Wii Balance Board Gives $18,000 Medical Device a Run For Its Money 422
Gizmodo highlights a very cool repurposing effort for the Wii's Balance Board accessory. Rather than the specialized force platforms used to quantify patients' ability to balance after a trauma like stroke, doctors at the University of Melbourne thought that a Balance Board might serve as well. Says the article: "When doctors disassembled the board, they found the accelerometers and strain gauges to be of 'excellent' quality. 'I was shocked given the price: it was an extremely impressive strain gauge set-up.'" Games controllers you'd expect to be durable and at least fairly accurate; what's surprising is just how much comparable, purpose-built devices cost. In this case, the Balance Board (just under $100) was compared favorably with a test platform that costs just a shade less than $18,000.
"Not for ________ use" (Score:5, Insightful)
What determines the price of a scale is not just its equipment or accuracy.. but also the insurance the manufacturer has to carry in case something goes wrong. That's why medical devices are more expensive... you're also paying for the liability of somebody being misdiagnosed by a technical malfunction. Highly unlikely, but the money that has to be paid when that happens and gets proven is huge.
Re:"Not for ________ use" (Score:5, Insightful)
What determinds the price is production, and demand. The wiimote is mass produced, which makes the price even less. And its in high demand.
Medical equipment? There is a certain number of hospitals involved ordering X amount of copies, and the demand is static. They will also pay for it. Basically its overpriced, but the question is how much its overpriced.
Re:"Not for ________ use" (Score:5, Interesting)
What you fail to see, and what the GP identified successfully, is risk. Now, with average consumer equipment the risk is very close to zero. If it doesn't work, no biggie. Get the customer to return it and 2-4 weeks later he'll get a replacement. If he gets hurt in the process of using it, no biggie either. We just told him we're not responsible for any dumb accident he might run into. If that can't be excluded, the price goes up.
I hate car analogies like anyone, but in this case it's one of the things where liability is part of the price. Faulty cars can result in incredible cost, and that is reflected in the price. You get the same with dangerous work and the compensation you get for it. And illegal drugs are not really expensive due to high manufacturing costs either, or an insane demand compared to the supply (you'd be surprised how high the supply for some drugs really is...). It's the risk involved.
You can actually get medical equipment very cheaply, provided you declare that you will not use it for human use. What else you could use a heart monitor for is beyond me, but when they can strip liability from the price tag, the price goes down. Considerably down. Think 1/10th of the "all warranties included" price tag. It's probably easier to see for the everyday user with consumables. Syringes can be used for more than injecting something into a living body, thus you can get the same syringes with or without "medical" quality. Both kinds are essentially the same syringes. One kind is "certified" and thus with all liability and warranty attached, one isn't. Both are equally sterile, simply because the manufacturing process is the same, they roll off the same presses. Now compare the price.
Re: (Score:3, Interesting)
Risk makes health care expensive? I though that including malpractice reform in health care reform wouldn't really matter with respect to cost......
Note as shown very directly by this article, the cost of malpractice insurance at every level of healthcare is a major driver of the enormous cost and leaving tort reform out of the current health care "reform" was unacceptable.
Re: (Score:3, Insightful)
Actually, NOT adding it would be insane.
The interesting part is that affordable healthcare saves money. When someone can actually go to a doc when he has a minor disease instead of trying to fix it himself (often by simply dumping antibiotics into his body, which can make it worse over time), he will get well again faster. Worse yet, if he decides to ignore it (because he simply cannot afford fixing a minor, non crippling problem with his body), in the long run he might end up as a cripple, unable to work a
Re:"Not for ________ use" (Score:5, Insightful)
We're talking about a diagnostic device. Not a life saving device. Not even for internal use. It is quantifying balance: we know the patient has balance, we just want to know how much of it. It is not even diagnosing whether a patient has a disease or not, or what disease a patient has.
If it is faulty, the doctors will know. Either it doesn't work, or the values do not make sense. A doctor with a little bit of experience will know from looking at the test about where the number should end up, and if out of expectations can take another device to test again. They're cheap, so you can have more than one on hand.
Sterility is not even an issue here (beyond basic cleanliness of course), it is not for use in an OR.
The main reason these things are/were so expensive I think is because of the very small product runs. Really small: hundreds, maybe a few thousand. There was no other use for these sensors, so development cost has to be shared over a few thousand pieces at most. Come the Wii with its gadges using basically the same tech, and both production cost and development cost per unit drop enormously. It matters a lot if you share costs between 1000 or 100,000 units.
Then probably the medical version is much stronger and sturdier, lasting longer, but the price difference is too big to make up for that.
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Would this "FDA" be the "Food and Drug Administration" in the USA? When the article mentions the "University of Melbourne", the only such university I am aware of is in Victoria, Australia. Australia does healthcare very differently from the US.
Re:"Not for ________ use" (Score:4, Insightful)
Production and demand are sufficient to determine price only when the market is perfect.
This is not true for medical equipment, because the market is highly regulated.
I work in the field of medical devices, so I see this every day. We have to keep copious records of the design process of the hardware, the testing to validate and demonstrate perormance, and each device has a record kept of every periodic maintenance call and every service call for a performance problem (e.g. breakdown).
All this adds to the cost to bring a product to market, and then adds to the cost of keeping a device running.
And on top of all that, the health "systems" that provide patient care in the USA are an extemely imperfect market...
I have seen many instances in the North Eastern states of extreme over-capacity. Great, in that if you need an X-Ray or an MRI you can get it done within fifteen minutes (which is three sets of paperwork to prove you can pay). But that means that a device is sitting around 80% of its time unused. But other posters will point out, "you can't put a price on your health", so people will cough up to $3200 for a simple abdominal X-Ray that takes, literally, 45 seconds of device time. The same X-Ray costs (I'm told) around $800 in Japan, and less in France or the UK. But in France and the UK, you turn up for your appointment, fill out no extra paperwork, but wait for maybe 90 to 120 minutes to go under the device, because it is utilised at 90% to 100% of the time.
Finally, even though you state that "demand is static", this is not quite true. There is relatively little growth in the number of hospital beds places in the USA,Europe and Japan, but the demand for every increasing resolution in imaging, ever faster turnaround, every simpler interfaces so that less qualified (i.e., cheaper) staff can operate the device for more qualified staff (i.e. doctors) to spend more time doing diagnoses... And that is in the mature, saturated markets of the world... then we can talk about BRICS...
AC
Re: (Score:3, Insightful)
depends:
- some costs are fixed: design, overheads
- some costs are linearly progressive: materials, though may be degressive w/ volume discounts
- some costs are degressive : marketing, certification and legal (if applicable), maintenance infrastructure (if any)...
so as a general rules, the more you sell, the cheaper it is to make. The exceptions are capacity constraints, either materials or manufacturing capacity.
now, price != cost, and prices may rise even though your costs fall:
- limited market: no point c
Re:"Not for ________ use" (Score:5, Insightful)
There is no justification for an $18,000 price difference for what amounts to the same fundamental technology. I don't need a formula, or theories as to why this is. The medical industry is full of a bunch of crooked greedy bastards. They use the same basic technology to accomplish the same result, probably with the very same components, all of which can obviously be had for very cheap. Costs are applied at the component level. If you can buy the same components for a Wii as in this other piece of equipment, their prices should be a bit closer. Our medical system has been gamed so badly for so many years, that a hospital doesn't even blink when they see $18,000 for a piece of equipment. They will happily pass the costs on to the patient, and the patients health insurance.
If this isn't a case of price fixing then I don't know what is.
What we really need is transparency is pricing for all medical costs. Force manufacturer's to provide their component costs for everything like eqiupment, drugs, and consumables, so that the consumer can see exactly what kind of markup their paying for.
Re:"Not for ________ use" (Score:5, Insightful)
You have obviously never worked in an industry with high quality control standards. The price of some product isn't the sum of its individual components. You have to pay people to design it, and people to test it, and then pay insurance on it. For small markets, this means that the price is very steep for even simple things. What would you price this device if the parts cost $100 per unit, but the R&D cost (2 doctors and 2 engineers for 1 year) was $1 million, the insurance cost was $500,000/yr, the customer support cost was $100,000/yr, and the market size was 100/yr?
Re:"Not for ________ use" (Score:5, Informative)
You have obviously never worked in an industry with high quality control standards.
I worked at a nuclear power plant that happened to be on a Navy ship. One of our supply guys had to order some simple part (a resistor or something) that was categorized as part of the nuclear plant, and it was maybe $100 through the supply system. He took the part number home, called the supplier from his home phone presenting himself as a hobbyist. It was about $1 for the same part. I guess we were paying $99 for the QC sticker they put on it before they sent it off through the supply system.
Disclaimer (because /. has taught me I need one): I'm not saying all QCed stuff is expensive for no reason. Just that sometimes people really are getting ripped off in the name of QC.
Re:"Not for ________ use" (Score:5, Insightful)
> I guess we were paying $99 for the QC sticker they put on it before they sent it off through the supply system.
Actually, there's a very good real-world example of a cheap electronic component that nevertheless can be very expensive when its quality is absolutely certified: electrolytic capacitors. Today, in 2010, brand new devices are STILL being manufactured with electrolytic capacitors that have substandard electrolyte. This is a problem that was supposed to have gone away YEARS ago. Why is it still around? Because the bad electrolyte is a tiny, tiny bit cheaper to make... and the capacitors tend to work just fine for at least a few months. In other words, they fail prematurely... but not immediately.
If you're building something that absolutely, positively, must NEVER use an electrolytic capacitor with bad electrolyte, you have no real option besides buying only capacitors that are certified (and can be audited) all the way from you (the company building the device that uses them) to the chemicals used to make the electrolyte itself. It's not enough to buy "a good brand". To get that level of certification, every party along the way -- distributor, wholesaler, supplier -- has to be certified capable of keeping them secure and properly stored. Otherwise, an employee (or manager, or higher) at the supplier could substitute counterfeit capacitors, then sell the genuine ones elsewhere.
The point is, that degree of auditing and handling is insanely expensive, because it involves SO MANY different parties (all of whom want to be reimbursed for the extra trouble). It's made more expensive by the fact that there are (fortunately) very few things that really NEED that kind of quality control. Life support equipment and nuclear power plant control systems are obvious excamples where it's justified, costs be damned.
That said, this particular device isn't life support equipment, regardless of how hard someone might try to make it sound like the tiniest malfunction would lead to death or injury. I think it's safe to say that this particular device's price is all but guaranteed to come down a few thousand dollars if they want to keep selling it.
Re:"Not for ________ use" (Score:4, Insightful)
Are you though? Because I bet if that did happen they still wouldn't assume liability.
Re:"Not for ________ use" (Score:4, Funny)
This would be more important in a nuclear reactor and not so big a deal to a hobbyist.
Depends what his hobby was. Muhahahahah....
Re: (Score:3, Insightful)
Well, specifically in regards to the military, this is not true. Since you cannot, generally, sue the US government because of sovereign immunity, they don't care about insurance to cover failure. All those components they buy, with few exceptions, don't come with additional guarantees unavailable through standard retail or wholesale channels. The price is because of vendor contract lock-in in this case.
Re:"Not for ________ use" (Score:4, Insightful)
I get it. So what you are saying is that governments would be far better off manufacturing all this stuff themselves rather than contracting it out. Not only are you eliminating wasteful profits but also enormous insurance costs because the governments can readily self insure.
Now lets have a little bit of fun with the insurance lie. If insurance costs are so high, then the private medical manufacturers must really, really crap, because that is what drives high insurance premiums, lots of failures (no failures, low premiums), so get rid of the private corporations because just like insurance companies, the government should also recognise them as being high risk. The quality control systems in all medical manufacturing facilities must be so bad, that no insurance companies give any of them a discount.
I would love to see some of the warranties on medical equipment, from the sounds of the marketing trolls it must be decades but I bet a lot of that junk comes out with nothing better than 90 days (now that's a big insurance risk, ha ha). The underlying reality is that all this low manufacturing run custom equipment should be manufactured by government, because no matter how inefficient they are, it well still be way cheaper than paying for inflated profit margins at the manufacturers, oh yeah and the insurance companies. Especially the insurance companies because according the medical manufacturing trolls, the very, very expensive quality control system means absolutely no failures.
Re: (Score:3, Interesting)
And people are telling me elsewhere that tort reform and health care are not the same thing. I disagree with that. If hospitals were allowed to post a sign saying "We'll do our best to help you, but if we fail or make it worse we're not responsible." then health care would cost a whole lot less.
Re: (Score:3, Interesting)
I believe you are confusing the words "price" and "cost." It would be laughable to suggest the cost of such an item was anywhere near $18,000.
But the price of something has very little to do with its cost. The price of something--anything--is very quickly and easily determined using the following formula:
Whatever someone will pay.
If someone wants to have their wallet fleeced to the tune of ~$17,500, I sure as hell wouldn't try to stop them.
You miss the point here - cost is irrelevant (Score:5, Insightful)
There is no justification for an $18,000 price difference for what amounts to the same fundamental technology. I don't need a formula, or theories as to why this is. The medical industry is full of a bunch of crooked greedy bastards........
I think your missing the point here.
It's not how much it costs or if there ripping us off .
"The how much it costs" argument is irrelevant.
Its the fact that we are now getting devices, which are used to play games, in our homes which are comparable to highly sensitive medical devices.
WOW !!!
The doctors in this melbourne hospital should also be congratulated for looking at alternative ways of doing things.
Re:"Not for ________ use" (Score:5, Insightful)
re: FDA approval, etc. (Score:5, Interesting)
Yes, but all of what you just said further illustrates why govt. bureaucracy is causing our medical expenses to spiral out of control. It's not sustainable. The only people who really "win" in this mess are the attorneys, and all the talk of medical reform in the USA right now conveniently skips changes in THAT area.
Not long ago, I was reading about a heart surgeon in India who among other things, got tired of the high cost of medical sutures. Apparently, the only supplier of the ones he needed was the Johnson & Johnson company, and they kept increasing prices each year. He finally got some investors together, who opened their OWN manufacturing facility to produce the sutures in India at a far lower cost, so he can now buy from them and cut at least 35% off of his annual expenses for them. (Since he's running huge clinics doing nothing but heart surgeries there, he benefits more than most would from "economy of scale".)
It seems to me, that's exactly the type of change the medical field needs to see. Unfortunately, government legislation often seems to stand in the way of progress here in America. (A doctor my friend knows heard this story about the medical sutures and angrily protested, "But I'm not even legally ALLOWED to invest in such a thing as a surgeon in the US!")
As it stands now, doesn't it bother you at least a LITTLE bit that you had to fork out upwards of $250,000 in *lawyer fees* just to prove that it was ok for a hospital to start using what's really just a touch-screen PC in a hardened metal frame?
Re: (Score:3)
So here's the rub. If 'the government' backs off and lets device and drug companies be less rigorous and more nimble in their work, whoo whoo...more change in less time, innovation, costs drop, new products stream onto the market...yeah.....happy day....
Until someone gets hurt because the company didn't do the things you should do when designing products that are supposed to save lives. A couple of years back the FDA did exactly this to a company making...ohhh flu vaccine. Seems they cut the company a bi
Re: (Score:3)
Everything you wrote sounds like a reason to dissolve the FDA (and perhaps a chunk of the legal system) and start over.
You mean "Start over with snake oil, patent medicines, radioactive sports drinks and toothpaste, miracle healers and other kinds of quackery, plus a couple deaths due to drugs that have been tampered with, and a whole new bunch of thalidomide cripples just to be sure"?
No thanks, I'll pass.
Re: (Score:3, Insightful)
Moreover, even when there are multiple insurance companies, it's generally very costly for them to send people around checking out all of the different options for all of the different hospitals to determine what they'll pay for what.
The competition needs to be pushed out a level: to the patient. Patients need to have a stake in the cost of their own treatment, and they need to have the ability to easily compare prices between competing providers (hospitals/physicians). It's the decentralization of cho
Re: (Score:3, Interesting)
Any health reform that does not change this won't contain costs. What you are wrong about is the idea that a one-payer system can't change this. It may not - I can think of several plausible national health care systems that wouldn't - but some in Europe do.
Agreed. I was speaking primarily of the approaches being bandied about for the US, all of which would strongly favor low or no-deductible coverage and trivial co-pays.
That said, I am not in favor of a national health care system.
A systen where deductibles were $10,000 minimum with 50-90% of costs (depending on price etc) were covered after that, would do wonders for keeping costs down and improving medical tech (that last bit national health care tends to be rather poor at)
T
$10K is a bit higher than I would go, especially if the deductible resets annually. For many people a $10,000 bill is a financial catastrophe. I'd start it at half that, maybe a little less. Although I'm generally quite libertarian, in this case I think I'd also like to see forced health care savings. The collection process could be handl
Re: (Score:3, Insightful)
Demand curves probably look like this:
Demand for a medical balance board @ $18000, maybe 1000
Demand for a wii fit @ $18,000 maybe 100
Demand for a medical balance board @ $100, maybe 10,000
Demand for a wii fit @ $100, maybe 10,000,000
Engineering cost for both, probably $1,000,000
Re: (Score:2, Interesting)
Actually, you're forgetting the "there's only 2 companies on the planet that build this particular specialist piece of equipment so we're going to charge you through the nose for it" surcharge. Let's face it, medical appliances are outrageously expensive because they can get away with it, not because they actually "cost" that much.
Re: (Score:3, Insightful)
Tell Washington, DC about that. If companies are charging a monopoly rent, they should be regulated.
Re:"Not for ________ use" (Score:4, Insightful)
Those companies are only abusing their monopoly if someone new comes in and is pressured out of the market by anti-competitive tactics. If no one else wants to take advantage of the opportunity to compete in a market, you're looking for a different reason why. Off the top of my head, perhaps there's too much government regulation making it too difficult to get into that field. Too much insurance costs because of liability concerns in an overly litigious society. Perhaps just no one realized how much of an opportunity there was here because no one really has a clue how much healthcare costs these days since no one using it looks at the bills anymore - they just have their insurance cover it and complain when there's a problem. How do you expect competition in a market to lower prices when the consumer doesn't decide what features to invest in and compare based on price?
In other words, the answer you're looking for is not "more government" - that is the problem.
-N
Re: (Score:3, Insightful)
That's a theory that's debated in college, and I take the opposite side. Proof that somebody was hurt shouldn't be needed to prove monopoly abuse. What about the company that was never founded because somebody told the would-be founder that it wasn't worth doing? If nobody's willing to extend you credit because the monopoly exists, then that's a barrier to entry.
Re: (Score:3, Insightful)
The threat of competition is enough to keep a natural monopoly competitive. If said company becomes too abusive, new businesses will be profitable regardless of entry barriers.
Citation needed that a natural monopoly that isn't abusive exists.
Re: (Score:2)
There's another way to keep them cheaper for clinical use. Create an approved testing regimen, and certify each one that's going into a clinic. For those prices you could afford to perform $9,000 worth of tests on each and every board, and they'd still be half the price.
Re:"Not for ________ use" (Score:4, Insightful)
What determined the price was the word "medical". It's a word, like "marine" which denotes adding zeros to the price of an item that costs only a moderate amount to actually manufacture.
Re:"Not for ________ use" (Score:4, Insightful)
Re: (Score:3, Informative)
It used to be the same with "unix" hardware in the 1980's/1990's, particularly with commodity components like mice, printer and scanner cables. An RS232 cable for an Apple Mac or PC clone that cost around $20, would be marked up for $200 for a UNIX workstation. To make sure that only the official cable was used, there would be loop-back configurations built into unused pins at each end of the cable, so that a connector patched up from twenty-five core cable and a couple of RS232 snap connectors wouldn't wor
Re:"Not for ________ use" (Score:4, Insightful)
To make sure that only the official cable was used, there would be loop-back configurations built into unused pins at each end of the cable, so that a connector patched up from twenty-five core cable and a couple of RS232 snap connectors wouldn't work.
Kind of like how Apple charges $35 for an iPod USB wall charger, and makes sure that my generic USB wall chargers / powered USB hub won't work.
Re: (Score:2, Insightful)
Let's just say for the sake of argument the Wii balance board, and the medical device both cost $10 million to research and design.
Ignoring the additional compliance, insurance, and qualification a medical device VS a toy has to go through to be produced.
Let's just say nintendo or their insurer was really concerned about safety, and perfect operation of the debe no complaints.
Further, let's say once all the preliminary work was done, the Wii board cost $75 per unit in materials and labor to manuf
Re:"Not for ________ use" (Score:5, Informative)
Nice post with a nice result, although you used some mystery maths to get there.
Sales proceeds need to be: $93.5 million. That means, the price for each unit needs to be: $93.50 per unit. What if they want a healthier profit margin? Their sole purpose in life is to manufacture medical devices, they don't sell software -- they need a good profit margin from selling their product. A fair profit margin is 100% or more. To achieve that, the minimum price is $930.50 per unit.
First you say 85 bucks is their break-even point, which means they have to sell it at 93.50 for a 10% profit margin (1.1 times 85). Then you somehow (almost) multiplied by 10 to get 930.50 bucks?
If 85 bucks is break-even, then they'll have a 100% profit margin selling at twice that, or 170 bucks. Not 930.50.
Also, 1 million sales is unrealistic for a niche product, it will probably be more like 200,000 sales. To maintain a healthy product with 1/20 of 1 million, the actual price needed will be 20x that, or $18,610.00
200,000 is 1/5 of 1 million. So following your line of thought, the actual price would be 5 times 170, or 850 bucks.
You did, however, say they produced 1 million of them, costing them 75 million in parts and labor. If they're only making 200,000 those costs would only be 15 million. Adding 10 million research costs to that makes a total of 25 million in production costs. To get that 100% profit margin, they'd need to earn 50 million in sales, meaning 50 million bucks/ 200,000 units = 250 bucks per unit.
Holy smokes, that's nowhere near the "$18,000 medical device" price.
Re: (Score:2, Informative)
Another question to ask is exactly how much time/effort/money Nintendo went through to get this controller FDA approved. What? It's not FDA approved?
Re:"Not for ________ use" (Score:5, Informative)
exactly. the FDA requires significant documentation of the hardware and software along all lines of the R&D, and manufacturing process. which are actively audited by the FDA. documentation, and documentation compliance is a huge chunk (not the largest, but definitely a line item on their accounting paperwork) of their budget.
Re: (Score:2)
exactly. the FDA requires significant documentation of the hardware and software along all lines of the R&D, and manufacturing process. which are actively audited by the FDA. documentation, and documentation compliance is a huge chunk (not the largest, but definitely a line item on their accounting paperwork) of their budget.
Seems to me that all this documentation and testing is perhaps not all that necessary for some "medical" devices.
Sure, something that's going to irradiate me to kill tumors or check for broken bones? Go ahead and get it all kinds of FDA tested. Pills? Drugs? Implants? Yeah, let's get those tested too.
A balance board or a scale? I'm thinking it's probably good enough to make sure they read accurately and then call it done. What's the worst that's going to happen if a scale malfunctions? Is anybody go
Re: (Score:3, Insightful)
What about the software that interprets the data? The driver to connect the scale to the software? Yeah I bet you could slap together some code in python in a day or two, but it still has to be documented, and verified by the FDA. I'd rather they be too careful, and have a device they can trust, rather than look at some data, notice an anomaly, and dismiss it because "the software is buggy", when in fact it might be significant in that you had a minor stroke and they didn't catch it due to crappy data coll
Re: (Score:3, Insightful)
But I'm suggesting that "good enough" may very well be good enough.
It depends on what you are measuring. A scale is indeed measuring only one parameter, but a balance board can easily measure several. You need syncronized access to all sensors to recreate your movements on the board, you can't just poll them one at a time.
If we're talking about a scale, do we really need to spend $10,000 for FDA testing and approval? It measures weight... Can't you pretty much verify that with another scale or two?
Do
Re: (Score:3, Insightful)
Someone could be misdiagnosed and sue is what could happen.
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How about the testing to get approved for medical use? Validation that it actually produces results good enough to base a medical diagnosis or treatment on? And the limited market that the medical devices get? When you get specialized, niche devices, the cost to get one is going to be high.
Volume manufacturing (Score:2)
Actually, it's more a matter of volume manufacturing. If you have to spread out your fixed manufacturing costs among only a few hundred of something for some hospitals, they're going to be very high per item, thus resulting in a very high price. If you mass market millions of them, those same costs might only be a few pennies per item.
Before the Wii, there wasn't much demand for mass producing these kinds of components.
Re:"Not for ________ use" (Score:5, Insightful)
What determines the price of a scale is not just its equipment or accuracy.. but also the insurance the manufacturer has to carry in case something goes wrong. That's why medical devices are more expensive...
You're missing a couple other issues:
1) Provably sterile out of the box. If the patient has an open foot ulcer, and some Chinese dude sneezed on the board before he wrapped it up, and then the patient dies of infection...
2) Bodily fluid proof, if not disposable or autoclave-able. The board is too expensive to toss and too weak to autoclave, furthermore god only knows what it'll do electrically when a patient pees on it. Or if not pee, some highly conductive cleaning fluid. Or blood.
3) Intrinsically safe. In the unlikely event of using or storing the board in an atmosphere contaminated by flammable anesthetics, it won't blow up. Closely related to oxygen proof plastics. No great achievement to make a plastic that does not support combustion in plain ole air, but I have no idea what plastics (if any) will not continue to burn in pure oxygen. And you know some heart patient is going to drop their oxy mask on the wii board and the batteries will spark at the same time. Also if the patient collapses and you need to use the crash cart, you don't want the electronics inside to catch fire. Would be unfortunate to restart a patients heart only to have the patient die of infected burns.
4) Proven EMC/EMI compatibility. Last thing you want is for the board to interfere with the patients portable EKG machine or whatever.
5) There are all kinds of allergen related issues. For example, no latex (rubber bands) used internally for any part at any time during construction. Peanut oil sounds like a "green" lubricant for metal machining, etc, until you run into someone with an allergy.
6) Connected. It needs to be sold by the current collection of booth-babe saleswomen with open purchase order accounts at the hospital. Its possible the hospital has no pre-existing relationship with any place that sells wii balance boards... Literally no way for purchasing to buy one...
7) Software licensing which probably prohibits this kind of activity, along with controlling nuclear power plants and air traffic control. "Lean forward to lower the control rods, lean back to raise the control rods. Lean left and right to control primary circulation pumps. Walk in place as if running away to declare a SCRAM."
Theres a bunch of other "EE" related medical device rules that are pretty interesting, especially as regards AC power supplies, until it gets too creepy realizing a bunch of folks died before they figured the rules out.
Its not so hard to follow the rules, its just HARDER to prove someone in China followed the rules...
Re: (Score:3, Insightful)
What determines the price of a scale is not just its equipment or accuracy.. but also the insurance the manufacturer has to carry in case something goes wrong. That's why medical devices are more expensive... you're also paying for the liability of somebody being misdiagnosed by a technical malfunction. Highly unlikely, but the money that has to be paid when that happens and gets proven is huge.
There's a lot of stuff that goes into a device to "certify it for blah blah use". Like you said, liability insurance. There's also a lot more stuff. Like the fact that doctors can expect to recoup greater amounts of the price of the unit than a gamer is likely to.
Take the same device, everything the exact same. Sell it to people who are paying out of pocket, and sell it to people who have insurance to cover it, and the people who are paying out of pocket are going to spend a lot more time assessing the
Medical insanity (Score:3, Insightful)
What determines the price of a scale is not just its equipment or accuracy.. but also the insurance the manufacturer has to carry in case something goes wrong. That's why medical devices are more expensive... you're also paying for the liability of somebody being misdiagnosed by a technical malfunction. Highly unlikely, but the money that has to be paid when that happens and gets proven is huge.
So they system is "protecting" patients right out of being able to afford treatment, and people are still willing
Re: (Score:2)
What determines the price of a scale is not just its equipment or accuracy.. but also the insurance the manufacturer has to carry in case something goes wrong. That's why medical devices are more expensive... you're also paying for the liability of somebody being misdiagnosed by a technical malfunction. Highly unlikely, but the money that has to be paid when that happens and gets proven is huge.
The ideal solution to that would be for a company to get a special development license where they agree to indemnify Nintendo against medical liability for the use of the device and they write the software while making use of Nintendo's hardware.
The software would likely still carry a heavy price tag for the testing and insurance cost, but it would be much cheaper than the $18,000 which includes likely includes large fixed development costs spread over a smaller number of units.
Re: (Score:3, Informative)
I call BS. I have been involved in medical device development and licensing for some time. I can ballpark what the liability for a device such as this would be, and it is pretty small. The reality of the medical device industry is that it is a bubble that is largely propped up by low expectations, high regulatory barrier to entry, and other inherent consequences of our current medical device market system.
Take, for example, a glucose monitor (specifically, the most widely used system on the market in the US
Re:"Not for ________ use" (Score:5, Interesting)
Not really. I think what's happening with consumer gear becoming more and more complex and "agile" is that the whole concept of expensive custom hardware is becoming obsolete.
While some devices (MRIs, x-rays machines, ultrasound imagers) are legitimately expensive, other gear, such as the one in the article, are being revealed to be extremely simple devices that are simple marked up due to the OEM knowing that their target market has deep pockets.
In some ways, it's analogous to the software movement in the late 80s where software engineers and their tools were in such shortage that they were only found in high budget corporate and government settings. The commodification of computers led to computer programmers becoming commonplace, allowing the development of cheap software development on consumer grade computers and paving the way for the open source movement where programmers' time is in such supply that they can afford to give it away for free(tm).
The mass production and wide availability of advanced components such as accelerometers, GPS chips, DSPs and other previously prohibitively expensive items are bringing highly sophisticated applications into the realms of the consumer where novel ideas are being explored and old expensive ideas are being redone with a Made In China label on them.
Finally, I could maybe buy the insurance line if we were talking perhaps even a few multiples, but a $100 device to $18k? That's one hell of an insurance policy.
Re:"Not for ________ use" (Score:5, Interesting)
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It's not the manufacturer's liability insurance that causes those high prices, it's the patients' medical insurance. The only reason they can set the price that high is because it just gets billed to the insurance. Then they inflate the MSRP even more so that they can still bilk the insurance companies even after a "discount."
When my mom was shopping for hearing aids, a particularly honest sales droid told her that the "MSRP" (which no one ever pays) was $12k for a certain model. They discounted it to $8k w
Re:"Not for ________ use" (Score:4, Funny)
Sony had it in a $500 camcorder for a few months before being forced to take it off the market because people were using it to film their neighbors screwing... through their neighbor's walls...
So you'll still need to pony up a few grand for that, sorry.
Re:"Not for ________ use" (Score:4, Insightful)
I'm not talking about IR. Hell, I have a $90 vid cam that does IR imaging. The Sony cam had a thermal imaging mode and yes, if aimed at a window, it would fail; but if aimed at a poorly insulated wall, you could make out the outlines of your neighbors.
People were worried about being recorded doin' the naughty, when it was easily foiled by properly insulating your walls. Not to mention that the quality was... well... quality isn't the right word for the image it would give through even the thinnest of drywall, let alone studs and siding...
Re:"Not for ________ use" (Score:5, Interesting)
There are different levels of IR.
The IR that most people are familiar with is just below the visible spectrum, which lets stuff like the Sony camera shoot in the dark, with an IR emitter. Basically, a light that it can see by.
Thermal imaging IR is "long IR", which shows heat. Anyone above 0 degrees kelvin puts off light at very low frequencies that we can't see. And no, there's no such animal as a $500 thermal imaging camera. You're looking at a starting price of about $3K. If Sony, or anyone else, were to produce a camera that retails at $500, they'd definitely do it. It's not a privacy concern that keeps the price high, it's the simple fact that the components are still very expensive.
Seeing through walls is pure scifi. You'd see the temperature of the wall. You may (just may) see something through a wall, if it's hot or cold enough to change the temperature of the wall. Like, you could see the general shape of a fire through a wall, because it's heating the wall. In scifi it works through "suspension of reality". You believe what you're shown, because it's necessary to the plot. Some people don't understand an impossible technology used in a movie, so they assume that it's real.
You'd be able to see through a glass window though, assuming nothing pesky like blinds are in the way. So, a couple having sex in a dark room, seen through an open window, is perfectly possible. Either IR would work, but that isn't quite what was suggested.
Re: (Score:3, Insightful)
The guy Parent was arguing with was probably thinking of this link, scroll down to "See through clothing"
http://www.kenrockwell.com/tech/ir.htm [kenrockwell.com]
The link specifically states what the camera sees through is cotton, at the time this camera was released I believe swimsuits got all the attention.
Comment removed (Score:5, Informative)
What have we here? (Score:5, Insightful)
Wii parts replacing 18,000 dollar medical equipment... PS3s replacing 10,000 dollar supercomputers... clearly the video game industry knows something we don't.
Re: (Score:2)
Closed consoles can buy parts in bulk. There's only one SKU of the Wii... you either get the default hardware or you can't call it a Wii. This makes programming a whole lot easier, because you know exactly what hardware your program is going to be running on.
Re:What have we here? (Score:5, Interesting)
Re: (Score:3, Informative)
As a guy who designs electronics for load transducers for living, I can tell ya that a balance board equivalent platform won't run you anywhere near $18,000. Probably more like $4k. One thing that makes the Wii device cheap is the mass production. Try selling a 100 of those a year for $100 apiece -- it's impossible. The tooling for plastic injection molding will cost you more than $18k alone. As for electronics themselves, they are not really a factor in the supposed $18k, er, $4k, price. I admit I haven't
Re: (Score:2)
And that something is producing 65 million units, and selling only a slight profit because it also sells game licenses, accessories and so on. I don't recall ever standing on a balance board at any doctor or hospital I've been to, and lots of people can probably use that one board, so I'm guessing the market is tiny.
P.S. It's not that solid. My pad has gotten to the point where the standing on one foot exercises will make the board black out. I use it as a weight with tracking these days, I was getting tire
Re: (Score:3, Funny)
Re:What have we here? (Score:5, Insightful)
It's all BS. Forget all of the posts regarding FDA, documentation, testing, and that crap.
It's just a matter of how many units get sold, like microprocessors.
If you design, make, and sell one, it's $500 million. If you design one, make 500 million, and sell 500 million, they cost $1 each. Profit is the same either way.
Not a lot of people buy medical devices, with some exceptions.
Nintendo can't make them and start with high prices, then drop them later. They have to assume how many they will make, sell, and guess a good price before their first unit is sold.
And yes, I have worked in medical device manufacturing, and I currently work in non-profit cancer research. We have numerous genetic sequencers around, like ones from Illumina. They cost like $750K each, but it's really surprising how little materials is actually in them. A $500 laptop is technologically 10,000 times more advanced than one of those Illumina boxes.
It's true that medical devices are more expensive, and I'd be the first person crying foul about it, but they often really really do have good reasons to justify the higher costs... usually.
If you want to talk about price rape, look no further than Cisco.
$2000 card
http://www.cdw.com/shop/products/default.aspx?EDC=1352161 [cdw.com]
$13,0000 card
http://www.cdw.com/shop/products/default.aspx?edc=1424619 [cdw.com]
They are the SAME EXACT CARD, with a little tiny firmware tweak. We have a couple of these in the 5580 series firewalls.
Obligatory (Score:5, Funny)
Ah, I see you have the machine that goes ping. This is my favorite. You see we lease it back from the company we sold it to and that way it comes under the monthly current budget and not the capital account.
No wonder (Score:3, Insightful)
Hospitals charge so much. Someone along the way decided to jack up a price and its been flowing downhill to the consumers ever since.
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Re: (Score:3, Insightful)
They actually have squat to do with each other.
"Tort reform" is the rich scaring the poor and stupid into absolving them
of any real responsibility for when something goes wrong. Not only do you
have to be stupid and careless in order to be sued, but you also have to
be a total jerk about taking responsibility for your actions.
Big scary verdicts only occur when perpetrators and insurance companies try
to blow off their victims. Then equally ignorant saps in the jury add zeros
with no real understanding of the nu
Re: (Score:2)
Medical malpractice lawsuits are tort cases... and we know how much testing is only done because of fear of the lawsuits. Limit the liability, and there would be much less wasted medicine being practiced.
Re:No wonder (Score:5, Interesting)
Medical malpractice lawsuits are tort cases... and we know how much testing is only done because of fear of the lawsuits. Limit the liability, and there would be much less wasted medicine being practiced.
Hasn't seemed to make much difference in Texas - the state with so much tort reform that the Governor likes to brag that malpractice insurance rates have come down - but no metric that measure the quality of healthcare has improved, for example:
Even worse - most of the malpractice savings have gone to the insurance companies, because malpractice payments have gone 67% but malpractice insurance premiums have only gone down 27%.
Public Citizen, Dec 17th, 2009 [citizen.org]
Re: (Score:2)
I don't have any problems with rationalizing medical liability, but the savings aren't all that likely to amount to much (the article references a CBO study):
http://www.factcheck.org/2009/10/malpractice-savings-reconsidered/ [factcheck.org]
Now, find 20 ways to save 0.5% of medical costs and you are getting somewhere, but this single issue isn't going to solve the whole thing.
It can vary some based on the field the doctor is practicing. There are some surgeries, where malpractice is so crazy high, because the insurance companies are afraid to defend the people performing the surgery. (This sentence should be read: the insurance companies anticipate big losses by covering the surgeons.)
"Tort reform" covers only one part of the hysterical increase in malpractice insurance. That insurance companies see it as a non-lucrative business to be in, means that they demand higher premiu
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"Tort reform" is the rich scaring the poor and stupid into absolving them of any real responsibility for when something goes wrong.
That doesn't seem to be the case in the UK; if you have a legitimate case you can sue, but you risk incurring big costs if you lose. In the US it's "free" to sue, the plaintiff might win but almost never loses; the defendant loses no matter what the verdict. [nytimes.com]
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Hospitals charge so much. Someone along the way decided to jack up a price and its been flowing downhill to the consumers ever since.
Why not? Your health is the most valuable thing you have. As long as it is a commodity that you have to buy from someone, what price wouldn't you pay for it? So far, the market will bear health being a sixth of the entire economy. Shall we try for a fifth?
Re:No wonder (Score:5, Interesting)
Oh ,there is much more to it than that...
A friend of mine recently had to wear a device that helps bones knit faster by using electromagnetic fields. The device cost (his insurance) $5000. I am an electrical engineer, so I couldn't resist tearing it apart to see what it was. Maybe, maybe, $20 worth of electronics. More likely $5 when manufactured with coolie labor in China.
And the reason my friend was willing to let me tear it apart? It can only be used once! It is designed to permanently disable itself after one period of treatment.
What a waste of time and resources. What a gouge to the medical consumer. You wanna talk about controlling health cost? Start here.
Price-gouging (Score:3, Interesting)
Is it due to the Wii's balance board being terribly cheap or is it due to the the price of the "medical-grade" device being extremely over-inflated? Some of the prices practised by medical equipment and even drug distributors are insane and they always hide behind the mysterious "it's fantastic, medical-grade stuff" and that quite possibly is plain bullshit to increase their profit.
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What separates the medicine you get at the corner store and the medicine you get at a hospital is the fact you find it yourself on the store shelf rather than a highly trained pharmacist finding it, and passing it on to a highly trained nurse to give it to you and make sure you are the right person, because the liability of delivering the wrong medication to the wrong patient is huge.
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Surely their systems aren't so bad as to deliver the wrong medicine to the wrong patient. I can understand the odd slip up leading to the wrong medicine for the right patient or the right medicine for the wrong patient but getting both wrong at once must happen far less frequently.
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It's an infrequent event, but the result if it happens can be a wrongful death... and nobody wants that to happen.
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True enough, it doesn't cause $18,000 to log things. Not every device used in patient care needs to be tested to the extent that 'medical devices' do. Mostly, it's simple patient safety stuff (no current leakage, etc.)
BS. The one I just used is a stock De
Price has a psychological impact too. (Score:3, Interesting)
With price comes respectability. That's why Christian Science practitioners always make a point of charging for their prayers roughly as much as a real doctor would charge for treatment: They know that something given away will not be percieved as effective.
Same thing here. Stick a patient on a wii board, and they'll regard it as quack rubbish. Stick them on an $18,000 purpose-built and impressive piece of diagnostic equipment with the logo of a respected medical equipment manufacturer (ie, not nintendo) and they'll feel far more confident, even if they do exactly the same thing equally well.
Customers who feel they arn't being given an expensive enough service are more likely to sue the hospital.
Perception (Score:3, Insightful)
This is not a shock... (Score:5, Interesting)
I had been prescribed a medical device to assist in night time breathing... after asking the clinic person to show me an itemized list of parts and costs, I was shocked at the bill - over $2,200 (USD). She was annoyed that I wanted this list printed out because my insurance was "going to pay for it anyway..."
A few months later, my insurance no longer wishes to pay the rental costs - so I have to return it or pay $250/month. Found online for $700 new and delivered with three years of support.
Only when you put medical care in a truly competitive market is when you'll actually see competitive prices.
Re:This is not a shock... (Score:5, Insightful)
I've started purchasing my own CPAP machine and accessories as well. Far cheaper than dealing with the home medical place locally (owned by my insurance company no less), even with insurance coverage picking up part of the bill. For less money, I get a better machine and direct support. And I can run the purchase through my FSA, so it's tax free. :)
FWIW, nebulizers are the same way. I bought a very nice machine online for about half the cost of the local place, and the local place wanted to give me a gigantic POS. I bought a very compact unit that has much nicer features.
Eyetoy (Score:2, Interesting)
The eyetoy from the PS3 is also de best camera in the market and it costs less than 40€. It has 75 degree wide lenses and can reach 125 fps. This is much more than what most cameras do. Even the 200€ ones.
accelerometers? (Score:3, Informative)
"When doctors disassembled the board, they found the accelerometers..."
They did? I couldn't find any information stating that the balance board had motion sensing. Everything I've read says it just has four pressure sensors, one for each corner and that's it.
Re:accelerometers? (Score:4, Informative)
New Scientist may have made that up. The actual journal article on ScienceDirect only discusses a black-box approach: i.e., putting patients on the board and seeing what happens. The procedure doesn't mention disassembling the device whatsoever!
Wii Fit vs Wii Fit Plus (Score:2, Redundant)
A plan to cheapen health care... (Score:2)
Nintendo should work on a fMRI-based game interface that can translate your thoughts into game actions. That should get the price of fMRI scanners down to a few hundred dollars each and immensely benefit medical research.
Once they are done with that, they can work on a DNA sequencing controller that customizes your on-screen avatar to look and act like you based on your genetic sequence.
And so forth, until all medical equipment and tests costs a few hundred dollars each.
Price is in the "too small for insurance" range (Score:2)
I could see some folks using this a first stage "cut out" instrument sort of like the difference between
most road side BAC tests and a real live blood test or as a "backup" device.
But can they use it? (Score:3, Insightful)
I know in my professional industry, there may be many a cool technology or device that i want to use, but may not be able to, despite the fact it looks good and can handle what i throw at it. However, i may not technically be able to use it because it has not been tested against specific guidelines or a part of the product was not tested against particular standards with the right amount of traceability.
I believe that’s why some particular product may cost more than any other. I.e a device to be used in a medical institute for diagnosis of any kind would probably require quite a lot of process in it's accreditation that the Wii probably didn't have to go through to be used as a game machine.
Has Little to Do with Lawsuits (Score:5, Insightful)
sounds familiar (Score:3)
This reminds me of the $800 hammer that defense contractors sold to the US government back in the 80's. It was an ordinary hammer.
"what the market will bear" (Score:3, Insightful)
Want to make a mint selling ordinary hardware?
All you need to do is either
A. Get it FDA certified for use in medicine.
Or
B. Get it FAA approved for use in aviation.
You can pretty much guarantee a 100x price premium in the former case or perhaps 10-20x in the latter case.
Of course, requiring government certification for things upon which the general public relies for life safety is not necessarily a bad thing, but the price premium that comes from the certification requirement probably is proportional to the square of the cost of doing whatever is necessary to obtain said certification.
Re: (Score:2)
It says a lot about the wastefulness of institutions when it comes to buying hardware. I bet you the Defense Department could find lots of savings by sourcing their parts from Nintendo, too!
Wasn't there something recently about PS3s being used for a high performance computing setup by the US airforce?
Re: (Score:3, Funny)
"I bet you the Defense Department could find lots of savings by sourcing their parts from Nintendo, too!"
Until the system fails because it wasn't built the have the shit beaten out of it in daily use. Military gear resembles professional construction equipment and is usually made in smaller quantities. While COTS solutions are attractive, they don't always suit the tasking.
Nintendo's systems are designed to resist small children; a force far more dangerous than anything the military can come up with ;p
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Tracking patient history and results?
Sounds like the sort of thing a beginning PHP programmer can knock out in a few hours.
Re: (Score:2)
Yep... but what PHP programmer will actually take the job when legal tells them of the risk if their program has a simple bug?