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Comment by DoubleGlazing | Hacker News Reader

She barely takes home minimum wage and she is self-employed. Most of her peers are in a similar position. It is not a vocation you get in to for the money.

Edit: A common problem in her sector, and other therapy sectors, is that all the recognised diagnosis and treatment systems get bought by the likes of Pearson and other big technical publishers who will demand recurring payments to use the system. For example Owls, a common speech therapy system requires her to use their pre-printed forms to take notes. The basic diagnosis pack costs over $700, but she has to keep buying the forms at $60 for 25 - even thought he system rarely changes.

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How much do you think it'd cost to replicate the software as an open source tool? I've written grants before for funding open source projects, and this anecdote boils my blood.

Yeah, this is just plain thievery from people who can least afford it.

Can you say a bit more about the process of writing grants for open source projects? I have some long-term education related projects that I'm considering grant funding to support. I have some ideas how to go about it, but I'd love to hear what you've done.

Taking on Pearson and other companies that use similarly predatory tactics to extract value from society's most disadvantaged is exactly the sort of "disruption" that the world needs more of.

That said, I doubt one could go at it alone with no support or with only a grant -- building up mind share, fighting off BS patent threats, and doing enough sales to break even on these non-development costs aren't the sort of things that a government/ngo grant will typically support. And even if you could find the money, you'll still need access to a network of experts.

Someone should setup a fund that force-multiplies government/NGO grants for societally beneifical OSS with funding and access to expertise for these other things (legal/marketing/etc.). The aim could just be breaking even on non-grant-funded costs by selling support/branding/etc. to institutional players like hospitals and large chains.

Sounds like something Ycombinator should look at soliciting startups for.

I agree.

I mentioned Owls above. You wont believe what it is... just clipart in a nice easel book form. I'm not joking, its just page after page of clipart, accompanied by a manual and 20 page copyright warning booklet.

The thing is Pearson has convinced governments, schools, charities, hospitals etc that this system is the best way to diagnose speech issues. My wife and a lot of her colleagues would beg to differ.

Tangent: Pearson sells curricula to a lot of school districts. These are the people that in part control what your children learn, and what their teachers can teach.

Agree re: disruption. I've thought about this type of thing a lot, and I wish there was a way to fix the root cause instead of what I consider the symptom (dodgy overpriced software for a specific niche, especially when it targets non-technical users and/or has to do with medicine / HELPING HUMANS PHYSICALLY). I came to the conclusion that it's Very Hard to disincentivize greed. Anyone have any ideas for what could be done to help curb behavior like this by companies (companies which are really just people who are making these kinds of decisions -- never forget that)?

I’m not sure there’s any overt greed exactly. A company saw a market and launched a product for that market. But like most companies and products, especially in the case of a de facto monopoly, they’re not very good. When there’s no competition, why spend the money to innovate or improve? Your customers are still going to buy your shit.

The best way to improve the status quo on a case-by-case basis is to introduce competition, say by developing a better product, marketing it well, and basically out-predating the theretofore market predators. The marketing is easy if you can get enough momentum behind it:

“FooCorp wants to sell you these materials for $absurd. We made these better alternative materials. You can print the basic set yourself for free, or order any of our wide, high-quality selection, starting from $reasonable.”

I don’t think there is a general solution to the underlying cause, though.

Competition from the open source world perhaps.

Realistically, what kind of skillsets, experience and understanding would be required to setup and operate such a fund?

Out of curiosity, are there effective and significantly cheaper systems in other countries outside of the US that people could purchase from? Or do they have industry associations and such eating out of their hand to mandate their use?

This is exactly the kind of thing I'd love to see China come in and drive the price down to commodity levels on.

Its really simple software, essentially a VU meter.

The therapy involves getting patients to shout in a certain way and try and reach certain volume levels or follow certain volume patterns. E.g. shout gently for five seconds and gradually ramp up the volume over 10 seconds.

It would be really easy to replicate. I reckon the most time consuming part would be testing and calibration.

The whole app directory is less than 2MB.

Seems like a audio program like Audacity or maybe Ardour would do the job.

Really, any audio editor would do.

But you should look into Max/MSP ( https://cycling74.com/products/max/ ), where you could build and bundle a simple audio app like that in minutes and have it tailored to your specific needs.

Another business that does this is the hearing aid racket. An audiologist examines a patient, comes up with a patient's profile (some kind of EQ / convolution map), and then loads that into the hearing aid using proprietary programming cable and software.

There are other settings more under the preferences category than DSP, like what profiles go on what switch setting, beeps, things like that. But these are all guarded jealously.

The aids are very expensive, more than $5k, for what's now ancient tech. They've only recently gotten BT and only then at the high end, more like $8k for the BT models.

We really need open hardware and software, so home users can get an audiologist to compute their profile and then do what they want with it.

I wonder how different the hearing aids are from a custom IEM designed for live performances... That market is vastly more competitive.

As I understand it, the audiologist prescription includes an EQ map as well as few different types of filters for different situations: music, conversation in crowded room, 1:1 conversation, etc. Hearing impairments are not totally amplitude dips but also comprehension ones. SO I suspect aids have a few extra DSP filters available to the programmer that IEM's don't, while IEM's probably have wider range and better reproduction for the musician's taste.

Yes you are right, this sector is full of scam artists. See here http://www.abc.net.au/radionational/programs/backgroundbrief...

My father who is in the age group now pretty much confirmed all of this when recently shopping for one. As it was covered by his health care they were trying to flog him one at a ridiculous price.

I saw this kind of predation secondhand when my maternal grandmother (I know her as “babcia”) went in for hearing aids. Her main problem was actually earwax buildup, not general hearing loss. But there’s no money in giving a patient a script for ear drops, so they managed to convince her to drop thousands in insurance dollars and no small amount of her personal dollars as well. <sigh>

But, she can hear, and she’s happy. I guess that’s how these companies get away with it—you can satisfy a customer without doing a whole lot of actual good for them.

> I've written grants before for funding open source projects

Is this a common thing? I would absolutely love to be funded to work on a bespoke open source project for such a good cause.

How does she barely make minimum wage as a speech therapist? My mother worked in the school system for 20 years making nothing. Now works in skilled nursing, people that just had strokes and other trauma learning to speak, eat, or breathe correctly again. She makes around 80k and regularly picks up side jobs at other facilities for $50+ an hour.

I have another friend from college who works in a hospital and makes 70-80k. Although there isn't much increase over the years in a hospital.

Just curious because I'm familiar with the field. Are things different in Europe?

Could a professional organization of speech therapist come together and fund a competitor? Obviously you would need to deal with the free rider problem somehow.

The "free rider" problem has been solved. Unfortunately the solution is to have ruthless for-profit businesses, which is where we're at today.

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