Yeah, but in a nursing home or hospital, which is probably where most adult diapers are used, the CNA's must change the diaper every predetermined number of hours. So as long as the cheap adult diaper can hold up for that long, there's no point in paying for anything with a larger capacity. And as you state, there are higher quality products out there available for those who are aware enough to care and pay for their own. But many of those still functioning on their own aren't fully incontinent...they maybe just have a little bit of bladder leakage every now again, so they wear the absorbent pads rather than full diapers.