Why the conversation on the right to reparation needs to expand further
The right to repair movement has been successful at the state level in raising awareness of the financial, environmental and ethical benefits of allowing consumers to seek repair and reuse of products, from watches to computers. At the White House level, this has been hailed as an important aspect of increasing competition, which helps and develops the economy as a whole.
President Biden’s executive order, “Promoting Competition in the US Economy,” was accompanied by a 72-point fact sheet explaining how this was to happen. The order goes so far as to encourage the FTC to speak out against anti-competitive restrictions on repairs and reuse. However, health products were not included in this. In health, prescription drugs, hearing aids, hospital groups and health insurance are singled out. While in agriculture, for example, the repair of equipment is discussed, there is no mention of instrumentation or equipment in healthcare, although manufacturers’ restrictions on the reuse of the devices. health care significantly curbs competition and increases costs.
The online magazine ICE – Advancing Imaging Professionals – describes this situation in an excellent article from July 14. The author also explains how MITA (The Medical Imaging & Technology Alliance, an association of technology manufacturers) celebrates this exclusion of medical instrumentation from ordering by emphasizing the category difference with medical device equipment, which “would raise both patient and cybersecurity concerns ”.
But not everyone celebrates this exclusion.
On September 1, Jarone Lee, MD, MPH, FCCM, member of the editorial board of BMC Anesthesiology and Associate Professor at Harvard Medical School and Director of ICU Blake 12 at Massachusetts General Hospital, reflected on the order and what it lacks in terms of medical redress. He considers the linear supply chain paradigm in healthcare to be unsustainable – financially and environmentally. Dr Lee, in fact, believes that regulating the right to redress “should enable the healthcare industry in the United States to become more sustainable, environmentally friendly and affordable.”
However, in terms of the success of right to redress approaches in health care, three main challenges exist:
- Patient safety (regulations and standards are important here)
- Cybersecurity (patient privacy, etc.)
- The need to make room for innovations in health (adaptability)
To overcome these challenges, manufacturers must stop incorporating planned obsolescence into the design process, and they must make parts and technical knowledge available for repair processes. Products must be designed to be repaired and reused, and reuse equipment must be subject to strict rules and regulations, standards that match those that manufacturers follow.
Dr. Lee’s observations are extremely helpful in moving beyond MITA’s commentary on patient concerns. I suspect that health products are specifically not included in the order information sheet, as health products are considered too dangerous to be changed in terms of reuse. However, this is an archaic notion and it is disappointing that the presidential decree ignores established healthcare reuse practices that pose no high risk to the patient and meet the manufacturer’s standards. MITA’s comment also ignores the fact that the same characteristics of the category they call (patient safety and cybersecurity) have been dealt with exhaustively in the regulation which specifically concerns medical devices and their reuse, and which has been widely used in healthcare for the past 20 years!
Reprocessing of single-use devices has been regulated since 2000 and is closely regulated by FDA procedures and rules. The practice of reprocessing single-use devices involves collecting used single-use devices at the hospital, then tracking, cleaning, testing and sterilizing the devices before they are made available to hospitals for a second use. . This practice reduces the number of devices that end up in landfills, it creates a more resilient supply chain, and it saves hospitals hundreds of thousands of dollars a year, sometimes more. Reprocessing of single-use devices is arguably the most successful circular economy solution in healthcare and could rightly be used as a model for how administration and industry embrace these principles, all in all. without compromising patient safety and adhering to appropriate standards.
Yes, health products are “Categorically different” from tractors and consumer electronics. Yes, the reuse of medical devices requires strict regulation. Yes, patient safety is a concern. But that’s not to say that practice shouldn’t be at the center of any administrative initiative regarding competition, the environment, and the desperate need for savings in healthcare. It is time for the administration and industry to become better informed and up to date on key health practices that could become a model for solving all of the issues raised by Dr Lee.
Photo: Vadim Sazhniev, Getty Images