cost of a latte every day on health instead. When you're so out of touch with the realities of your patients' lives, it's malpractice. A lot of prescriptions don't get filled because the patient can't afford it.

A doctor wrote an essay in he New England Journal of Medicine about how her hospital was reprimanding doctors for violating the rules against giving patients their own personal money. She said one mother didn't have money for food for herself and her two children, so she gave the mother $20 (and told her it came from a "special fund" so the mother wouldn't be embarrassed).

Thanks for an informed comment

[Anonymous Coward]

Nice to see an informed post, though really what you have said for me only reinforce the subtext of the video, that the medical industry overcharges for products that often do not meet the needs of the patient but are in the practitioners interest. From what you have said it sounds like the patient was originally provided with a product that didn't meet their needs when other less expensive products would, and equally that the product provided was poorly fitted. It sounds like someone made alot of money out of this patient without the patient receiving real benefit for it.

Of course the patient may have originally asked for the more expensive type that didn't do what he wanted and would provide the highest commission for the doctor.

Re:Obamacare exists because...

[nbauman]

...forcing people to get insurance, so that they pay ahead of time, seems like the next best thing.

So tell me, now, how you're going to force people who are living on what they can dig out of the dumpsters behind markets because they don't have any money to buy food to buy health insurance?

Well, you're half right. People who are digging food out of dumpsters will usually be eligible for Medicaid, and making up to about 100% of the poverty level, will not have to pay anything. People who make up to 250% of the poverty level will get significant subsidies to buy Obamacare.

The problem is the people between poverty level and lower middle class. Obamacare pays to expand Medicaid to cover people making between 100% and 250% of the poverty level.

However -- because of the Supreme Court decision in the Obamacare case, the Medicaid expansion is voluntary for the states, and half the states (mostly Republican) refused to expand it. So in those states, poor people really are stuck. They do get kicked out of hospitals and get left to die of treatable conditions. http://www.texasobserver.org/a...

So you're half right. In Democratic states, people get Medicaid, and in Republican states, they do without.

Obamacare is a terrible health plan. Most people who understand the health care system wanted a single payer plan. They predicted that Obamacare would be expensive, lousy insurance. To pay for it, they squeeze most of the money from the lower class and middle class.

Re:Obamacare exists because...

[nbauman]

What they charge you depends on what they treated you for. You don't say what the problem was that led your inlaws to go to the doctor.

If you go to the doctor with a cough or cold, there really wasn't much reason for you to go to the doctor in the first place. You don't need x-rays or antibiotics in the first place.

I can't imagine how a county health department would treat non-residents for free. They're excluded from Medicaid, and hospitals that treat non-residents who can't afford to pay are taking a real beating.

The important point is that you can't compare medical treatments. One patient goes to the doctor because he's a hypochondriac and has a cold, another patient goes to the doctor because he has symptoms of heart failure. If he actually does have heart failure, that's a big bill.

Re:Obamacare exists because...

[nbauman]

Obamacare exists because the poor can't be bothered to pay $90 for a doctors visit. Instead they rack up a $900 bill at the local hospital (because hospitals are required to see you, doctors aren't) and they never pay it.

this makes no sense. so, does the doctor's visit cost $90 or $900?

One of the most common problems is:

1. Patient has asthma.

2. Asthma gets worse.

3. Doctor prescribes drugs to control the asthma (~$60/month).

4. Patient can't afford $60/month for the controller medication, so he doesn't get it.

5. Patient gets an asthma attack, can't breathe.

6. Family calls an ambulance, patient goes to hospital, spends a night in the hospital breathing oxygen and maybe gets a steroid shot. Total cost: $3,000

Medicare saves: $720/year in asthma controller medication.

Medicare loses: $3,000 in one hospital visit.

I saw a printout of the admissions at Montifiore Hospital in the Bronx, and the most common one was an asthma attack. This is what happens to real people, in typical situations. No Ronald Reagan stories.

Re:Obamacare exists because...

[Truekaiser]

Move to japan, that is their system.

Re:obamacare says "no way"

[S.O.B.]

obamacare requires people to buy health insurance by law. there is no escape, muwahahahaha!

The government requires you to have car insurance and there's no outrage over that. It protects you and anyone you might get in an accident with.

How is requiring health insurance any different? It protects you and your family from unexpected medical expenses that would bankrupt anyone but the 1%ers.

Masturbation Machine

[Anonymous Coward]

Some may think it is a joke; but, out there somewhere is a man with no hands and an erection he can not lose.
There IS a need for a hands free solution. Stump broke mules are few and far between, not to mention, untidy and kinda gross.
It would ,of course, have to undergo testing to make sure it doesnt make you go blind....

Re:Masturbation Machine

[Primate Pete]

Somewhere out there, there's a sad robot missing a hand.....

Re:obamacare says "no way"

[flyneye]

All in all, we should put money into 3D printing and regulate the medical industry like the criminals they are.
BUT, be prepared for the Koch bros. to try to stifle that like they did when the govt. presented solar/wind initiatives. Kochs got money in medicine too, surprise ,surprise.

Re:Obamacare exists because...

[CrimsonAvenger]

If you have a medical issue that requires several $90 office visits, and the choice is between paying that or feeding your family (or possibly buying gas to get to your minimum wage job so you don't lose it), how is that "can't be bothered?"

Of course, if you have a minimum wage job, you're not making enough for the subsidies to kick in, so you don't actually get cheap medical insurance under the ACA.

What you get with a minimum wage job is the same Medicaid you got before....

Re:Obamacare exists because...

[jonwil]

I live in Australia and most medical practioners dont care how you pay. I bought glasses recently and the optometrist charged me no different because I was claiming on my health insurance (why would they, they get the same amount no matter how I pay)

It should be like that in the US,

Medical is designed to rob you.

[Lumpy]

Everything "medical" is heavily overpriced for the maximum profits. So there is no surprise that a DIY item is better than the ungodly overpriced device made by "engineers" and then had FDA approval to be sold as a medical device at extortion prices.

Sorry, but a doctor does not deserve to drive a Porsche, he can drive a Chevy. The whole point of becoming a doctor is to help people not be rich.

And the big one ... safety analysis

[Anonymous Coward]

The medical prosthesis has been deliberatedly designed and rigorously (granted, probably excessively) to not damage the user. What toxins are leeching out of the 3-D printed prosthesis? Has the surface been designed to prevent complications in the stump?

Re:One word answer: Liability

[Anonymous Coward]

If someone were to make open source designs avaiable for prosthetics so that people could print them themselves, youâ(TM)d think that the user would be taking all the liabilty into their own hands right? Ha! When something goes wrong, the maker of the 3D printer will get sued. And no matter what kind of disclaimer they put on it, the maker of the 3D schematics will get sued too. All because people find amazing ways to hurt themselves and sue over it. Especially with medical devices.

And here we have an excellent demonstration of why the best and most innovative companies in the US today are run by immigrants. Long time citizens have learned that anything out of the ordinary will be challenged by some unstoppable corporation, by a vindictive government regulator, or by ruthless liability lawyers, and it is therefore best just to keep one's head down and show up for your job a Halliburton on time.

Such a sad life it must be, when the reward for success is persecution.

Re:Obamacare exists because...

[Alistar]

I can agree with Television and Cellphone even, but internet access is pretty much a required necessity these days. Even if you are flipping burgers as your sole income, if you ever expect to get out of that, internet access simply to help find jobs, raise your skills and communicate is so important these days that I would consider it more important than standard phone service even.

Re:Obamacare exists because...

[gnoshi]

An in Australia, if you tried to reverse that you'd get lynched.
People here generally feel that everyone should have access to healthcare regardless of income.

Re:Obamacare exists because...

[pnutjam]

Let me guess, you live in a semi-wealthy urban area.

I'll have to hand it to him

[jennatalia]

At least now he knows to never stop searching for a better product.

Episode One

[TechNeilogy]

The most important subtext here is that this is just the beginning. The printed hand doesn't have to win against the manufactured hand on all counts just now. If it even comes close, think what that means for 3D printing a couple of decades from now, not just for prosthetics, but for many other things. We tend to think of 3D printing in terms of it's ability to displace commodities, which it will never do. What it will do is to provide less-expensive, highly customized solutions from a vast number of sources rather than expensive shelf models from a few vendors. When manufacturers realize that, cue the lobbyists and lawsuits.

Re:Obamacare exists because...

[Digital Mage]

Why piss on the doctors and not the hospital bureaucrats who actually set the pricing rates with insurance. Unless the doctor is running his own practice, it's the hospital network managers who are setting the rates and creating the 2 tier system.

This is akin to pissing on developers for charging a higher price for business level software and a lower price for consumer grade software. In most cases it's not the developer setting the price on that.

Missing the Point

[Grizwoldo]

I think there's a bigger point that many are missing here. The point that I see is that someone put in a lot of work and made something of incredible quality readily available to the masses. You make valid points as to why the pro version costs so much more, but that's really besides the point. The key here is that a quality prosthetic is available to the uninsured, those in a 3rd world country, to anyone who wants it. It's something that the maker community can build on and improve to create a device that really is better than a pro model. If people were paid for this, labor costs would be insurmountable. Instead, prosthetic technology is being pushed forward by the people, for the people, for no real cost to the end user. Brilliant. And as far as not being able to use a 3D printer, come on. I can't reliably fix my car every time, but I sure as hell can find a friend with the knowledge and skills, can watch youtube for easy stuff, and can have someone pay for it. I don't have to buy a new car when the oil needs changed, and they don't have to buy one arm at the cost of an arm and a leg.

Insurance Co are evil

[Anonymous Coward]

This is why insurance companies are so detrimental to USian society. If Adam Smith's invisible hand were at work we would have the best possible health care for the best possible price. (NOTE: I didn't say the absolute best, just best possible with a given societies technological and economic status) Instead we sepperate the payer from the service provider with a for profit intermediary along with millions of legal regulations, lawyers, and the AMAs.

People should stop calling the Corporate Insurance Care, Omama Care or the worse the Affordable Care Act. It is not affordable, nor did President Obama come up with it. It was dreamed up by Obama's boss (the large mulit billion dollar international corporations) that vote our elected officials into office. Obama is to blame for going along with and buying into it. But on the other hand the guy he was running it actually implemented it in his state. There is no difference between Rep and dems, they are both run by the same people.

The fact that you have people buying 42000 hands (yes he bought it, it was just spread out over the coarse of his premiums) instead of the 500 usd one is an indication that our medical system is seriously fucked up. Mandatory Corporate care is just going to make things worse.

-Resistance to a tyrant is obediance to the will of GOD! Are you willing to be subservient to the government and it's corporate overlords? Are you willing to serve?

Re:obamacare says "no way"

[operagost]

I feel that there's something wrong when a powerful lobby is fighting to make Hobby Lobby pay for abortions but doesn't mind people having to pay for their own prostheses.

Re:Obamacare exists because...

[operagost]

Yes you will-- he'll be standing next to the President on his daily fundraising speech. What we never see are the thousands of people who can't afford their premiums for plans that don't actually cover anything until you've spent $50,000.

Re:obamacare says "no way"

[operagost]

The STATE government require you to have car insurance. You can avoid it by not driving a car, or by going to a state with lower or no requirements. Is there anywhere in the USA you can live without health insurance now? You are "taxed" for breathing.

Re:Obamacare exists because...

[Anonymous Coward]

Comments like this actually strike a nerve....

I'm a father of 3 kids, a 17yr old, an 11yr old and an 8yr old. I have a wife in college. I make $36,000/yr as the chief IT guy for a company with 28 retail sites *AND* have several serious disorders (Borderline Personality Disorder, Bipolar Disorder Type II and Paranoid Schizophrenia) making me undesirable to employ which make people think I deserve less of a salary even when I'm highly skilled. I can't even afford Obamacare. My disorders wreak havoc on my social life and make climbing above 40k difficult especially with so many doctor visits, counseling appointments and the occasional lengthy hospital visit. Oh, and my kids share some of these disorders and also need constant care and expensive medication. Medicaid covers my kids but not me.

Can't be bothered? Loser? FUCK YOU.

Re:obamacare says "no way"

[scuzzlebutt]

Contraception != abortion. You're either making a joke I'm not getting or being deliberately obtuse. I hope it's the former.

re

[Anonymous Coward]

Question is why are these people starting a family that they cant afford and shifting the cost of having that family to us the tax payers? I am 35 years old, and I would have certainly loved to have started a family earlier (in my 20s) but had to wait until I had sufficient savings to a point where I can afford to provide my kids with opportunities that they will need in other to succeed. While I believe everyone should have a choice on how many kids they want to have or when to have them, I do not believe it is fair to tax strangers for your reproductive decisions.

Re:re

[kilfarsnar]

Question is why are these people starting a family that they cant afford and shifting the cost of having that family to us the tax payers? I am 35 years old, and I would have certainly loved to have started a family earlier (in my 20s) but had to wait until I had sufficient savings to a point where I can afford to provide my kids with opportunities that they will need in other to succeed. While I believe everyone should have a choice on how many kids they want to have or when to have them, I do not believe it is fair to tax strangers for your reproductive decisions.

This would hold up if people always made rational, well thought out decisions. But we all know that is not the case. Plenty of people on this site will tell you that free will doesn't exist; that we are all driven by reactions to the events around us that are colored by our genetics, predispositions and previous experiences. I don't think it's quite that simple, but the fact remains that we all have stressors and attitudes that shape or choices. We are not rational actors, and our actions cannot always be justified logically.

Re:Obamacare exists because...

[Anonymous Coward]

The Ambulance may be free to that person, but someone pays for it. Not sure what it is like in France, but a little for everything you buy goes to pay for that stuff, so you ARE paying for it, just indirectly and most don't realize it.

Hate to ruin the party...

[Larry_Dillon]

While the expensive commercial hand seems overpriced, it also reflects costs like R & D, field testing and marketing that a printed hand may not have incurred. It seems as though the designers of the 3d printed hand probably looked at different commercial models and copied the best features from them, making this something of an apples/oranges comparison and it may infringe on (so called) intellectual property, if offered commercially. Could the printed hand exist without resting on the shoulders of the commercial products?

Re:Obamacare exists because...

[oic0]

Visit and one X-ray. When I tell you it was 200 at the door I'm not joking. I called around later and found one that was only $150 at the door for a follow up visit, but they just billed me more latter so it came out about the same. The doctor kept wanting to do various tests and I kept saying nope to expensive (I knew it was pneumonia. Give me antibiotics and send me home!).

Re:obamacare says "no way"

[RKThoadan]

> regulate the medical industry like the criminals they are

I got a bit of a chuckle out of this. The Medical industry is rather intensively regulated, and durable medical equipment (the category this stuff falls into) has among the most stringent requirements and an awful lot of red-tape to cut through.It's not necessarily a bad thing, but it does add a good chunk to the cost of these, and DME companies are generally doing very well.

Of course, all that regulation does is give you something your insurance might consider paying for, they probably can't legally pay for non-regulated equipment even if they want to. When you get things cheap enough that we can afford them without insurance, cool stuff can happen.

please

[Anonymous Coward]

Then the focus should be on those making millions in tax breaks by being able to spend a few thousand to game the system in so many other ways, or...and here's a big one, allow actual competition, especially drug costs. Congress is systemically making it harder for the lower classes to be anything other low class, poor people. It seems like instead of being able to put people into real treatment, and treating the addictions, we're just letting our doctors get rid of them. Maybe if we focused on treatments that actually worked instead of the garbage twelve step crap your wife and her colleagues push, she wouldn't have the repeat offenders. There are most definitely systemic issues at play here that need to be addressed, but it starts with your attitude and aloofness about what's actually going on, the issues don't stop or start when they walk into the doctors office.

Re:One word answer: Liability

[Anonymous Coward]

When my dad worked in anesthesia, and a patient would come in without insurance, he would sit him down with the surgeon and say "This wrench we'll use on you costs the hospital $10,000, because it is approved by the FDA and insured, but we can't use it twice, so you will pay us $10,000 to use this wrench in your procedure. This wrench, in my other hand, comes from K-mart and will cost you $5 and is/does the exact same thing. Which do you want us to use?"

He practiced medicine for about 30 years. Worked pro-bono on uninsured patients. He never got sued. He never lost a patient (people would still die on the operating table, obviously, but not from botched anesthesia or in recovery, when the death would be attributed to the anesthesiologist). After taxes and insurance, he estimated that he made about $0.20 on the dollar. You can only imagine how many good things he has to say about lawyers -- and how he felt when Obama said he wouldn't review the Tort System when promising to fix an out-of-control medical cost system.

Re:obamacare says "no way"

[kilfarsnar]

I feel that there's something wrong when a powerful lobby is fighting to make Hobby Lobby pay for abortions but doesn't mind people having to pay for their own prostheses.

Who is making Hobby Lobby pay for abortions? Do employees submit expense reports for their abortions?

Re:Obamacare exists because...

[Anonymous Coward]

As EMTs in the US, we are NOT allowed discretion in refusing service. EMS managers are scared of liability in case someone with a cold happens to have a heart attack thirty minutes later after we refused service. Apparently, there was a civil suit a while back where someone was refused service, died of something unrelated a little while later, and the lawyers argued that he wouldn't have died if he'd been in the hospital. It's absolutely ridiculous.

Re:obamacare says "no way"

[CrimsonAvenger]

It protects you and your family from unexpected medical expenses that would bankrupt anyone but the 1%ers.

If that were true, it would require catastrophic coverage (y'know, like your auto insurance does, or homeowner's insurance does), rather than coverage of routine expenses (which would be like auto insurance that paid for carwashes and new wiper blades or homeowner's insurance that paid for someone to mow your grass)....

Re:Obamacare exists because...

[ganjadude]

an android device with a wifi hot spot at any number of public places will be more than enough if it comes between paying for medicine or paying for internet but you are correct without the internet there is no real way to do a lot these days

Re:Obamacare exists because...

[Anonymous Coward]

Some folks don't have insurance or Medicaid. These people simply refuse to pay. Collectors will call them, but no matter how back their credit, we still have to serve them.

Re:Obamacare exists because...

[ganjadude]

Thanks for the perspective on what someone in the top 1% thinks of the bottom 10%.

I highly doubt he thinks ALL the lower 10% fit in the category of people who abuse the system. He was giving his statement about people who abuse the system. Its telling that you feel that the bottom 10% are abusing the system or you wouldnt have pulled that number out of your ass

Re:Obamacare exists because...

[kilfarsnar]

Also virtually nobody in the USA chooses between a $90 doctor's visit and feeding their family. The choice is usually between a $90 doctor's visit and a $90 cable or cell phone bill.

You need to get out of your socio-economic class more. You may not know these people, but 16% of the US population lives below the poverty line ($23,050 yearly income for a family of four). Those people may indeed have to choose between eating and a $90 doctor visit. It may not be a lot to you, but $90 is almost 5% of their monthly income. They are feeding, housing and transporting four people on less than $450 a week. An unexpected $90 expenditure reduces that to $360. That's a significant hit; one that requires forgoing other things.

Re:obamacare says "no way"

[ravenshrike]

If by add a good chunk of the cost you mean from several hundred to several thousand percent depending on the device, you are correct.

Re:Obamacare exists because...

[Bryan Ischo]

Not uncommon enough that she mentioned it to me as something that she thought was extremely wasteful. Exactly how often it occurred I cannot say, but the impression I was given was that it was something that happened multiple times per week. And she saw it herself, she worked in the hospital. I did say she was a doctor didn't I?

I don't believe that ambulance crews have the authority to refuse service to someone who has called and claimed they need an ambulance. Even if they did, why would they? They get paid for their services when they pick someone up and bring them to the hospital.

Anyway this was in 1998. Things may have changed since then, I don't know.

And you're welcome for my perspective. Talk is free, after all.

Re:Obamacare exists because...

[weiserfireman]

However -- because of the Supreme Court decision in the Obamacare case, the Medicaid expansion is voluntary for the states, and half the states (mostly Republican) refused to expand it. So in those states, poor people really are stuck. They do get kicked out of hospitals and get left to die of treatable conditions. http://www.texasobserver.org/a...

I live in one of those States that refused to expand Medicaid. I live in Idaho. I don't think we could have afforded to do it. Because of another Court case a few years ago, the State of Idaho now has to pay for education in Idaho out of the General Fund. It used to be mostly funded by property taxes at the local level, but now it is funded by Sales Tax at the State level. We also have a Constitutional requirement in Idaho to balance the budget every year. Approximately 60% of the State budget is now Education. Every other State Agency has seen their budget slashed by about 30% over the past 10 years.

And then the Federal Government orders the State to massively expand Medicaid. My State just doesn't have the resources to do it. It isn't because people don't care, we just don't have the income. 90% of the Students in my School District are on free or reduced lunch. Median Family income in my town is $31,000 per year. 20% of the people in my community live below the poverty line. There isn't a whole lot of room to add more taxes to expand another Government program.

If our State was doing better economically, there would be more support for expanding Medicaid. But we are all suffering. The idea of having to pay even more taxes is daunting.

The truly poor still have access to Medicaid in Idaho. The program didn't go away. It just didn't expand it to people above the poverty line.

Re:obamacare says "no way"

[Richy_T]

You can also ignore it by just breaking the law. Which many people continue to do. So your own insurance still needs to cover uninsured drivers and because insurance is now mandatory, your premiums went up. Big win...

Re:obamacare says "no way"

[Anonymous Coward]

Out of curiosity, what part of the medical industry would you like more regulation in? I work for a company trying to assist the medicaid management groups in various states meet the state and federally mandated goals and measurements to continue serving the patients. As part of this, we need to contact the patients by phone. In addition to getting a script for this phone call approved by my own company's directors and legal eagles, we have to get it approved by the management group. This was all done in January, it's now almost the end of April, the state has yet to approve the script in question (and has no feedback for why it's not approved, or when we should expect approval, just that "it's pending"). These goals and measurements need to be hit by December. We're ready to go, the regulators are not. And this is just one of many bottle necks in the "medical industry" that is a result of over used and ineffective regulation.

Don't get me wrong, there are certainly reasons to have certain regulations in the medical industry. But we're long past the "helpful" regulation point.

captcha: inhuman
Pretty much the whole medical regulation industry.

Re:Obamacare exists because...

[Anonymous Coward]

This exists in part because medicare (prescription coverage) and medicare (hospital coverage) are two distinct silos in the medicare system, each with the mandate to keep their costs down. Medicare (prescription) doesn't want to pay for [effective drug here] because it's expensive. So the patient goes without (or goes inconsistently) but as you point out, it shows up as a savings on their bottom line budget. And since their budget has nothing to do with medicare (hospital)'s budget, they have no reason or incentive to change, because total patient care is not part of the medicare mission. At least your private insurance is (usually) responsible (or billed for) the costs of both hospital and rxs.

Re:obamacare says "no way"

[wiggles]

Don't forget the new Obamacare tax on regulated medical devices adds a bit to the cost as well.

Re:No escape from the tea party nomenklatura.

[wiggles]

You, sir, are in the minority. Your mother would have had to have an active infection on her vagina right at your birth. It sucks that you were screwed over by her life choices, but alas, you must play the cards you're dealt. I hardly think that means that society should pay for it in any case.

Re:obamacare says "no way"

[Bartles]

The Koch's are libertarians, you fucktard. My guess is they'd start making inexpensive hands or donating millions to help with printed hands. Harry Reid is the fascist asshole you need to stop listening to..

Re:obamacare says "no way"

[Bartles]

You are very correct, Hobby Lobby does not object to paying for contraceptive coverage. But they cannot support abortifacients that reverse a fertilization.

Re:Obamacare exists because...

[Bartles]

The "poor" who cannot afford $90 for an office visit, were eligible for medicaid long before the ACA went into effect. I on the other hand, had good individual insurance, it was canceled, apllied for the exchange and was forced into medicaid. Fuck you, for defending this shitty albatross of a law.

Re:Obamacare exists because...

[radtea]

Repeat after me: "Data is not the plural of anecdote."

Your post, while I'm sure is sincere and heartfelt, actually takes away from the data-driven policy debate that the US needs on health-care. Anecdotes like your wife's informal observations are anti-scientific, although they can be used to motivate science, which is the discipline of publicly testing ideas by systematic observation, controlled experiment and Bayesian inference.

Anecdotes feed into nice, neat, narrative accounts of human behaviours that rarely stand up to scientific scrutiny. We have long-since rejected them as the basis for the physical sciences.

Aristotle's physics was based on exactly the kind of informal observation and narrative reasoning you are deploying here. If you reject the utility of Aristotelian physics, you need to explain why you do not reject your own reasoning in this case. It's a serious question, and there is no doubt the discipline of science is really, really hard.

Most people can't practice the discipline of science: their anecdotal, narrative cloaking of reality is too powerful and comfortable, and stripping it away makes them feel vulnerable and uncomfortable. But for those few of us who can, in the end it's worth it, because it allows us to create solutions to problems that actually work, rather than pursuing policies that have failed before and will fail again.

The data with regard to health care shows that single-payer, even when rather badly run (as it is in Canada) is much more economically efficient and socially effective than anything remotely resembling the US system, either before or after Obamacare.

Re:Obamacare exists because...

[Bartles]

We were told that 47,000,000 people were uninsured. We passed a law forcing people to get insurance. We were were told 8 million signed up, after 6 million lost their insurance to start with. What about the other 45,000,000 people?

Thank you!

[itwasgreektome]

I was reading through all the comments to see if I would have to mention this myself, but you beat me to it. The engineering costs of translating brain/muscle signals into mechanical signals I imagine would account for the bulk of the $42k engineering price of the other hand, of which the plastic printed model uses none.

Costs are higher than you think

[Anonymous Coward]

chuckle.

$90 is only the tip of the iceburg I'm afraid :D

Afterwards, if your insurance doesn't pay 100%, you get to make up the difference until you have met your deductible for the year.

Example: A bronze plan doc visit will cost $60 just to be seen. The last test I did plus lab work came to an additional $1200. Assuming a Bronze Plan ( cheapest plan ), insurance will pay for 60% of that and you get to pay the rest. 2014 out of pocket expenses are $6350 for an individual, $12,569 for a family. ( So total out of pocket so far is $540 for this ONE visit, PLUS whatever your monthly premiums are. ( Assume ~40 years of age puts the premium at $~300 / month )

The problem isn't how bad the insurance coverage really is, rather the ridiculous prices the medical industry can charge for their services. THAT'S what needs to be regulated. Fix that and most folks won't even have a need for insurance at all. ( Which is probably why it won't get fixed. )

Re:obamacare says "no way"

[Anonymous Coward]

Who is making Hobby Lobby pay for abortions?

Obamacare (aka PPACA) requires all companies larger than a certain size to offer affordable "basic" insurance coverage to their employees on a non-discriminatory basis, or face a hefty fine. One of the elements of "basic" coverage is paying for so-called plan-B emergency contraceptives (one that aborts a pregnancy after fertilization).

Do employees submit expense reports for their abortions?

As with all medical procedures that is an option, but for most typical pharmaceuticals, the pharmacy bills the insurance provider directly (after collecting a co-pay from the patient). However, since emergency contraceptives are required to be available over-the-counter like ibuprofen, one way to pay would likely be for the daughter of a covered employee to pay at the register and submit an expense report directly to the insurance company after the fact w/o informing their parents (if the insurance administration policy would strictly conform to HIPPA requirements).

Re:Obamacare exists because...

[luther349]

that's not the doctors raping you on the rates. its the insurance company's.

Re:Obamacare exists because...

[Anonymous Coward]

The shock from withdrawals from harsher narcotics can kill you

Actually, there are only two drugs that cause withdrawal symptoms which can kill you: benzo's and alcohol. I don't remember what benzo withdrawal does but I do know that alcohol withdrawal can give you fatal seizures. (don't ask... but I do know from up close)
Other drugs (heroin, cocaine, oxy, etc...) are going to give you a really, really, _really_ nasty and incredibly painful set of withdrawal symptoms, but the withdrawal symptoms themselves aren't lethal.

Re:obamacare says "no way"

[stephenmac7]

Posting this to undo bad moderation.

Re:Obamacare exists because...

[nbauman]

The truly poor still have access to Medicaid in Idaho. The program didn't go away. It just didn't expand it to people above the poverty line.

Truly poor? Do you think someone who makes $2,800 a year isn't poor? http://www.idahostatesman.com/...

In my understanding, single non-disabled people aren't eligible for Medicaid in Idaho at all. http://www.medicaid.gov/Medica...

What do you do with these people? Do you leave them to die, like they do in Texas? http://online.wsj.com/news/art...

And then the Federal Government orders the State to massively expand Medicaid. My State just doesn't have the resources to do it. It isn't because people don't care, we just don't have the income. 90% of the Students in my School District are on free or reduced lunch. Median Family income in my town is $31,000 per year.

The federal government offered to pay for your expansion of Medicaid. Most of that money would come from the federal government, and it would continue for at least the next several years. That's because people in other (mostly Northern, Democratic) states, like my own New York, are willing to help other parts of the country get essential needs like health care. If the federal government dropped support for Medicaid in the future, you could have changed the program then.

How can you not afford health care? If your child has a life-threatening illness, do you say, "I can't afford it, I'll just have to let her die"?

You can't do without health care. Your choice is to pay for private insurance, or to pay for it through taxes. Paying through taxes is cheaper. When you cross the border into Canada, they don't have any problem paying for health care.

Idaho can afford to put people in jail for 10 years on a marijuana charge. How come you have enough money for prisons for non-violent crimes but you don't have enough money for health care for the poor? http://cjonline.com/news/2013-... http://www.ktvb.com/news/7-inv...

Idaho has enough money. They're just spending it on the wrong things. Do you want to spend it on schools and health care, or do you want to pay for drug-sniffing dogs and prisons?

Re:obamacare says "no way"

[Anonymous Coward]

That's because the lobbies fighting private businesses can't see two feet beyond their own existence. They don't care about anyone but themselves. They don't realize the damage left in their wake.

Re:And the developer of the 3D printer is relying

[AK Marc]

For many things, the designs are released for free. How do you steal the "free" item?

Not that simple

[Anonymous Coward]

As someone with an on again, off again disfiguring muscular condition, it isn't that simple. Even if I'm not in any way self-conscious about how disfigured I look (and mostly that happens to fortunately be true in my case), it doesn't change the fact that people react differently to me when I look disfigured, and often their reactions get in the way. People around me have trouble ignoring my problems to move on to the unrelated topic at hand or worry about how to react socially, interrupting the normal flow of socialization. That doesn't embarrass me, but it isn't my preference.

Re:Obamacare exists because...

[camazotz]

I'm also trying to wrap my head around the idea of a paltry $90 for a doctor's visit. That's damned cheap, and I'd be suspect of the quality of service is that was the uninsured price they were charging. Next time you get your doctor's bill and an insurance claim, take a moment to do the math on how much you would have paid without insurance, and that'll give you a more realistic picture of uninsured health costs. If it were only $90 we wouldn't be having this discussion........I still have lingering medical debt from my uninsured days fifteen years ago.

Re:No escape from the tea party nomenklatura.

[Sique]

Oh, my mother also has the herpes since birth. It runs in the family, so to say.

Also not in the news

[KingMotley]

You also won't find in the news the guy next to him who decided he didn't need health insurance, also got into a terrible accident just like your brother. Of course, he couldn't afford it, landed up declaring bankruptcy, and while bad for him, the hospital and doctors got stuck with the bill, so now they need to pass it on to the rest of us. And welcome to the $15 asprin.

I'd rather have the $42,000 model

[Anonymous Coward]

Because I'm so wealthy and rich and evil and I throw such lavish parties

Re:obamacare says "no way"

[flyneye]

95% corporate, 3% R&D, 2% all other

Re:obamacare says "no way"

[flyneye]

The Kochs vote libertarian, maybe, probably not. They DO put up a front anyway.
Did you get a load of their Citizens for Prosperity extreme right ads protecting their investment in energy? Guess not.
Sayyyyy, didnt I bang your mom?

Re:obamacare says "no way"

[Bartles]

No, I'm pretty sure my mom hasn't been laid since about 1987. That's when my dad died.

Re:$10,000 investment in quality 3D printer

[laird]

There are plenty of ways to "rent a 3D printer". The most obvious is that you can use a service bureau such as ShapeWays, which operates high-end 3D printers (the $100K+ kind), which you "rent" by sending them STL files to print and ship you. And there are numerous "Maker spaces" that have 3D printers that you can use for the cost of membership. And there are enough people with 3D printers around that you can ask around to see who can do you a favor and print the parts for you. Or you can look on the e-NABLE map http://enablingthefuture.org/c... and see if there's a group member in your area who can help you out. There are several universities doing substantial volumes of this work as well, because their students learn a lot by designing and printing parts and working directly with patients.

Re:obamacare says "no way"

[Anonymous Coward]

"Knock Knock"
"Who's there?"
"Tijuana"
"Tijuana who?"
"Tijuana bring your mother to the gang bang. Yes you do. It's been a long time since she had a screw. When she was younger, and in her prime, she used to gang bang all the time."

FDA is the BIG PROBLEM

[PortHaven]

For almost ALL medical devices...

FDA, makes a $40 CPAP cost $1,000 and a $20 CPAP mask $800. It's disgusting. MRI machines are millions of dollars but ancient technology at this point. Even Xrays, I mean consider that Cathode ray tubes are ancient, you may recall them as CRT monitors. But Xray machines are still big bucks.

Sure, it's all in the name of regulation and safety. But that is just dumb, because lets be honest. It's like building inspections. Sure, you're required to get your home inspected for safety and liability during construction. But when, if ever, have you heard of anyone getting to sue the city inspectors when something was done wrong and passed. Does it ever help against the contractors? Nope, they just start new LLCs.

The FDA's role should be one of advisory, and spec mandates. In other words, the FDA should simply publish open source reference designs and safety specs.

No X-ray machine should emit more than x amount of radiation, and backscatter should be no higher than y. And here is a reference design that meets that spec. As long as the safety is achieved, than it should be fine.

Oh, and they could offer a testing lab to certify. If you sell, and don't get certified, you could be sued for greater liability during injury. But regardless, not necessary.

This would do a lot to greatly reducing medical costs. DVD players were $4,000 and now they're $40. The same should be said for CPAPS to MRI machines.

The only reason

[Anonymous Coward]

That the choice between feeding a family and paying a $90 doctor visit is because to many people, $90 is more than they could ever come up with to feed a family.

Of course, seeing as how your wife is a doctor, I'm pretty sure you have no idea what it is like for the vast majority of the people that do your work for you for minimum wage.

boy, you really are that naive then.

[publiclurker]

no wonder you fall for the teabagger rhetoric.

Which they don't have to.

[publiclurker]

of course, teabaggers and religious idiots don't care for science, do they.

Re:Obamacare exists because...

[publiclurker]

ever hear of families and family plans?

Re:Obamacare exists because...

[publiclurker]

So your insurance company canceled you and you blame everyone else. Typical.

Re:Obamacare exists because...

[publiclurker]

That's because those garbage plans are not allowed. The reason your imaginary thousands don't get reported is because every time the tebaggers bring one up, the adults check it out and find out that it's total BS.

You obviously have no idea what society is.

[publiclurker]

other than a source of things for you to leach off of without any intention of giving back.

Re:obamacare says "no way"

[laird]

Of course, in reality the contraceptives that Hobby Lobby objects to aren't actually abortifacients. At this point Hobby Lobby is fighting for the right to impose *incorrect* beliefs on their employees.

If people have the right to not have to pay for things that go in any part towards things that they object to, then millions of pacifists are due a huge tax break!

Re:obamacare says "no way"

[laird]

Plan-B does not "abort a pregnancy after fertilization", it prevents the egg from implanting. Women's bodies do that millions of times a year - good luck making that illegal.