One really relevant aspect is to demand as price what the market is willing to pay. Pricing typically is a market thing and as it is, what is wrong with saying it. More disturbingly though, why do I have to say it (and why is no prosthetic part manufacturer getting up to say it): if a prosthetic wonder hand only is regarded as superb, unique and really bionic (all bloated sales terms) if it costs 90000 USD plus, then it would be silly to offer it for 7000 USD. Simple as that. From where I am standing, a prosthetic hand such as the ones I use that cost significantly less than 1000 USD cannot be as good BECAUSE OF THAT in the eyes of many people – and as long as that is the case, we are commenting on prices that are made outside any rational range.We are dealing with emotional and market driven prices.

A second relevant aspect is the personnel being employed. Quite frankly, the interaction I had with Otto Bock employees would (even as their supervisor) lead me to immediately sack them. What an entire waste of bandwidth these people were. One does have to resort to rather extreme measures to enforce useful replies there, a consistent experience that others have. I think, better to have no marketing personnel than such. Even in a moderately agreeable mood I cannot understand at all why anyone would hire anyone that tells customers “if the prosthetic has been construed wrongly we recommend you get physiotherapy”. That these personnel cost add to the total price of any prosthetic component – sky clear to me. And yet, just ever so unnecessary from point of view of a user. So that bloats costs massively.

A third important aspect is responsibility abandonement. It is extremely rare that individuals or end users directly buy off the manufacturer and if so (I do that quite often as Swiss consumer, as we have laws that make it hard for manufacturers to not sell to me) I actually so far had gotten fairly good prices. However, when regular sales channels are used, prices are extreme also “because no one is responsible” – and that fact is massively exploited by prosthetic component manufacturers just as it is exploited by the whole medical industry generally. Regularly, I would ask the prosthetist to apply for the prosthetic. The prosthetist (not me) types up that sheet (I never see it usually) and sends it to the (my!) insurance that then sends to away to another company that checks it for them. They, unknown to anyone, will then issue a recommendation that may be “out there” or not, and the money that is then being offered to pay does not seem to be anyone´s personal responsibility. The prosthetist will try to construct something slightly cheaper than what insurance pays so they can profit a bit, and I have no idea (normally) what it is they would have paid. Obviously I know the guys that check my insurance applications personally, they know my components from own eye inspections because I offered to go there and perform show and tell, but that is not how the system normally works. Normally, the abandonment of any personal responsibility allows for extreme percentage additions and a product I might get for 400 bucks ends up costing 2000 bucks through normal channels. At any later time, insurance will tell me that they will not re-imburse my direct purchases for adminstrative reasons and not pay the 2000 USD order because that is too expensive. Then telling us that manufacturers have this and that as reasons to demand more does not explain what really bugs the user.

Fourthly, almost no self respecting prosthetic manufacturer has a clearly visible end user price list, and no prosthetist order price list, that anyone can see and use. Also, hard tech specs are missing wherever the eye looks. Weights in grams, speed, cost for maintenance, all that. – In other words, we are not dealing with an industry that is a bit tricky and sly to deal with – no, we are confronted with a molasses that is so thick we cannot see the hand in front of our eyes in terms of lack fo transparency. If I was trying to make a case for honest pricing, I first would ask of my own and fellow companies to be transparent in at least a minimal way.

Last but not the least, prosthetic components are consumer products like any other. They compete with consumer products (not necessarily prosthetic products!) like any other – let there be no doubt. Instead of sinking a substantial amount of money into a “”bionic”" hand last year, I bought land for about 200000 USD, and a new car, believing these to be far better investments into my overall well being than what the industries had to offer then in terms of “”bionic”" hands or arms. I increasingsly come to the conclusion that in order for a deal to be a deal, both parties need to have a mutual understanding. So far, I see very very little in terms of “mutual understanding” when it comes to prosthetic part builders to treat customers fairly – not everyone, but big ones and some important ones. Instead, what I see, is an industry whose representatives seem to never have realized that I be missing a hand but not a brain, not a heart and most definitely not my business sense and from that angle, any such attempt to dodge issues also are something that I regard as a bit of an offense. I am handicapped and treating me like that is something I view as offensive, and from there, I may just do the same to them. So I will want to see A LOT of improvement in attitude, in honesty, in fairness to the customer, in transparency for pricing and all, before there will be a “deal” whenever it may come the time when we look at prosthetic costs for something “more expensive”.

Your last point first: as I note in the “about” section of less is more, I work for a prosthetic component manufacturer. So there’s little doubt I see the world at least in part through that lens. Not a lot I can do about that – it’s part of my life.

As for your first point that I “act as if prosthetic prices were “as is,” I’m not sure I could write this particular post any other way. I’m addressing how things actually are in the U.S. reimbursement world today.

Your alternative proposal – insurance companies developing their own prosthetic devices and controlling costs as a result – is an interesting concept, but it’s purely theoretical at this point in the U.S. Doesn’t mean that it’s not worth discussing, but it wasn’t the intended subject of this particular post.

Thanks!

Thanks for sharing your experience.

I hear you re. amputees doing more than able-bodied individuals. My thinking process when I wrote that was as follows: (1) many able-bodied Americans live sedentary, unhealthy lifestyles; (2) some amputees live comparatively active, healthy lifestyles; (3) therefore, there are amputees who do more than their able-bodied peers. That doesn’t mean they’re high-end athletes. It just means that maybe the amputee walks 7,000 steps a day while the able-bodied person walks 2,500.

But your point is well taken.

Thanks so much for reading and taking the time to reply!

I’m frustrated because the parts for my expensive nowhere-near-as-good-as-the-real-deal are not being covered by insurance anymore. The same foot that I have used for probably 17 years, is no longer covered because it was deemed “medically unnecessary”. Are you KIDDING ME????

In concluding my very frustrated rant, I concur with your statement “Insurance companies do things that make me angry!”