It is possible that the YouTuber guy is a total idiot and decided to make a $1000 wheelchair instead of buying a $200 one, but that shouldn’t be a default assumption, haha.
I see it a lot in practice especially when discussing early-stage business ideas.
You're talking if guys pitching overpriced and underquality gear is completely unheard of, or if flawed business ideas are a rare occurrence.
I get it, support and enthusiasm is always nice to have. But if you descend into the real world you'll see that more often than not you'll see a mix of fraud and overconfident people pitching undercooked ideas that they under deliver, and you're criticizing those who might as well have experienced that first-hand for a few times.
It's not like these people are providing a valuable service, steering everyone away from the dumb scams. They're just pattern matching and assuming everything they doesn't seem to make sense (in their generally not-well-informed opinion) must be bad.
It's unnecessary, and is noise just as often as it's not.
Unfortunately that recommendation is also pushed by snakeoil salesmen.
But from here, floating in the imaginary clouds, the error of the cynics was pretty easy to spot. It was that there are different types of wheelchairs and the cynics were just googling up the bargain-basement mass produced ones. I guess in the real world everything (including medical devices) is one-size-fits-all?
The word you're looking for is "arrogance." HN comment sections are no better than reddit, if not worse, with people arrogantly making all sorts of statements that are demonstrably false with a simple google search.
Seems insane to assume that but we see it in tech all the time where someone unknowingly spends a ton of money on reinventing something that already exists.
There are a couple of reasons for that. The most obvious is that they did not do their research prior to embarking on the project. The less obvious is they did extensive research before embarking upon the project. Plenty of tech popped up in the 70's and 80's that flopped or only found a niche market, that later turned out to be quite popular. Sometimes the tech wasn't ready, other times it was just too expensive when it was introduced, yet other times he market simply wasn't ready for it.
I think it’s worse than than. Amongst the people doing the work, someone usually knows that there is a product out there that already does the job, but the higher ups think they know better.
Somethings the higher ups don't know anything in detail, and just believed the new hire guy who said "I can't believe you're still using jQuery! We need to throw this all out and re write it in Angular!".
And then believed the next new hire a few years later who said "I can't believe you're still using Angular - they screwed up the 2.0 to 3.0 migration so badly how can we trust them any more? We need to throw this all out and re write it in React!".
And then believed the next new hire a few years later who said "I can't believe you're still using React, Facebook are awful! We need to throw this all out and re write it in Flutter!".
And then believed the next new hire a few years later who said "I can't believe you're still using Flutter - Google are bound to graveyard it any day now! We need to throw this all out and re write it in React - its new features are _amazing_!".
And today they're 2 years into the latest rock star new guy's 6 month rewrite of the entire front end using Rust and wasm. He's _almost_ got it working on his laptop, it'll be ready for testing with the staging backend platform any day now.
Meanwhile the company's B2B sales team are doing several million dollars of MRR from clients using the "legacy" jQuery front end from 2012. And the backend Java guys are all WFH and haven't had a single bug fix of feature request ticket in 3 years. They cosplay "scheduled maintenance" every 3 months by sending out notification emails to all customers and then just writing reports to management claiming successful updates with zero downtime and no measurable increase in latency or error rates. Half of them have second jobs or side gigs that pay more than their salary there.
Instead I conclude that likely my understanding is lacking, and maybe educating myself a little bit would be beneficial. Either I find out something new and potentially useful about the world, or finally see through a swindle and understand how it works, which is always a good skill to exercise.
You nailed it. If I could go a bit deeper, I think the drive-by cynicism comes from a fundamental misunderstanding of people.
Statistically, you are probably not significantly smarter or dumber than most people you meet. In other words, someone who has spent months or years on a problem probably knows more about it than you do if you’re just now reading about it. So if someone with more experience is doing something you think is dumb, your first reaction should be to ask why rather than dismiss.
I don’t get the negativity.
This guy claims to be different in that he has enough money already and he's just trying to make the world a better place, but pretty much every startup makes claims about how they're different and therefore they're going to succeed. They can't all be right. I'd prefer to hear unbiased opinions about viability from intelligent people on HN/reddit/twitter rather than biased opinions from the guy who's trying to market his company.
I'm not saying that this wheelchair is going to flop, I'm just defaulting to skepticism of new ideas in general.
It's the epitome of current state of the internet. We're on a social platform with coins to be gathered, which doesn't induce a deep, well though discussion, rather short snarky comments that gets clicked.
The piece raises at least a half-dozen possible answers, not all of which are compatible. The author pushes the "low cost" angle quite heavily at the start, so there being much cheaper options is reason enough, IMO, to ask the question what the point of the project is.
They say the chair won't make money, but it's a for profit company. They say they want it to be employee owned and to make their employees lots of money.
The author basically says 'it's a good second chair' (not a quote) that lacks in some features their own chair has. The piece also talks about cutting out expensive considerations like assessment by a physio and assessment of pressure points - that doesn't sound great, although if it's just a second chair, maybe those matter much less.
It seems more like the YouTubers decided to make a $2M wheelchair - real estate, machinery, employees, etc. Then see if they could spin it out to a short lead-time, online customer-specified production.
Good luck to them. Hopefully it will turn into a great example of a cooperative that's producing well-engineered affordable wheelchairs.
It's not asking questions though there's a lot of saying 'how is this cheaper? I found this crappy thing on amazon [that's clearly a completely different design] . why are they making this?!'.
I've yet to see a cheaper option that's the same type of chair. The ones I keep seeing posted are collapsible ones that are used in hospitals which are much heavier and way worse than the product in the article, they're not fitted to the user and much more likely to cause issues. When comparing to a similar product these chairs actually are much cheaper than what's out there.
I am right handed, but overused it and switched to a left-handed mouse.
There are basically infinity right-handed mice, but basically zero left-handed mice, most of which are hedged ambidextrous mice.
so looking at office chairs and standing desks and all kinds of ergonomics oriented towards healthy sitting, it seems amazing that there isn't more competition for people who sit more than anyone.
My sister used to use a neutral mouse, with her left hand, on the left side of the keyboard but in "normal" or "right handed mode". Now she has a laptop with a big touch pad in the middle.
Even game that way. Started using it that way as a kid, by the time I learned it was possible to switch the buttons that seemed less natural than leaving it as default.
Also made it much easier to use shared computers in school labs and the like.
It's specific to each task but I can normally get the left handed version as good or better than the right. I am willing to bet most people could do this, you just have to spend a bit of time awkwardly re-learning.
The Logitech G300s has been solid as a lefty. They used to be cheap enough that replacing them every couple of years (depending on usage) was feasible, but I'm not sure if the market has driven up prices since then.
It seems like a massive pain though. Rebuilding a non-symmetrical mouse the other way would take electronics tinkering as well as 3d printing, and probably a ton of work to get all the connections and tolerances right.
I am left handed, and I use trackpads with my left hand, but I gave up on lefty mice years ago and use an ergonomic one right-handed.
It's also far less like bikes than you're thinking. They have 5 major adjustments for a total of about 25k different configurations. And those don't seem to be majorly exclusive to each other either.
[0] Check out the number of tweaks available in their configurator: https://notawheelchair.com/pages/configurator
We sorta have that with everything though, you can source direct from china for a fraction of the cost, but the often pay several multiples of the actual cost for someone else to import it and provide the level of support and QA you expect from products.
Only because bikes are made up of commodity parts from many suppliers which drive the costs down, whereas this is mostly bespoke.
It is hilarious that people keep throwing out prices of $200 or $500, when $200 might get you close to the cost of one of the wheels on this.
>IMO the disconnect is this looks like such a rudimentary/basic product
Only to someone that's not familiar with what this is and what its competitors are.
I think that's what people are missing.
His competition is $5k wheelchairs that are often pictured with another $10k + of customizations.
I don't think that most people realize that $5k wheelchairs don't come with so much as a seat cushion as standard.
https://freakonomics.com/podcast/why-do-your-eyeglasses-cost...
Frames have crazy 100x markups and the market is dominated by a small number of companies. They interviewed people from Warby Parker (a newer, more inexpensive brand) and even they said they had to raise prices so they didn’t seem like knock-offs.
A $10k bike designed for racing has the same kind of components as a $100 bike from Walmart, but every single one of them is far, far better - better materials, higher tolerances, a geometry finely tuned to the rider. None of that is really obvious until you look closely. A rally car looks kind of like a road car, until you realise that it only shares a few body panels - every other component is built to a far higher spec.
Maybe this would be a $200 product if he was mass producing them to the same dimensions. But he's not, they're custom made on order to the dimensions of the user.
I've owned a few low cost Chinese bikes, and while they're OK, there's always parts on them that fail because they're clearly made to be as cheap as possible. If I depended on a wheelchair for moving about every day, I'd be damn sure it was well built and reliable. That's the market he's operating in.
It's an endemic problem in many fields but you see it a lot with programmers. It's the same class of cognitive bias that births ideas like "the law should be like a program, that would be much simpler" that were (still are?) big in tech circles. Lazy pattern matching and thinking that understanding one complex thing (programming) makes one automatically better at unrelated fields (complex manufacturing).
[0] The type most people are most familiar with, large wheels, collapsible, handles for assistance from others. Generally not used by people who are able to move under their own power.
[1] similar to "medical" but without the large back wheels so they're only mobile with another persons help or by scooting around using your feet.
Yes, there are different kinds of wheelchairs, there's no reason a premade, presized wheelchair has to cost thousands and they don't. The premade chairs certainly serve a need - for those who can sort of walk but need the chair to go distances (etc).
But the reason for custom wheelchairs is they are for people who spend all day, everyday in the chair. And that's where the need and the pain is greatest and so exhibiting a "ready made" chair just isn't going to impress them.
Are the powertrains and control systems in power wheelchairs really that specialised? Or is it another case of the medical device markup and regulatory hurdles driving up costs?
I ended up adding a long range remote control to it. A remote control power chair is fun to drive around. People do get a little concerned when they see a chair rolling around without a driver
This makes me actually appreciate reliability in e-vehicles motor cutoffs etc. I keep thinking if this could have been avoided with a better quality e-bike or if actually it would be even worst with a cheaper one.
Which makes one think, how often a wheelchair with cheap e-scooter parts would crash people into staris, cars etc
It's these little things that get you. The scooters all have some kind of debounce logic, disabling the accelerator until you're moving sufficiently fast - but the logic doesn't kick in when you stop without releasing the lever. A little bit of redundancy would've helped here.
He sort of knew, but didn't expect it, that when the roll of the device exceeds a certain threshold, the device will shutdown. Even if you're on a curve going with some speed. Broke his wrist. Since then he's also wearing wrist protectors that keep the hand straight.
Actually it was a bit unexpected that it would have known to do that; it must have used its complete IMU data to even know it was rolled, as plain accelerometer would have been pointing "down" as usual.
That actually feels like overengineering based on well-intentioned, but wrong specs. You probably want to just use sideways acceleration for "falling over" detection, instead of roll.
Those e-unicycles terrify me. No way I'd trust my life to one. Once you're at speed, every failure mode results in instant passenger ejection. I see people flying through traffic on those things - they're just one sensor glitch or integer overflow away from serious injury.
Add a hat and a scarf on a wire and you've got a Halloween prop.
Now i learn from you that that low quality device is so bad that you consider it a separate product class in itself. Can you tell us more what does it lack? In other words what features are you looking for when you are looking for a 40-cell brail display? (What is the minimum quality for it to be a “car” in your analogy?)
I’ve long thought that open source would make a lot of sense for assistive devices, and that it has the potential to change incentives within the cartel of assistive device manufacturing.
That would be interesting to know if his solution could match the 4k$ in term of usability or if there is some issue like refreshing rate that make the piezo based system necessary for a good user experience.
However, as you have pointed out, since it is also a market where people have few choices, there is no incentive for any new player to significantly lower the prices. Even if they easily could. Because they know that they will get the customers anyway.
That seems to be the root cause of the excessive price problem. An existing oligopoly of rent-seeking companies. Or a cartel, if you like.
I think that one of the ways to disturb this market and bring the prices down is for some honest company to join it and price their products fairly.
Once there is one such company, I assume that everyone else will lower their prices as well. Because otherwise they will run out of business.
That said, a quick google says there's 65-132 million wheelchair users worldwide so it's not a small market either.
The wheelchair is like starting to fall apart. What should I I get them that will last many years? Thanks!
I think you're spot on with certifications.
I was stupid a few times and needed orthopedic equipment. Each time, the price flabbergasted me. But it didn't matter since the health insurance fully refunded it.
In a regulated market, if you can influence the cap, the item will cost exactly that, no less. And if the market is small enough to not allow any disruption, then it will stay that way forever.
I need to talk to my girlfriend who's a physiotherapist about it. But for now I'm hoping his YouTube fame would start a snowball effect.
Thinking he could do with the wheelchairs what Elon is pretending to do with EVs is truly exciting.
Of course you’re not going to have a very easy time entering the market. But even though they buy these things on regulated supply deals, they’re not cheap. If you could get a certified electric one on top of a (I’m not sure if it’s called regular), then you would be posed for disrupting the market.
But, to the point, hospitals don't buy custom wheelchairs.
- You can buy a reasonable wheelchair for moving people relatively short distances across flat surfaces for less than $1000. E.g those used in hospitals and for the partially mobile.
- You cannot currently buy a reasonable self propelled wheelchair for full time use for less than $1000 (give or take the manufacturer in the article).
Take aircrafts or (to some degree) a racing car. You need a screw. Sure you can get one at your local hardware shop for a penny, but for regulated market you need one with certification and that will cost you something close to $10. I know it's crazy but that's how it works.
Vs the one from the hardware store could have come from Alibaba and be a plastic core with a thin coating of metal for all you know.
I guy selling mobility scooters told me that most customers never service theirs as it is easier to get the health insurance to pay for a new one every x years. This results in a very limited second hand market.
Many (most?) children have bikes, and lots of elderly people have some bikes somewhere in a shed back from when they used to be able to ride.
Almost everyone can afford a beater bike. That's why they are so common in the third world.
I'm not sure how out of shape you need to be not to be able to ride a bike? In any case, I wasn't wondering about how many people actively ride bikes. I was wondering how many bikes there are.
However some of what they are spending money on would make those bikes in Rwanda much better. Better/more comfortable seats can greatly ease the toll on your body. Disk brakes would stop the load much better and so make them safer. A couple gears would be nice (assuming it doesn't compromise drive train strength too much). Modern cargo bikes likely have a better cargo position as well.
Living minimally is a skill that society has essentially turned into a negative trait. Our planet can only support so much, and individual humans are very selfish. There are 8 Billion now.
Is it desirable? Not necessarily. The goal is to be more efficient with water sourcing, distribution, and usage so people have more water to use, not less.
And of those people that do, how much do you think they spend on their bikes?
No one who uses a wheelchair does it because they like doing it
Everyone who rides a bike for 16 hours a day does it because they like doing it, and/or they’re an athlete
When you’re done riding your bike for 16 hours a day - likely one week in a year - you can go to the gym, stretch out
The wheelchair guy has to drag himself everywhere
When you have all the components for a cheap bike made in 100s of thousands by ie Shimano, the price goes down dramatically. Wheelchairs? Unless there is 1 dominant manufacturer its not going to happen to smaller shops, and monopoly has its own issues.
When you have regulatory tape which require some steep price hikes to cover some specific aspect (which may not be that important), combined with above you get what you get.
I was recently wheelchair-bound for a month due to my recent paragliding accident (crutches now for at least 1 month more, overall an interesting experience of various limits lying everywhere you don't even realize until you are there), and can appreciate even basic wheelchair and its various functionalities. Its simpler than bike for sure, but its also foldable (at least mine) and relatively easy to pack into trunk of any decent car in a minute (not for me of course but accompanying person).
NYC is awash in bicycle couriers, and they probably ride all the time.
Do people here really not grasp the difference between a disabled person being forced to use a wheelchair - which they can’t get out of casually and stretch about - vs a fit person willingly using a bicycle?
> I don’t think most bicycles are designed for 16 hours of daily use…
Was stated. The answer directly to the statement was:
> In nations where bicycles are the norm, I would not be surprised if many of them get used 12+ per day. NYC is awash in bicycle couriers, and they probably ride all the time.
No AI needed.
Looks like it might be necessary for interpretation, though. That's not something I have any control over.
BTW: I am quite familiar with Serving disabled folks. That's pretty much my job, at home.
I guess this might be because strong opinions are best formed from a surface level understanding of a subject, while intricate and complex opinions require deeper understanding.
Manufacturing is cheaper in cheaper countries because of less taxes, inflation, bureaucracy, and a dozen other factors that aren’t negative socialist bullshit. Their workers get by just fine with the wages they’re paid.
https://permobilwebcdn.azureedge.net/media/hylifiyf/creative... - note the clinical rationale and notes sections on each of these options.
https://permobilwebcdn.azureedge.net/media/4ozh2ary/tilite-s... - seating cushions and backrests
https://permobilwebcdn.azureedge.net/media/npxlfuoh/tr-tra-o... - current ti lite order form.
https://permobilwebcdn.azureedge.net/media/hjvhuqlw/tilite-p... - component list / prices. There are almost 11,000 individual parts that are available for purchase for years after the chair is sold so it can be supported through the expected life of 5 - 7 years usually.
And through all of this you are working with professional therapists that are trained to properly size all these measurements, because an ill fitting chair can cause more harm than good.
These seem to be mainly intended as secondary chairs or for part-time wheelchair users, rather than as primary chairs. My wife has three wheelchairs and I can see a case for buying one of these as her fourth.
Mind you, the situation with electric wheelchairs is very different. Many electric wheelchair users are at elevated risk of pressure sores, may not be able to get in and out or reposition themselves independently, etc. The profit margins on these chairs are still inexcusable, but the amount of custom fitting and memory foam everything is warranted because the user may well be in this chair, in that position all day every day. The cupholder and the umbrella mount are must-have accessories.
What Zack and Cambry are doing is great.
(edit) I’d like to add that I think part of being able to drive costs down is that they’re not offering these via insurance so they sidestep the need for FDA approval to market it as a medical device (hence the company name), CMS approval and HCPCS coding and all the regulatory costs that come with that.
Now don't get me started on power wheelchair cost...