> I'm skeptical of it being just regulation driven
It seems to be blatantly obviously regulation in this case. There are electric wheelchairs in other countries. What's stopping them from being imported are the regulations.
It would not necessarily fix things if private equity wasn't involved, but private equity is particularly effective at identifying cases where a market or regulatory inefficiency is not being maximally exploited, and jumping in to extract profits from that. So sort of by construction, when private equity enters a particular market, things are likely to get worse for consumers. It doesn't mean that things are golden if private equity is not involved.
> regulations don't just disappear to allow for such imports as in your example
My point is the regulations are leading to the duopoly, which is the source of the problem. The last private-equity owner seems to have been fine. And the market was competitive before the CMS rules in 2005. I’m not suggesting scrapping the rules. But the rules are clearly well past safety.
Perhaps you've confused which comment I was replying to with one further up, from what I can see you were trying to answer the question, and nothing else is visible:
> how would it fix things then if it wasn't private equity dominating that market?
The visible answer is clearly contingent on some future regulatory landscape coming into existence, otherwise it makes no sense, so I was wondering how does it answer the original question?
Well, that's the interesting thing. You likely can import and use these wheelchairs, but they can't be sold as medical devices and, subsequently, won't be covered by your insurance.
The dumb thing is these super cheap wheelchairs would likely cost the end users more money than the expensive ones as they will buy them out of pocket vs having their insurance/medicare cover most/all of the cost.
The reason these companies don't sell these wheelchairs in the US is likely because the marketing would run afowl of regulations about selling medical devices. You probably could sell these as bicycles and hobby chairs though.
> they can't be sold as medical devices and, subsequently, won't be covered by your insurance.
This is something I've never really understood. Wouldn't the insurance company be ever grateful to you if you accepted a non-medical wheelchair because it's 1/10th the cost. Hell, have 5! Is there any reason insurance can't pay for them?
Not if it's owned by the same private equity firm as the wheelchair guys; then it's just another face of the same racket.
Also, medical insurance is supposed to cover bona fide medical treatments and supplies. So this likely bumps up against regulation again. If something goes wrong with the out-of-regulation device that insurance paid of as if it were a medical wheelchair (e.g. safety incident leading to injury), they could be liable.
It's the same as why dental insurance won't pay for your next door neighbor handyman to pull out your tooth with a pair of pliers.
No and you needn't bother with the medical tourism. You're allowed to use whatever assistive device you'd like, it's only when you wade into getting insurance or the govt to pay for it that the regulations start to matter.
What exactly do you mean 'blatantly obvious'? Because to me, the issue that is blatantly obvious is that we don't have enough regulations on PE.
Let's say in this scenario you do import an electric wheelchair. You fork out a few thousand dollars on the expensive costs of said purchases. It breaks. No one in America can repair it. Or if they can repair it, you have to go through the PE-owned wheelchair market, whom charge a premium. Your options are fork out the money for repairs, import another wheelchair, or send it abroad for repairs.
Assuming that instead you create a company designed around importing said wheelchairs, PE buys you out and then sells imported wheelchairs at monopolistic prices.
It seems to be blatantly obviously regulation in this case. There are electric wheelchairs in other countries. What's stopping them from being imported are the regulations.