$42,000 Prosthetic Hand Outperformed By $50 3D Printed Hand 288
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."
Re:Sunk Costs (Score:5, Insightful)
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.
More money does not always buy better things. (Score:1, Insightful)
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. (Score:5, Insightful)
"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:Sunk Costs (Score:5, Insightful)
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.
One word answer: Liability (Score:5, Insightful)
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.
Re:Sunk Costs (Score:4, Insightful)
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 (Score:5, Insightful)
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/ [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... [enablingthefuture.org] 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:Obamacare exists because... (Score:5, Insightful)
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:Obamacare exists because... (Score:2, Insightful)
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... (Score:3, Insightful)
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, 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?
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:No escape from the tea party nomenklatura. (Score:5, Insightful)
Re:Obamacare exists because... (Score:5, Insightful)
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, 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.
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).
Re:Obamacare exists because... (Score:3, Insightful)
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... [texasobserver.org]
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 says "no way" (Score:4, Insightful)
All in all, we should put money into 3D printing and regulate the medical industry like the criminals they are. ,surprise.
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
Re:Sunk Costs (Score:4, Insightful)
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:obamacare says "no way" (Score:2, Insightful)