# How cheap do prosthetics have to be for poor people to afford them?

A common sight that can be seen in Sci-fi is the sheer amount of people who have prosthetic limbs. Even characters who are apparently live in conditions implying they are poor are somehow able to buy a prosthetic that would cost thousands of American dollars. After noticing this trend I wondered, how cheap must those prosthetics be?!

Assuming that somehow a society built extremely advanced prosthetic limbs, how cheap would they have to be for the poor, lower people citizens to be able to afford them? What reasons, other than cost, could explain why poor, poverty stricken citizens can have such advanced prosthetics?

• Free, because poverty is relative. Poverty =/= poor - the poor are richer than those in poverty. Poverty is general scarcity, dearth, or the state of one who lacks a certain amount of material possessions or money. The people in sci-fi with prosthetic limbs are not in poverty - they may be poor (compared to the average person) but they are definitely not in poverty. – Aify Jul 12 '16 at 4:43
• In the manga Gunnm almost everybody is a cyborg because if you're injured for example you broke your arm "medics" just cut off your arm and replace it with a robotic one. Then you are forever in debt to the medic. And in the violent world of Gunnm there is plenty reason to be injured. – Rigop Jul 12 '16 at 7:29
• I read the heading and assumed that you meant cheap robots, like the free robot that USR&MM gave to Will Smith's mother in the I, Robot film. It might be worth modifying the heading to indicate you mean prosthetics (or cybernetic implants :D)? – Karl Castle Jul 12 '16 at 10:42
• Title is about robotics but body is about prosthetics. Cyborgs are not robots. I came here thinking you wanted everyone to have 2 or 3 robot workers to do their chores, not a spare hand. Could you update the title question please? – TafT Jul 12 '16 at 12:37
• You don't even need health insurance if the country has a national welfare system that covers medical care. People in Europe today who need prosthetics generally get them for free regardless of income. No reason for that not to extend to more advanced prosthetics as they become available. – Simba Jul 12 '16 at 14:23

### They may have not paid for it

Prosthetics may be considered to be reimbursable by your healthcare provider.

If there was a big war (that could leave a lot of landmines), or some natural disaster that would cripple a lot of people ("thanks to our new safety systems, nobody died, they're just broken a little"), or just enough lobbying from the robot industry (which is actually very likely if it starts being cheap).

### "Everybody has a smartphone"

Everybody, everywhere (actually not, but smartphone ownership spans over most social stratifications). Whether it's a low-grade one, a stolen one or a "I've-ruined-myself-but-it's-totally-worth-it" one.

If your social status depends on it and there is a way to get one, getting one is a chance to get out of poverty or at least forget it for a while. I don't think any poor person wants to be seen as such.

### "Special" payment plans

A very honest prosthetic seller said this to me one day:

Here, I'm giving it to you for 10 $. Just sign this contract, oh, don't read those tiny lines about you being indebted for life, they're here for technical reasons. I was not poor at the time. Now I am. I'm not allowed to sell my prosthetic back. I'm actually legally bound to publicly say that it is great and I could not live without it. • "Everybody has a smartphone." — I guess I'm nobody, then (I could afford it if I wanted, it's just that I don't want it). But then, I'm not sure how long it will take until I actually need one just to take part in normal life. – celtschk Jul 12 '16 at 7:43 • Edited. That was indeed a pretty harsh statement from me. – PatJ Jul 12 '16 at 7:49 • @celtschk: I guess you haven't heard about Pokemon GO. – Romain Fournereau Jul 12 '16 at 9:21 • @RomainFournereau: Indeed, I haven't. And after a quick look at the Wikipedia page, I don't think I missed anything important. – celtschk Jul 12 '16 at 9:48 • @celtschk I think it is about time to go yell at some young whippersnappers about getting off your lawn ;) – Shane Jul 12 '16 at 20:19 Prosthetic limbs are actually becoming cheaper, even in the real world. People are currently 3D printing prosthetic limbs. The technology behind human/prosthetic communication is becoming better as well. The electronics arent that complicated compared to other technologies. In the future, I would expect getting a prosthetic limb would be as simple as going to a clinic. The doctor/tech would use a computer to size and print the limb, use mass produced electronics, give you an instruction manual, and shove you out the door. 80% of the world's current population has a cell phone. Why? Because the technology and manufacturing is cheap. Even people without working toilets have cell phones. • How much does the cheap price of cell phones relate to the abuse workers of third world countries? If, say, the same cellphone or a notebook was produced in Europe, where each worker was paid a fair wage, worked up to 40 hours a week, 8 hours a day, had health insurance and permanent contract. Would it still be a commodity as it is now? – Maurycy Jul 12 '16 at 11:12 • @Maurycy I may be completely wrong here... I am no economist. But I've always had the impression that cell phones could in theory be completely built by robots, just like cars have been built in some factories for decades now. I think electronics manufacturers go to China and other places where labor is cheap not for the labor itself, but for lower taxes more conivent laws. The countries that accept those manufacturers then have them hire a large workforce as a "solution" to reduce unemployment rates. Quid pro quo. – Renan Jul 12 '16 at 11:18 • @Renan never underestimate the cost of the robots, all that expensive maintenance and initial capital investment. Cheap workers can be much cheaper. – gbjbaanb Jul 12 '16 at 11:59 • Ha, I like your definition of poor. A 3D printer of sufficient quality to print prosthetics would be at least >1k dollars, if not > 2k dollars, plus materials. – Toby Jul 12 '16 at 14:44 • @Maurycy It should be noted that even if you exploit workers, you benefit them. That's because unless you are literally forcing them to be in the factory, they would be doing something else. They aren't because all their other options are worse, and your option is making them better off. – PyRulez Jul 12 '16 at 15:51 It's not a matter of the poor being able to afford prosthetic limbs, the government gives them to the disabled. Why? Because it's cheaper than paying out welfare benefits. This way the poor can get back to work again. Pity about the likelihood of them losing more limbs in the oppressive sweatshops where they're forced to work. No-one wants them living off the State. Why waste good tax dollars on social welfare for the poor when there are richly deserving corporations that need propping up and safeguarding against the incompetent decisions of their executives, that periodically bankrupt them. EDIT: I forgot to mention I assumed the prosthetic technology is mature, development costs have been paid off, and manufacturing costs have plunged. For technology, most of the cost of making something is in the research and development, not the actual manufacture. The research, development, design of both the device itself and the means to manufacture it is a once-off cost and once it's paid for, it's simply a matter of churning out millions of the devices, and assuming you can sell them all you can sell them quite cheap. This is why you can get a smart-phone, which is a highly advanced computer which can also do advanced telecommunications, take photos, etc. as well as fit in your pocket for under €100 In other words, your robotic limbs can be affordable by even the poor as long as enough people use them • for under €100... How about for$3 established technologies always get cheap to the point of commoditisation. – gbjbaanb Jul 12 '16 at 12:01
• Apart from R&D, another important cost factor is machinary / Infrastructure, and marketing. Other than that, i agree with you. – Burki Jul 12 '16 at 14:51

Can your society afford not to give people prosthetics?

Consider the two very widespread forms of medical device that huge majorities of the population have: eyeglasses and dental fillings. First-world healthcare systems make these available to everyone for either nominal fees or completely free for those that are unable to pay. Why? Because not having them is debilitating and potentially removes the ability of someone to be a useful contributory member of society.

It might also be worth questioning in both your future society and the present where the need for prosthetics might come from. The UK's Paralympic team has a large contingent of ex-soldiers in it. The Iraq war caused a large number of limbs lost to mines. Society can't really abandon its wounded veterans any more than it could charge for battlefield medicine.

Assuming the story happens in a first world country, they would likely have free public healthcare. The government pays for the prosthetic as part of the treatment for whatever injury they suffered.

Also, I don't think a mass-produced robotic prosthetic would be all that expensive, compared to many other modern day treatments. In a highly robotized world, things are not expensive, human labor is.

It all boils down to two necessities: energy and manufacturing capacity.

3D printers could, in theory, create pretty much anything if you feed it the right goo. However, this process is likely to be very energy-intensive, especially if you are creating more than an intricately shaped piece of plastic or metal.

This does assume that the research has been done to create sophisticated robotics and other items with a Star Trek-style replicator, however the facts of science and engineering are not dependent on time or society, so if the knowledge exists and is freely available (which is to say, not constrained by patents or other intellectual property laws), then one could imagine that the printer goo could be delivered in a form where it can be broken by the 3D printer into the base components necessary to create pretty much anything, and can be pumped in and out of a dwelling like water and electricity.

A technologically advanced civilization may have abundant energy, resources, and the scientific understanding to create advanced mechanisms cheaply, but if we were to base this civilization from what we know about our own, the most expensive component may end up being intellectual property royalties and/or licensing. This is not unlike the pharmaceutical industry, where legal monopolistic production allows medications that can be produced at $10 per dose be sold exclusively at a price a hundred times as high. Let's assume, for argument's sake, that these prosthetics are$5,000 (in today's world, that's fairly reasonable for the lower-end models), and that, just so that I don't duplicate anyone else's answer, this is a very un-generous society that refuses charitable acts such as giving one of these to someone for free.

Most poor people probably could afford to spend $1 a week on such a thing, if they really felt they needed it. 5,000 weeks is about 96.15 years, or 96 years and 1.8 months. That would mean that according to this theoretically viable payment plan, albeit a ridiculously long one (on which either party might insist on the right to back out at any point before the payment is complete), the person with the prosthetic, and probably his children, would be paying for this thing for their entire lives. Yup, much easier for everyone just to fork it over. I was recently a juror on a lengthy medical malpractice case involving an amputee. I'm nowhere near an expert, but we had to learn quite a bit about prosthetics in the course of the trial. My biggest surprise was how often adjustments and fittings needed to be done to get a good fit for the individual person. If the fit is not just right it results in some very painful blisters, and best case you're back in a wheelchair while it heals, worst case you require surgery on your limb. I think that constant readjustment and refitting by a professional is really what drives the cost up. If you want to bring the cost down for a mass market, you'd have to create a technology that would take that professional out of the loop somehow. Just pick up a kit at your local drug store, have it scan your residual limb, and it auto-adjusts for a perfect fit. • That's a lot of the idea behind 3d printing them actually -- be able to print something that's custom-fit to a 3d scan of the stump, so that it comes out right the first time. – Shalvenay Jul 13 '16 at 4:33 Sophisticated prosthetics as we currently know them are almost always prototypes or custom built high performance devices like the carbon fibre feet paralympians use. They require custom parts, custom materials, hours if not days/weeks/months of skilled labour to design and construct; I am emphatically not including 3D printed prosthetics in this category. The manufacturing processes used to create prototypes and one-off devices is completely different to the processes used in mass manufacturing. A silicon mold cast may take hours to set and cost hundreds once you include the cost of making the mold, the mix-&-set resin and the labour cost of the skilled craftsman. Whereas an injection molding machine can create the exact same thing from cheaper materials (ABS) every few seconds, reducing the cost of manufacture to little more than the bulk materials cost + shipping. The same principle applies to almost every component, only a few specific metal parts will need to be individually machined and automated CNC mills and lathes already exist, really the only thing preventing them from being mass manufactured now is the relative infancy of brain-computer interfaces. Once these "augmentations" are popular/mainstream the companies that build/sell/market them will want to create ever increasingly desirable models to convince consumers to buy their products again and again, like how Apple releases a new phone every other year or so. This obsolescence by fashion means there will be a thriving after market of second hand and out-dated prosthetics, eventually culminating in perfectly functional yet undesirable prosthetics ending up in the trash. I used to work in retail and I remember throwing dozens flip phones that were the height of 90s fashion in the bin, the packaging hadn't even been opened. how cheap something has to be for someone to afford it doesn't make sense to me. Any any price point, there will always be somebody who cannot afford it! Consider if prosthetics were available for$500, at that price point a lot of people could afford it, but then there will always be a proportion of people (albeit smaller population than before) who will not be able to afford it. Maybe, what can be done is increase the variety of prosthetics available at various price points (with obvious price:functionality tradeoffs) so that many more people can afford them. Expecting health insurance or govt to foot the bill is not a solution on aggregate societal basis. It is just transfer of costs within society members (and not always fair). if funds can be invested in material and design science, maybe it could be possible to produce reasonable functional prosthetics at much lower price points that present.

Suppose one defines poor, as 'struggling to get basic neccesities'.

In this case I would argue that something is affordable for poor people if one of the following two points apply:

# 1. It is a basic neccesity

Hopefully this derives from a social perspective (rich societies consider it a basic need, so they subsidize).

Possibly this derives from a survival perspective (you need prosthetics to survive, so you simply won't see any poor people without prostethics as they fail to survive).

# 2. It does not cost more than basic neccesity

In order to survive, poor people will have to be able to come up with funds to get basic neccesities like food. If they are (just) capable of that, than most poor people should be able to get prostethics at some point if they don't cost more than a few cheap meals.

# Conclusion

If prosthetics are a basic neccesity, they could cost anything. But otherwise not much more than a few cheap meals.