Medical devices are largely designed in the United States and while the US has a decent size medical device manufacturing industry, it has been significantly moved offshore the last twenty or so years. The offshoring I've been part of hasn't worked out nearly as well as the executives planning the move has hoped with the offshore sites running into labor or quality problems that took years to work through. Two articles have recently caught my attention on companies starting to inshore production.
The NY Times published an article which covers the negatives of out sourcing and companies who have shifted manufacturing to the United States:
Time was foremost among them. The Indian mill needed too much time — three to five months — to perfect its designs, send samples, schedule production, ship the fabric to the United States and get it through customs. Mr. Winthrop was hesitant to predict demand that far in advance.
There were also communication issues. Mr. Winthrop would send the Indian factory so-called tech packs that detailed exactly what kind of fabric he wanted and what variations he would allow. But even with photos and drawings, the roll-to-roll variance was big. And he couldn’t afford to fly to India regularly, or hire someone to monitor production there.
He also found that suppliers deferred to his wishes, rather than being frank about some of his choices, which weren’t, he conceded, always good ones.These negatives match my observations and aren't easily solvable. Additionally, Atomic Delights details how Apple makes the Mac Pro in the United States:
What makes Apple fascinating is not that they are using some wiz-bang alien technologies to make things - even here in Portland, Oregon, all the technologies Apple shows in this video are in-practice across numerous local factories. What makes Apple unique is that they perform their manufacturing with remarkable precision and on a scale that is simply astonishing, using techniques typically reserved for the aerospace or medical device industries.Usually a company undergoes an expensive clean up the line activity (clarifying documentation, improving equipment, etc.) before offshoring, then still runs into the problems. I think if companies spent more of the money they spend on offshoring on improving production processes then they could be just as profitable in the US.