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A $1k Wheelchair

963 pointsby bo0tzz10/01/2024429 commentsview on HN

Comments

fotta10/01/2024

Custom fit lightweight wheelchairs are expensive. My Ti-Lite (one of the most popular lightweight chair brands) Aero Z starts at $3k and goes up quickly with wheels and backrest and casters and various other options that I need for sitting 16 hours a day without creating more problems. Insurance covers this for me every 5 years, but of course that's not a luxury every one has. Most plans don't cover DME 100%.

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...

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Havoc10/01/2024

For context - he has a ~9m sub youtube channel on phones that must be banking it. This is a side project that appears to be grown out of frustration of disabled wife & seeing the shitshow that wheelchair market is. Seems 10/10 wholesome to have this disrupted by someone that cares

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Waterluvian10/01/2024

My former girlfriend gets powered wheelchairs through the Ontario Disability Support Program, and I witnessed and learned that the whole thing is such a fraud.

Her powered chair was just over $20,000 and was a terrible piece of machinery. You were definitely not getting the "medical devices have to be reliable" premium. And any time the technician came out, we got a bill to forward to ODSP for thousands of dollars, even for the simplest fix.

And of course there was zero competition: there was one and exactly one vendor you could go to for this stuff. They were, of course, terrible with customer service, terrible with technician competence, and their products were consistently terrible.

I'm usually instantly skeptical of any tech startup that wants to airdrop into a problem space and disrupt things, but in this case, I'm 38,000% confident that there's something that can be done with this one.

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nothercastle10/01/2024

The BOM for this wheel chair is probably 200-300 of just wheels and bearings maybe more. People who say this can be bought for 200$ are completely out of touch. You can’t even buy a decent bike for much under a grad new and bikes have much better scale.

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wojo120610/02/2024

We live in IL, US. I just received wheelchair for my 3 year old son. We waited for this 9 months. This wheelchair has not any electronics or complex parts and, according to EOBs, costed our private insurance exactly: $18,212 (yes that is 18K! I just added this up and verified) after all deductions and discounts! After that, we received follow up call from the company that delivered the chair. We expressed our not satisfaction because we seen other wheelchairs that looked much more portable and sleek comparing to ours. I think the problem was that we were not provided with options at all. After which, they stopped communicating with us.

patmcc10/02/2024

This looks like a very cool project and I'm happy to see it.

But please, to the author: give us some real price comparisons! I don't know how much a wheelchair costs. After reading this article, I still don't. Just be crystal clear and say "a simple manual wheelchair, approved by insurance, is often $4k, with $1k paid out of pocket" or whatever.

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ninalanyon10/02/2024

In the UK you can buy a simple wheelchair for 132 GBP: https://www.uk-wheelchairs.co.uk/ugo-essential-self-propelle...

And what look like slightly fancier ones for between 300 and 500 GBP: https://www.millercare.co.uk/collections/self-propel-wheelch...

A magnesium alloy framed one is only 450 GBP: https://www.mobilitysmart.co.uk/magnelite-self-propelled-whe...

So what am I missing?

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xnx10/01/2024

Went down a bit of a rabbit hole and found this industry guide to Taiwanese contract bike manufacturers:http://www.wheelgiant.com.tw/ebook/flib/2024TBS_%E6%95%B4%E6... If there was enough demand, I'm betting some of the companies in here could make quality wheelchairs real cheap.

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tocs310/01/2024

It would be nice to see a little more of this in the world. Thank you Cambry and Zack Nelson.

BaudouinVH10/02/2024

Meanwhile in Europe, you can buy a wheelchair for 558 euros (about 620 USD).

https://monfauteuilroulant.com/Fauteuils-Roulants/Fauteuil-r...

modeless10/01/2024

I just watched a factory tour of this yesterday: https://youtu.be/oBId9w7NgAQ Seems like they are setting up a pretty fancy operation using their YouTube money. Pretty cool!

amadeuspagel10/01/2024

It's cool how they get both capital and distribution from their YouTube channel. Are there any other "real" business started from YouTube like this?

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hinkley10/01/2024

It did not occur to me that wheelchairs are this expensive. But then again they make fewer of them than bicycles and a bicycle you want to be on hundreds of days a year can start at that price and go up into car prices.

rtkwe10/01/2024

It's odd seeing the number of dismissive comments missing that there are whole categories of wheelchairs for different purposes. It's like asking why XPSs exist when there are Chromebooks, something most people commenting here would immediately realize as a silly question because they suit different needs and functions but the idea doesn't come up because it's an unfamiliar problem.

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jrexilius10/01/2024

This pretty much embodies why I love hacker engineering. Solving hard problems by itself is fun, making peoples lives better in the process makes it really worthwhile.

acyou10/01/2024

If it pans out, looks like an OK way to get a backup chair. But we still need the mainstream way, which is the seating specialists and therapists to accurately spec, size and adjust the chair with the user in it.

Curious if they will go get FDA approval, so that they can get the chair properly funded. I suspect that the same people who don't have health insurance also won't have $1000 lying around. If the chair is funded, they should be able to access a larger market and help more people going that route.

For power wheelchairs, FDA application process is a huge reason they have limited competition and are so expensive. For those who love to wave their hands and cut red tape, I think it mostly has to do with people not dying because they are set on fire by power wheelchair battery fires, or getting crushed by their wheelchair actuators.

I am just curious about this from a safety perspective. The FDA approval process covers a lot of ground. Who makes sure the chairs are safe? Who checks the pinch points? Who crash tests the transit tie downs? Who does fatigue testing? Who does tip-over testing? What happens if someone is using the chair and gets hurt due to a material or design flaw? Who makes sure the chair fits properly and users don't get repetitive stress injuries? Who tests the upholstery to make sure it is fire retardant? Who checks the chair with the user in it to make sure they have posture that doesn't lead to severe long term problems?

I, for one, would not consider sidestepping FDA in order to ethically and legally answer for all of those risks. But despite all of that I admire the sentiment of this project, it certainly seems to be done with the best of intentions.

stevage10/02/2024

I'm surprised there isn't some cheap option from China. There must be millions of wheelchair users around the world, it's a small market but it's not tiny.

flower-giraffe10/02/2024

There should be an IKEA for medical devices relying on scale to absorb design, testing and regulatory compliance.

The AirPod hearing aid feature and other OTC hearing aids from headphone manufacturers demonstrate it’s possible to leverage modern consumer electronics improvements for devices with a higher engineering barrier to entry than a wheelchair.

I think paying a premium for anything via insurance is detrimental to markets and only benefits bottom feeding bandits and deferring or deflecting the cost.

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pkphilip10/02/2024

$1k for a manual wheelchair? and that is considered cheap?

I have no idea why a wheelchair should be that expensive. We get them here in India for far less - you can buy pretty good wheelchairs for much less than $100. You can get powered wheelchairs for around $500.

https://www.amazon.in/b/ref=dp_bc_aui_C_3?ie=UTF8&node=11365...

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sizzle10/02/2024

Tapping into the collective wisdom of wheelchair enthusiasts of HN. What would you recommend for my parent, they are using a crappy Medicare approved Medline wheelchair that’s like $300 on Amazon.

They can’t use their right side of their body really due to a stroke paralysis. They can wheel around with one arm and leg.

The wheelchair is like starting to fall apart. What should I I get them that will last many years? Thanks!

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sandworm10110/01/2024

>> It’s mesmerizing to watch. When the laser is done cutting, sometimes the leftover material just falls out, but sometimes it stays in place.

Please be very careful when watching an industrial laser, particularly one cutting shiny metal. I would honestly support any reg that puts hard barriers between eyeballs and running laser equipment. Invest in a good camera and watch the show on a screen.

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jillesvangurp10/02/2024

I just did a search for wheelchairs on the German version of Amazon. I'm not in the market but I was just curious.

https://www.amazon.de/-/en/gp/bestsellers/drugstore/28602980...

There are lots of models with very reasonable prices and features; mostly well below 1000 euros. Including a few electric ones. Manual ones seem to be generally well below 500 euros. At 1000 euros we're talking some seriously tricked out models with all sorts of features that I'd probably want if I was in the market. I'd probably spend a bit more. And I'd be very surprised to not get support from my insurer for this.

The model in the article pretty bare bones in comparison. Not just a little bit. Like really bare bones. I'm sure it's great and ergonomic and really good quality. But what's the real story here? Inept US manufacturing or corrupt US insurers? Or both?

For reference, I just found a very reasonable looking electric wheelchair for 999 euros by a company called WISGING. With some 5 star reviews from buyers. In stock. Would arrive around 9 October if I ordered it now. 20km range, apparently.

The stuff on Amazon looks like it comes mostly from China where they are probably producing these things in large volumes to provide affordable, decent wheel chairs for whomever needs them around the world.

The world is bigger than the US and people use wheel chairs all over the place. The kind of pricing and quality cited in the article in the US would be completely unacceptable in most parts of the world. And never mind the shipping times. Is it not possible to simply import these things? I'm sure there are some tariffs to deal with but even so, what's stopping people here?

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syntaxfree10/01/2024

Resale value is important for wheelchairs. My dad had an electric one for about 8 months before he passed on, and the TCO was well under the price of all these alt concepts.

codedokode10/01/2024

As I understand, it doesn't even have a motor? Why cannot we have an electric wheelchair for everyone today? How do you climb uphill (or from an underground passage) without a motor?

Also, I don't know anything bout wheelchairs but googling shows that there are Chinese electric wheelchairs below $1000 (don't know anything about their quality).

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xyst10/01/2024

That’s a wholesome story. Hope the company stays employee owned for a long time. Seen too many companies which started like this but after exchanging a few hands (ie, ending up in the hands of grand children). It ends up getting scrapped for parts and sold to the highest bidder.

kqr210/02/2024

https://whirlwindwheelchair.org/

Professor Ralf Hotchkiss used to teach a course at SFSU on how to build wheelchairs.

double0jimb010/01/2024

Two passes around the holes with the laser will get rid of the rewelding issue.

ChrisMarshallNY10/02/2024

I find the story of the company inspiring.

As someone that Serves a small, rather shunned demographic, I applaud them.

One difference, though, is that I am not competing with moneyed interests. They can play dirty.

robocat10/01/2024

Hopefully someone does the same thing for rollators (walking frames). I bought a few second-hand for my mum and they were all had disgustingly terrible usability. Brakes that didn't work properly (huge safety issue). Parts poking out (and flying brake-lines) that would catch on everything, or cause mum problems.

One sharp bit at the wheels damaged the skin at her ankle and she couldn't do anything for weeks to recover. It was a very serious problem caused by thoughtless design.

And we are in New Zealand which is better than many places. It is terrible watching people struggle in other countries (or lack access to the simplest requirement).

Good usability is hard enough to find for the smart and strong.

It is extremely hard to find for the weak and infirm. Especially when supplied through government services!

Finding her a wheelchair was hard because she is tiny and needed a teen sized one. But everything available second-hand or through our social services was designed for heavier people with wide arses (imported chairs?). Luckily found a wheelchair manufacturer in my city that had one designed for a teen on special (end-of-line - not manufacturing standard wheelchairs any more - changing to focus on expensive specialist sports chairs).

agumonkey10/01/2024

Are there open source community for all things biomedical devices ? even partial exoskeleton (not joking, looking for practical attempts to help elders)

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jimnotgym10/02/2024

You can get a crappy wheelchair for £100 off ebay. The gap from crappy to decent seems very high!

whoitwas10/02/2024

$1000 seems very expensive. But considering it's always being used, maybe not terrible.

changing199910/01/2024

I have no knowledge of this specific product area but wondering what aspect of the wheelchair in the photo results in this seemingly high cost? (to note, I understand that this is still far cheaper than other wheelchairs). Is it the material cost? It looks like it's just a few pipes, a cushion, and a pair of wheels. About the same build as a basic bicycle.

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ossobuco10/01/2024

Or, what happens when you take greed and profit out of the equation.

nojvek10/02/2024

Yessss!

Made in America with humans and CNC robots.

That’s the future we should be aiming for.

jmyeet10/01/2024

So I follow some disability activists and it's kinda depressing just how hostile society is and people are to people with disabilities. And this crops up everywhere.

So for wheelchairs, for example, airlines routinely damage or destroy or lose wheelchairs, like 1000+ a month [1]. You need to be aware that wheelchairs typically need to be customized for the user. You typically can't just buy a wheelchair on Amazon and you're good to go. Using a replacement wheelchair can represent a significant safety risk.

Only now is the DoT starting to take action to curb this [2]. But what other group of people would such reckless disregard and gross negligence be tolerated for?

We just had Hurricane Helene wreak havoc through Appalachia. Usually in these situations people on the outside will criticize those who didn't evacuate. This happened in Katrina too. But you know who often can't evacuate? Disabled people.

Look at our response to Covid. The powers-that-be wanted everyone to get back to work and be busy worker bees that could once again produce value that would be exploited. So isolation restrictions were loosened. We capitulated to the irrational and completely self-centered whims of antivaxxers. There was a war on mask mandates. This went so far in some places as to literally ban masks [3].

This is all despite some people being immunocompromised and Covid never going away. We're essentially decided those people can just die.

But beyond them, you know what else Covid was? A mass disabling event. I'm talking about long Covid. This affects probably millions of people. These once healthy people are going to learn the hard way what the wanton disregard for disabled people looks like.

Anyway, I applaud efforts like cheaper and faster to produce wheelchairs. They won't suit everyone but we shouldn't tolerate a situation where it might take months for someone to get a wheelchair, But can we stop destroying wheelchairs too?

[1]: https://blurredbylines.com/articles/broken-wheelchairs-airli...

[2]: https://www.npr.org/2024/02/29/1234708784/airlines-wheelchai...

[3]: https://abcnews.go.com/US/wearing-masks-public-now-illegal-n...

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basirulbillah10/01/2024

1k for a wheelchair is unbelievable for me. In Bangladesh they cost about 7 to 9 thousands taka which is equivalent 60 to 100 USD. I don't understand.

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GaryNumanVevo10/02/2024

Mormons get it done!

jeanlucas10/01/2024

Hah, now it makes more sense why Jerry was being so active on GoodTimesWithScar Twitter feed. Scar is also a wheelchair user, but is mostly famous for his YouTube landscaping videos.

Nice to see this, Jerry is not just another YouTuber grifter, he's a maker and has been involved building for his wife for a while.

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beej7110/02/2024

Home crap. I thought at first this was advertising an expensive wheelchair. TIL.

thomasfl10/02/2024

Isn't this communism or socialism? I thought US citizens were allergic to socialism? That's the only reasonable explanation to why USA still has an archaic, super expensive private healthcare?

"To be clear, Not a Wheelchair isn’t a nonprofit — it’s currently licensed as a benefit company, a newer designation of a for-profit company that provides a public service."

pjdesno10/02/2024

Just wondering - why is it that a bunch of tech bros who would think nothing of spending $2-300 on some fancy-ass keyboard because it’s incrementally more comfortable to their fingertips than a $15 one from Microcenter think that a person doesn’t care about the quality of a wheelchair they’re going to be stuck in for all their waking hours?

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stevenseb10/01/2024

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lofaszvanitt10/02/2024

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flimflamm10/01/2024

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not_the_fda10/01/2024

Quite frankly this is against the law.

Wheelchairs are considered a class II medical device. Just because you are cheeky and say its "not a wheelchair", its still a wheelchair and is subject medical device regulation.

A wheelchair can cause a sorts of harm if not designed properly and built of high quality.

zaps10/02/2024

Wheelchairs… engagement presents… it never ends!

jojobas10/02/2024

There electric bikes way under $1000, and allow frame bikes under $200.

Just checked and there are $400 wheelchairs out there. How is a $1000 wheelchair an achievement?

loloquwowndueo10/01/2024

I just checked online and wheelchairs here (Canada) can be had for about US $500. What am I missing in this $1K “affordable” wheelchair idea?

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SirFatty10/01/2024

before clicking the link, I thought it would be something along the lines of a Dean Kamen iBOT chair. Seems like a lot of money for a basic wheelchair.

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