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Wednesday, March 21, 2007

Inflated prices on medical equipment leave us with pictures from catalogs


{Visual description: Photo of magazine clippings on a corner wall above a table containing bottles.}

I hear story after story from people trying to buy medical equipment, ranging from wheelchairs and hospital beds to hearing aids. The terms "denial of claim" and "restricted reimbursement" are usually part of these conversations.

What I don't hear being discussed is the fact that prices on many of these items are wildly inflated. Bloated prices and high markups have been encouraged rather than discouraged for years in an industry which excuses its high prices due to the fact that it cannot mass produce most of the equipment it sells.

This is a dangerous argument for several reasons and those of us in the disability community need to take heed. First of all, with the advent of new technologies, many of the items we need are getting increasingly expensive. Insurance companies are denying more claims since they don't want to be saddled with these costs. Our options for lower cost items are decreasing since companies, eager to sell these items, push them to the exclusion of lower cost alternatives. Go to any disability expo and check out the items that vendors are showing. The prices are in the thousands of dollars range now.

Secondly, as our choices for lower priced alternatives narrows, there is no protection on the prices that can be charged for these higher priced items. Even as the numbers of people who need these items increases as baby boomers age, there is no regulatory control to keep the industry honest in terms of numbers. Just as the auto industry is regulated, allowing consumers to see the invoice on vehicles and then compare dealer markup, we need laws in place that make the industry accountable.

The only cost saving measures being taken at this point are by those who have traditionally paid for these items - such as insurance companies, Medicare/Medicaid, and workers' compensation. They are setting and enforcing policies limiting reimbursement amounts and denying claims to items. This leaves more of us with disabilities in a position where we will be raising money privately or spending our own or our families' money to purchase some of these items if possible.

It's time for us to speak up in numbers to question why the inflated costs of this equpment are only being dealt with in this one sided manner - to protect the financial interests of insurers and providers, but not to protect our access to equipment.

Unless we let our legislators know that we need laws protecting us as consumers of medical equipment, wildly inflated prices will continue. And these items, intended to improve our quality of life, will be available to an increasingly small number of people with disabilities.

4 comments:

Anonymous said...

And, even if you put all your resources into buying outrageously expensive equipment, the customer service and follow-up is often lousy to non-existent.
Janet

Ruth said...

Absolutely. I paid top dollar for one wheelchair (my first) and when I needed service found there wasn't any. The wheelchair I use now is from ebay. Need I say more. Yet another issue is why repairs for durable medical equipment is not regulated as to regional availability.

Dream Mom said...

Good post. Equipment is getting very expensive and you are right, we are being priced right out of the market.

Dear Son has a $2,000/year limit on Durable Medical Equipment which doesn't go very far. Last year, he needed a lot of equipment: new tilt wheelchair ($10k), new bath chair ($3k) plus IV pole, pump and Hoyer lift. I just got a new hospital bed for him ($3k). Fortunately I have a secondary insurance that picks this up or most of it anyway.

I desperately need and can not afford a wheelchair van however so we don't get out much as I can't lift him very well into my car and his chair barely fits in there.

Rising equipment costs and rising prescription drug costs and the fact that there isn't any daycare so I can work full time doesn't help. And be sure to throw in the cost of diapers, wipes and underpads for the bed. They aren't covered at all by insurance and it's a huge expense for me.

Ruth said...

Dream Mom -
I'm glad you left this comment - it's specific and really shows the dilemna of trying to afford not only the big ticket items but the everyday ones. I always say to people "a dollar only spends once"...this is why we need to speak up about inflation in prices because we're a population that cannot afford high markups.