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.
There would still be regulations that would allow public equity wheelchair makers to jack prices.
I'd start importing them for less than $500 from India [1]. (Versus $1,500 to $6,000 for these jalopies.)
[1] https://www.amazon.in/electric-wheelchair/s?k=electric+wheel...
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.
> 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?
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.
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?
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.
Can the FDA stop a person from using one by coming to their home and confiscating it?
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.
Vested interests sell regulation to the public as a "consumer protection" mechanism, then use regulatory capture as a tool to erect barriers to entry and impose complex rules that supersede common-law jurisdiction while giving them a range of tools to evade liability. The threat of competition is restrained, and a de facto collusive oligopoly can squeeze the market dry.
I don't think people give Meta enough credit for their roll in that. Microsoft/OpenAI got cozy and thought they had a huge moat made of $100K hardware to protect their $10B investment. Then Meta shadow drops Llama and within weeks regular folks were running GPT3 level LLMs on consumer hardware. That was such a huge win for opensource and consumers.
The same way we address security around cars: we don't ban individuals from working on project cars, or driving them on public roads - instead, we have standards for OEMs and individuals, and prosecute negligence.
AI safely is similar to GM lobbying for laws making it illegal to tweak your own car or changing your own brake fluid for "public safety".
I'm not quite sure what you mean, or what in AI safety you see as analogous.
For other technology, certainly building and using certain things is illegal - you can't make hand grenades, lots of chemicals; I'm pretty sure you can't own certain instruments of crime, counterfeit money, etc. Many things you can do; it's not all or nothing.
IMO, for the general public, current AI models are much closer to cars than they are to anti-personnel weapons, when plotted on risk/benefit axes. FWIW, vehicle regulations are not an all-or-nothing affair either - there are things that remain verboten.
Those who claim AIs are too dangerous to be in the hands of the public have ulterior motives, and/or are far more optimistic than I am on the speed and ease the chasm between LLM and general intelligence will be bridged - if it at all.
Regulatory intervention makes it harder, not easier, for individuals to take charge of these matters for themselves. You can bet that the first casualty of a regulatory regime for AI would be to suppress development of FOSS solutions that would eventually give people the maximal control and benefit from AI, and force them into dependence on third-party solutions offered by organizations that have influence over the regulatory regime itself.
If AI takes over the world, or others pump lots of GHG into the air and cause climate change, or someone sets off explosives and burns down my neighborhood, or my frozen chicken contains poisonous bacteria, or my bathroom sanitizer doesn't really sanitize - how do I opt out?
Plenty of regulations coexists with FOSS, obviously.
The arguments against all regulation are transparently weak, and the apparent dogmatism discredits everything else. Why be so dogmatically anti-regulation? Dogmatism isn't about finding truth but about serving someone's political interests. If I understand correctly what's happening, whose interests are you serving and why?
This is a potential concern, but no currently-existing computer system (that I'm aware of) is any kind of risk for that. Certainly, nothing OpenAI has produced is.
I'd say the currently-real unaligned-agent behaviour of our institutions is a bigger risk than currently-fictional computer-instantiated unaligned superintelligence. And we do have regulation in place to constrain the behaviour of many institutions: governments, corporations, utility operators, and so on.
The unaligned agent problem was not discovered by the AI safety people. They merely named it.
In other disciplines, this is known as the "principal-agent problem" [1] or "fiduciary risk" [2].
Like you, I'm far more worried about the behavior of human institutions controlled by third parties with their own agendas than I am about the behavior of software that implements stochastic algorithms.
The risk in both cases comes from people surrendering their own agency and autonomy to external parties, and we already live in a word where too many people put blind faith in dysfunctional institutions which are demonstrably "unaligned" with the actual values and interests of those they pretend to act on behalf of. Turning to those very institutions to stop people from relying on "unaligned" software seems absolutely insane.
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[1]: https://en.wikipedia.org/wiki/Principal%E2%80%93agent_proble...
That strongly depends on the details. In particular, regulation that compel clear disclosure of information to individuals.
Imagine how impossible it would be to "take charge for yourself" if none of the food in the grocery store had any ingredient/nutrition/allergen information, and bottles of pills didn't tell you the active ingredients and amounts.
I can't think of many such things. Do you have any examples?
> There's not really a way for an individual to opt out of a corporation using AI in a way that negatively effects them.
Refrain from doing business with that corporation? If they are transgressing against your person or property, that's where the law comes into play.
My eye doctor office got bought out. They pay the doctors as little as possible and maximize the number of appointments per day.
At smaller places, sometimes the owner sells to PE and stays on - they just don't want to deal with the business side of things anymore.
Quitting your job to start your own thing is never an easy step.
I wonder if regulation that stipulated that a change of ownership of some percentage would require recertification of the entity would stem this a bit. Or restrictions on buying HIPAA covered businesses with patient data. Might pose a problem to folks in the business today, but could slow down the massive acquire-and-merge train in these industries.
PE is responsible for PE's actions. If these services and goods decline under PE, with the same regulations as before, then the cause is clear.
In a free market, "moats" like regulatory capture would not exist. In a market like this, where the customers--wheelchair users--are generally pretty savvy about what they need, a free market would have no trouble providing products that met customer needs at an affordable cost, because customers would have meaningful choices about who to buy from and who not to buy from, and customers would see the full cost of the products so they could make meaningful cost-benefit calculations.
In capitalism such as we currently have, none of that is happening. The government aids and abets rich people who want to siphon off even more wealth than they already have by putting regulatory barriers in place that stifle competition, and it removes visibility into actual costs by forcing all medical products and services to be provided through health insurance, even when, as in this case, there is no insurable risk involved--it's an ongoing medical need that is already known (not a risk) and which is predictable (so insurance makes no sense anyway). The result, of course, is that the customers get shafted while rich people get richer.
In a free marked that is absent of regulatory hurdles, it is far from guaranteed that costs would be affordable.
Freedom from regulation about how wheelchairs have to be constructed would go hand-in-hand with freedom from regulation against monopolistic practices!!!
In a completely free market, devoid of regulation, wheelchair makers can get together and fix prices. Or buy each other.
It independently evolved in Rome and India to provide legal personhood to cities, guilds, public works and later, in the former, the Catholic Church.
That's one aspect of capitalism, yes. But in capitalism as it is currently practiced, most of the people who are accumulating capital aren't people that are trying to start new ventures. They are people that are already rich but think they aren't rich enough, who are unable to start new ventures themselves because they have no actual skills at providing valuable products or services, so instead they find some existing venture and siphon off all its wealth. (This pattern is not new, btw; it's the same way the "robber barons" in the late 19th century operated.)
> In a free marked that is absent of regulatory hurdles, it is far from guaranteed that costs would be affordable.
Nothing is ever "guaranteed". But the article under discussion makes it obvious that with regulations in place, not only are costs not affordable, but even the very existence of products meeting customer needs is not happening. A free market couldn't possibly do any worse.
> In a completely free market, devoid of regulation, wheelchair makers can get together and fix prices. Or buy each other.
This would only happen if it were economically more efficient for wheelchairs to be made by a monopoly. I strongly doubt that is the case. It's not the case for the vast majority of products and services. If it's not economically efficient, the monopoly (or price-fixing cartel) will simply be out-competed in a free market, because it will have no way of keeping other companies from producing at a lower cost.
Historically, virtually all monopolies have been the result of government interference. (The original meaning of the word "monopoly" was a royal grant of the exclusive privilege to sell a particular product or service.) Most large corporations today are not the size they are because that is the most economically efficient way to deliver their products or services, but because it's the best way to buy government favors.
I'm with you on this. In general, the state (by definition) functions to protect the interests of the politically dominant class, which, under capitalism, is the owning class. From the haymarket massacre to Biden's strike breaking shenanigans, this is absolutely beyond dispute. The state will always facilitate monopolies. The only way to get rid of monopolies is for the workers to organize and overthrow the dictatorship of the owning class. Until that happens, it's all Disney, Amazon, and pseudo democracy.
It worked very well in Tsarist Russia, but that could have been a fluke.
It could get chummy with them and fix prices. It could buy them.
Which were put in place in response to other rich people lobbying the government for regulations that favored them and their companies. Perhaps there haven't been many recent ones put in place specifically in response to lobbying by private equity companies (though I'm not sure that's true). But that doesn't change the main point.
That's why we have regulation: to establish the minimum standards.
Simple medical devices like wheelchairs (Class I or Class II) are also not super over-regulated, you don't need to do clinical trials to certify them. All-in-all it'll cost you around $10m, which is not at all a moat.
Only if a wronged party has the resources (time, money, political capital) to pursue it.
Which is but one reason why it is deeply silly to rely on it to make a society go.
In a free market, if there is a market need for more efficient achievement of redress for wronged parties, the market will produce it.
> Which is but one reason why it is deeply silly to rely on it to make a society go.
But of course relying on governments to achieve redress for wronged parties works just great. Not.
In our current market, many companies have worked around redress of wronged parties by mandating arbitration in various contracts.
> the market will produce it.
Only if it's profitable. Feeding poor people, caring for the indigent, etc. isn't profitable.
Are you confusing markets with business?
To profit means that you accepted a debt instead of getting something in return for your efforts. Business seeks profit because the expectation is that it will pass the debt on to the stakeholders who will then call the debt and get something in return for their efforts.
But it is people who participate in the market. If they demand profit continually, therefore not getting anything in return, that just means they're working for free. People won't feed the poor unless they can do it for free? Methinks that's not what you meant.
Regulation is by nature slow and highly susceptible to corruption or stagnation. Whereas the courts, as onerous as they may be, essentially achieve the same thing through liability but it is more dynamic, more responsive, and more likely to error correct than the former.
Likewise regulation is limited to preventing foreseeable issues, and is often only implemented after somebody suffers damages.
The difference is that regulations are imposed by a third party whose interests may not be aligned with those who are actually involved in the matter. This is good in circumstances where there are externalities, for example just because I'm okay with entering an agreement with a company to use my backyard to store toxic waste doesn't mean my neighbors would be very happy. But when people are making decisions that will only affect themselves, such as what wheelchair to purchase, liability really is the more sensible consumer protection.
No, it isn't, because nobody will buy chairs from a company that does that. In a free market, no company can use the get out of jail free card of "but I was following all the regulations". Businesses have to actually meet customer needs.
And in a free market, customers can't delude themselves that Big Brother is looking out for them (even though Big Brother is not actually doing that); they know that they have to enforce quality if that's what they want. That means customers know that it's on them to be savvy enough to be able to evaluate the quality of products and services.
> That's why we have regulation: to establish the minimum standards.
That's what regulators claim, but all history shows that claim to be wrong. The end result of regulations is to reduce the quality and availability of products, not increase them. The wheelchair market described in the article is a classic example: it's regulated up one side and down the other, yet customers can't get simple things like proper footrests.
> Simple medical devices like wheelchairs (Class I or Class II) are also not super over-regulated, you don't need to do clinical trials to certify them.
Doesn't this contradict your claim that regulation is the only way to avoid exploding chairs? If you don't do clinical trials, how do you know the chairs won't explode one day after the warranty expires?
Of course the answer to this is that the regulators just, you know, look at the design of the chairs to evaluate them for certification. But customers could do the same thing for themselves, at less cost (what, you think those government regulators work for free?). So the regulations are actually adding zero value. But they're certainly not adding zero cost.
> All-in-all it'll cost you around $10m, which is not at all a moat.
So you'll be going into the wheelchair business then? Looks like there's plenty of opportunity to out-compete the current incumbents.
> regulators just, you know, look at the design of the chairs to evaluate them for certification. But customers could do the same thing for themselves, at less cost (what, you think those government regulators work for free?). So the regulations are actually adding zero value. But they're certainly not adding zero cost.
I have little idea how to evaluate the safety of an electric wheelchair, and don't have the time to acquire the expertise to learn how to do that with everything I buy. But we all can chip in and pay someone, who has the expertise, to do it once rather than than millions of people doing it redundantly.
Also, I don't want to live in world of frauds and scams and other crimes, trying to navigate it, for obvious reasons. It's also an economic disaster.
You're doing an awful lot of work to empower already powerful people by removing democratic power over our society.
Yes, what if it does? Unfortunately getting FDA approval isn't going to do anything to prevent that. I fully acknowledge that regulatory bodies are good for dealing with externalities, but consumer protections do not fall under that category.
> Also, I don't want to live in world of frauds and scams and other crimes, trying to navigate it, for obvious reasons
Then, as I said, just stick with the FDA approved products. Government standards would still exist, you'd just have the option to purchase things that didn't meet those standards. The freedom to color outside the lines includes the freedom to color within them. You're not harmed by other people choosing differently.
> It's also an economic disaster.
Citation needed. Typically heavily regulated economies fare worse than those where competition is permitted.
> You're doing an awful lot of work to empower already powerful people by removing democratic power over our society.
We clearly have very different ideas about who holds power in our society.
Meeting customer needs is optional, what businesses might decide to do instead is change their name once a week on amazon/ebay, hire teams of robots to fake reviews, and then deceive customers into buying doll house furniture at full size prices.
It seems unlikely you are unaware of this type of behavior, so I guess you have an explanation for how an unregulated market in a modern context is supposed to deal with bad actors?
Ok, I know we’re assuming electric wheel chairs, we don’t want fires or stuck accelerators, but really? This is still fairly close to literally reinventing the wheel, or adding complexity, a RC car.
It’s pretty sad to think this level of almost Stone Age technology only needs a 10 million dollar investment to bootstrap.
It's really not. If your chair overturns and traps a disabled user, it can be a death sentence for them. If your battery starts burning, your user _might_ _not_ _be_ _able_ to escape the flame.