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Yesterday, we heard about an effort to make hearing aids less expensive. Today, we meet another of the people behind that effort. His name is David Green - no relation to you, David. This David Green is on a mission to drive down the cost of medical devices and services. His tactic: Use market forces and business strategies slightly tweaked to make health care available to even the poorest people.

As NPR's John Ydstie reports, he has had some amazing success.

JOHN YDSTIE, BYLINE: David Green is demonstrating how to program his company's new hearing device on a cell phone.

DAVID GREEN: So I'm putting the device on my ear, and I'm turning on my Bluetooth-enabled phone.

YDSTIE: It must be the smallest Bluetooth earpiece available, about the size of your thumbnail. Green has helped create the enterprise, Sound World Solutions, to market a new high-quality hearing device developed by his partner Stavros Basseas.

GREEN: I click personalize on the phone, and I start the hearing test. And right now, I'm hearing tones and I'm clicking a box...

YDSTIE: The device, which we reported on yesterday, will be sold in the U.S., but the main market will be in developing countries, where it will sell for a couple hundred dollars, a fraction of the cost of high-quality hearing aids. It's based on off-the-self Bluetooth components. Green says his strategy is to minimize the cost of technology, production and distribution so he can push prices to the lowest possible level and force other companies to compete.

GREEN: My competitive juices get flowing when I start to think about a big, you know, $4 billion medical device company and how I'm going to beat them, how I'm going to sort of pop my head up out of the reality that we all think that we're in, that medical stuff costs so much money, and see how much can we make it really available for. How do we make sight and hearing, or even life itself affordable to poor people?

YDSTIE: That might sound like hopeless idealism, but Green has helped create a number of companies that do just that. The most notable may be a company named Aurolab in India that manufactures intraocular lenses. They're lenses that are implanted in the eyes of cataract patients to correct their vision.

I met Green there on a reporting trip to India two summers ago.

HARI PRIA: This is called the phacoemulsification procedure. This is considered the gold-standard of cataract surgery across the world.

YDSTIE: That's eye surgeon Hari Pria in an operating theater at Aravind Eyecare in Madurai, India. Aravind does more than 300,000 cataract surgeries a year. When I visited two years ago, David Green showed me the Aurolab manufacturing facility that he helped Aravind set-up to produce intraocular lenses.

GREEN: These are the two workhorse, semi-automated lathes that we used to get into production back in 1992.

YDSTIE: And these are the actual machines?

GREEN: Yeah. Yeah.

YDSTIE: Through Aurolab, Green helped drive down the price of the lenses from several hundred dollars a piece to $2 now. And Aurolab's lenses have helped millions of people regain their sight. Green has also set up eye care programs in countries from Nepal to Kenya, created less-expensive testing for people with diabetes, and helped set up social investing funds.

He eschews charity and uses market forces and business strategies in his enterprises. He sets up for-profit companies, or non-profits that run operating surpluses, so the firms have the ability to invest and grow. Green describes his approach as empathetic capitalism.

GREEN: Yes. You have to have an economic model that ensures you can be profitable and sustainable. But how do you channel that sustainability to serving others where you can be in empathy with their predicament, with their suffering? And in this case, we try and address suffering in a very direct and pragmatic way, with restoration of sight if somebody's blind, or in the case of hearing, helping people who can't hear very well hear again.

YDSTIE: So what's Green's payoff? As a normal entrepreneur in the medical sphere, he could be making millions. He says he's happy making between 100 and $200,000 a year. And he says most of his rewards can't be put in a bank account.

GREEN: When I think of Aurolab, I think they've helped something, like, 18 million people see to date. And so that's what I have, and, of course, it's something I really can't put in my pocket. But maybe from a karmic point of view, that's money in the bank. I don't know. I hope so.

YDSTIE: That's David Green, social entrepreneur.

I'm John Ydstie, NPR News, Washington.

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