Dean Kamen's robotic "Luke" arm - How long before this can perform martial arts? | Hacker News Reader

Dean Kamen's robotic "Luke" arm - How long before this can perform martial arts?

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I'm missing a foot (don't BASE jump kids!), but I can't imagine how difficult it would be to be without an arm, much less two. I have to wonder if they'll ever be able to get the reliability of this arm design sufficiently high that it won't be a constant maintenance burden for the user. I break some aspect of my prosthesis every few months, and it's a pretty simple design. This arm has perhaps perhaps three orders of magnitude more components.

Furthermore, the market for these will be quite limited as insurance companies are unlikely to provide one for an amputee, especially one who has an arm remaining. I'm told it's very hard to get the Otto Bock C-Leg (http://www.ottobockus.com/PRODUCTS/LOWER_LIMB_PROSTHETICS/c-...) paid for now, and it's "only" $40K for a complete system. The likely segments are those who have military injuries or workman's compensation claims (the same thing, I guess) where the burden to restore one to "normal" is much greater.

For me, I'm much more interested in schemes to attach lower limb prosthetics to existing bones (a tibia in my case) as most maintenance issues are related to the socket rather than the foot or other parts.

That's really a sad fact. Insurance companies are in it for the profit sadly.

One part of the problem is that prosthetists are paid a flat rate for providing a leg/arm/whatever based on a set of standardized product encodings for the parts/labor.

This leads to two incentives:

1. Pick the cheapest components that meet the category requirements. So, in each reimbursement category (micro-controller knee, etc.), its a race to the bottom as there's a financial incentive to choose the least expensive knee rather than the best one. Component providers race to reduce costs once a new category is assigned a reimbursement code (another problem altogether).

2. Pick the cheapest patients. An active person like me is much more demanding than a demented old guy in a nursing home. I make appointments to get things fixed if there's something wrong and demand a functional, comfortable leg. The old guy gets a leg because Medicare pays for it even though he may never actually walk more than a few feet on it! This is actually a common scenario. So, the old guy accepts whatever leg he's given and doesn't complain. Furthermore, since the amount reimbursed for labor increases with the complexity of the system (term used for bundle of parts that make up leg/arm), there's an incentive to provide too good of a system for a patient's needs (people in wheelchair don't need a $40K leg).

Luckily, my prosthetist doesn't optimize for short-term financial gain. However, I'm told that practices like this are common. So, the insurance companies protect themselves in coarse-grained ways, often at the detriment of patients with real needs.

I don't know what to do about this problem. I think it's part of a broader issue with healthcare in the US -- we are unwilling to accept the notion that human happiness might not be maximized by providing everyone with the "best" possible medical care. We provide life support to 90 year-old people who are unlikely to live much longer no matter what we do. We buy new wheelchairs when refurbished ones would be sufficient. Insurance companies spend money one people even when they might themselves choose to forgo the spending in lieu of the cash. We expect our insurance companies to pay for everything that's "medically necessary" and (I think) mandate such care by law. So, because market forces aren't allowed to throttle demand down to rational levels, the insurance company implements bad proxies.

Technically every business is in it for the profit. If not an insurance company, then it would have to be a non-profit (too underfunded to make a big difference) or the government (insert your own concern).

Ok, so the segway didn't change the world, but I completely believe that Dean Kamen can, in fact, change the world. This plus the water purifier, plus the thousands of kids brought into robotics and science via the FIRST program... I kind of feel like he's a modern Edison, despite being a dropout from a second tier technical school. I guess someone forgot to tell him that pleasing your professor is more important than pursuing your dreams.

What's important about this, too, is that we, as software folk, often forget that there are many, many different kinds of technical "start-ups," that have nothing to do with the web or personal computers. It's nice to be reminded that the technical world has room for small, lion-y robotics and biotechnology start-ups, as well.

How long before it can perform martial arts? Give it a configuration like this one: