How a shampoo bottle is saving young lives(economist.com) |
How a shampoo bottle is saving young lives(economist.com) |
https://www.openpediatrics.org
A video going into more of the detail, on reflection the big idea seems to be the air pressure oscillations
There is the FOAM movement (Free and open acces meducation - https://lifeinthefastlane.com/foam/) but I bet there's many more out there.
It feels like there is some foundation for medicine to evolve like software evolved, where there is more and more open source knowledge to build upon, democratizing and lowering the cost of access to that knowledge.
(Note that I'm not saying that we necessarily have too much regulation or that medical industry profits too much; I'm just saying that in this specific case they would be failing to save people, while overall they could still be optimal)
I understand the precision and expertise that goes into medical devices, and they've saved millions of lives (mine included) — but in countries where $6,000 means something might as well not exist, they need something in-between precision manufacturing or nothing at all.
I don't think it's a story of over-regulation, as I doubt Bangladesh has regulations in place only allowing the $6K version.
Well it still could be. It's not because there's no over regulation there that there's the expertise required to build and market an inexpensive CPAP machine there. As far as we know, as soon as they get the expertise, they could just move to another country and get a better wage in doing so.
I'm a software engineer and it's something that I think about. I'm only making 60k$ in Canada while the US the average is higher and in USD. I'm only 2 hours away in car from the US.
It's true that some money goes to designers, lawyers etc etc but when they see an opening, they do rip people off.
This seems like an oversimplification. The people capturing those gains are very often not the manufacturers. Often it's the retailers, not the manufacturers, who build those empires.
Unless it's different specifically in the medical device industry; if so, do you have examples?
Let's use this word in English as well, as it allows to direct our attention to jugaad immediately.
I do this in my native language (Dutch) as well. My favorite one I came up with is "search term scavenger hunt" in Dutch it is one word as "zoekwoordspeurtocht".
Also, damn, neonatology must be brutal to work in at times.
There's a happy period where you're doing extremely fulfilling work, then a difficult time when you're distraught at your failures, then a complete indifference to suffering that you've normalized.
Managing fatigue and stress in any job is extremely important, managing compassion fatigue is even more so.
Alas this can only be said about the first world. In less developed parts of our world this would be the complete opposite I imagine.
Exchange visits(+) a good use of money perhaps? - spark that innovation.
(+) not necessarily just to 1st world countries by the way
i guess they could get inspired by military solutions in emergency situations which must be also hacked from what's available
Innovation like this is facilitated by the lack of medical device regulations in Bangladesh.
https://glog.glennf.com/blog/2016/3/25/citation-appropriatio...
That's why WHO recommends it to hospitals who can't afford anything else.
(Yes I have an adblocker installed)
Not a critique of the thecatspaw.
Though I agree the cookie banner + "free special report" popup + the bottom subscription banner takes an absurd amount of space.
You might not get stopped from doing it if it was immediately obvious that it was effective but eventually hundreds of thousands if not millions would be spent on studies or approvals before a “proper” device made its way into the supply chain at 10000x markup over injection moulding cost.
Even if your motives were good, you were arguably doing what is best for society, and the device had nothing at all to do with the situation your career is over... Who in their right mind is ever going to do that?
Also physicians can file INDs with much less paperwork than a company could. But it’s nonzero, so doesn’t happen all that often.
Had they had as low fatality rate as developed countries, I doubt weak regulation would have spurred innovation.
Which is supported by the fact that fatality rates now almost match developed countries. If it was the weak regulation that spurred innovation, the rate should continue to fall.
I think the fallacy in your reasoning is to assume that innovation is “proportional” to death rate somehow. Doing it cheaper (or even at all!) under the constraints you have is still innovation. Put another way I think we have different definitions of innovation. The way I think of it, equivalent outcome for way less cost still counts.
Disclaimer: I am not an MD, but I used to work in drug and medical device development, where the regs did have to be followed strictly to the letter, and became quite familiar with where flexibility was and was not).
(And I meant IDE -- device exemption -- not IND, which is a drug exemption).
It's an interesting hidtory, it basically shares no (known) common roots like most languages around Europe do.
You also get Pharma-Bro types selling medication WHO considers "essential" for 750 dollars a pill. Only the one company has(had) the regulatory approval to make a drug so basic Aussie school kids can make in chem class[0].
[0] https://qz.com/851416/why-martin-shkreli-and-turings-darapri...
Or, take high insulin prices caused by a government-granted oligopoly from the FDA. The FDA maintains high barriers to entry. We all suffer from artificially high prices and reduced access.
For a good treatment of this and many other aspects of US healthcare costs, see An American Sickness by Elisabeth Rosenthal.
Waiting five years for it to go to any kind of trial and then potentially being found guilty anyway because the jury sees an evil insurance corporation and an evil for-profit corporation and an evil, manipulative doctor trying to further his own career...
You’re going to lose anyway, and in the intervening 5 years you’re unemployable... and no matter how the trial turns out you’re also unemployable. That’s a lose-lose, and that’s why they always settle.
It's a good thing there's regulations in place here preventing the use of less effective hacks when better devices exist. And yeah, it's not just regulation but also legal liability that comes into play here; in the long run it's more expensive to use cheap hacks and risk many-million-dollar lawsuits if they kill someone than to pony up the thousands of dollars for the correct equipment.
They can only afford it because we spend such an absurd amount of money on healthcare.
The situation gets turned on it’s head when it’s an experimental procedure, though. “Insurance wouldn’t pay for x because it was experimental!” is an all too frequent complaint (it’s even the entire catalyst for the show Leverage).
Well, why do you think they don’t pay for it? Not only is it always insanely expensive, but it’s also got a 40% chance of success according to the doctor who wants to perform it (who is incentivized to keep his stats up) and it’s not endorsed by anyone... and that is a huge liability.
So I suppose my point here is that, for the armchair physicians online, every chance there is to save $1k there’s a chance to spend $100k. If you remove regulation you’re not just accomplishing savings on one thing, you’re opening up a pandora’s box of expense on another.
I don't understand your argument at all. Of course it's worth it that this device exists. It works. And it only exists because we've spent money on development and acquisition. This is exactly when higher spending on healthcare is beneficial. Contrast with Bangladesh, where they can't afford these devices and as a consequence many more infants die (or they have to hack together inferior replacements from shampoo bottles that don't work as well).