If you look at a chart of China's exports to the U.S. over the last twenty years, it looks like a ski jump, with products of all classes - from sneakers to software - flowing into the U.S. at the tune of over $179-billion in 2004.  Low wages, increasingly-skilled workers, affordable land, and industry-friendly laws make China - as well as other Asian countries - among the most cost-effective origins for many of the goods in our daily lives, including many mobility products.   Like all goods, the manufacturing of mobility products falls into economic models, where market forces - brand competition, funding constraints, and decreased U.S. manufacturing infrastructure - dictate more cost-effective manufacturing.  Over the past two decades, the manufacturing of many durable medical goods moved from the U.S. to Mexico, then to Asia.  It's been over the past seven years, however, that the U.S. mobility industry has made a notable shift toward manufacturing increasing numbers of manual wheelchairs, powerchairs, and scooters in Asia.  Further, the trend has not only shown U.S. companies pursuing manufacturing in Asia, but also Asia-based manufacturers introducing their own products and brands to the U.S. marketplace.  While the realities of mainstream manufacturing efficiencies affect the mobility industry as they do most other sectors - automotive, electronic, textile - how do Asia-originated products affect mobility consumers, especially in terms of quality?  It's this question that leaves some U.S. consumers wondering if their 2005 mobility products are of the same quality as their 1995 models? To fully understand the quality of mobility products manufactured in Asia, it's vital to recognize the varied channels that bring such products into western markets.  In the low-end of durable medical goods - walkers, steel wheelchairs, economy scooters and powerchairs - there is a level of unbelievably low-cost products that are designed and manufactured in Asia, shipped to the U.S., and distributed under little-known names (this same supply chain allows providers to bring in shipping containers of products, as well, for independent branding and distribution).  These products are commonly advertised on the web and EBay, where you can buy a "New 18-inch Lightweight Wheelchair" for $75 or less.  As the cliché says, you get what you pay for, and the poor integrity of these products isn't what most would knowingly choose. The next level of Asian exports is that of mid-range brands, imported by U.S.-based companies that have minimal levels of customer support, who sell through providers.  These products typically land in the low-end but coded manual and powerchair markets, serving a dealer price point slightly lower than that of the major manufacturers.  While coding suggests that the products meet ANSI/RESNA and FDA protocol, they can still prove of questionable quality, often designed and manufactured in Asia, with less-than-ideal quality control in the country of origin or when distributed in the U.S.  Nevertheless, these products - imported from Asia by U.S.-based distributors - are a step above pure Asian container products exported to the U.S.   The top level of manufacturing in Asia - and, of most relevance to high-end mobility users - is that of the major U.S. mobility manufactures.  Whereas low-end products are typically designed and manufactured in Asia, and merely distributed in the U.S., the major brands' manufacturing is more conventionally based in the U.S.  Using a mid-range powerchair as an example, the product is designed and tested in the U.S., with a mixture of globally-tooled components, including those from Asia, all of which are often assembled in the U.S.  Further, for products exclusively assembled in Asia, most U.S.-based manufacturers implement quality control procedures and on-site personnel in Asia that maintain high standards, performing additional quality control procedures once the goods arrive in the U.S.  Put, simply, most major manufacturers don't simply import products; rather, most major manufacturers originate designs, testing, assembly and quality procedures in the U.S., then draw upon Asian tooling to enhance cost efficiencies.  (It must be noted, however, that for higher-end ultralight manual wheelchairs, powerchair, and power seating products, most tooling and manufacturing remains in the U.S. - some products simply have too many variations and too much customization to import.) As much as the mobility industry can seem an entity of its own, it fits the class model of most 21st-century industries.  You can buy an inexpensive pair of athletic shoes at a discount store, or an expensive pair of Nike shoes at a department store - and both pairs of shoes are made in China.  As it turns out, though, the discount, no-name shoes rarely offer the design, construction, quality, or longevity of the Nikes - that is, Nike, as a manufacturer, dictates the design and quality of its products in ways far beyond simple shoe importers.  This principal proves true within mobility products, where low-end import brands, as a whole, simply don't prove the same quality as the major U.S-based manufacturers. Regardless of individual philosophies toward "buy America," the reality is that it is a global economy, where much of what we use in our daily lives is manufactured in Asia, including many mobility products.  However, the question of quality in this age of manufacturing  in Asia - as shown from the difference in quality among direct imports, U.S. distributors, and major U.S. manufacturers - isn't based on the country of origin; rather, the difference in quality, much like no-name shoes versus Nikes, comes down to the quality of the manufacturer.  Put simply, in this age of global manufacturing, the consumer equation remains truer than ever:  Quality companies manufacture quality products, regardless of geography.