Thursday, July 19, 2007

Where is our protection as consumers of products for disabled?

One of my friends who uses a wheelchair and has for most of her life is being denied a wheelchair through her work health insurance. It's in appeal.

Her doctor, to date, has written three letters indicating that she requires an ultralightweight wheelchair due to her inability to push a 30 pound wheelchair but the insurance company will not honor that. Instead, they are holding up her claim with paperwork, have demanded letter after letter and now are using letter number 1 against letter number 2 against letter number 3 despite the fact that in each letter they asked for different information. They appear to be saying that it's more of a matter that there isn't one letter (despite the fact that all the letters came from the same doctor) that is written properly.

In the meantime the accessible car she bought has glitches. For example, the windows go up and down erratically when the ramp is deployed. Due to the way they installed things, safety features were disabled and she doesn't feel safe. Passengers cannot embark and disembark except by using the ramp because of the placement of certain items - on which she wasn't consulted or informed. The total cost of this car: approximately $45,000. She waited over six months to get this car. She is now looking at another vehicle because she doesn't feel safe in this one.

Where is our protection as consumers with products that we need for our disabilities? Where are our lobbyists? Because, folks, that's how this country works. The answer is that we lack sufficient representation. We are rapidly losing our right to wheelchairs in this country, which in my opinion was a tenuous one. The poor among us know that getting a new wheelchair is a thing of the past and are using used and, in some cases, broken equipment daily. Insurance companies are denying more claims for the equipment we need. People wait months for accessible vans despite the high costs and then, upon delivery, discover glitch after glitch - ramps that don't deploy or deploy without warning, doors that won't open, etc.

Where is our protection? There isn't any. From having insurance pay for a wheelchair, to getting products replaced swiftly when we depend on them - we don't have the protection we need to meet these situations. Check this out. One woman spent over a year getting a replacement for a used wheelchair van which was a lemon that a dealer sold her. She hired a lawyer and spent that year without a car. How can that be sufficient protection when you're buying a product you need because you require wheelchair access? It's not as if she can use any car in the meantime .

We need specific laws and mediation processes so that issues with essential DME and other items can be swiftly resolved in light of the unique purposes of this equipment. Why is it okay to charge us these inordinately high prices (we're told it's special equipment so they have to charge more) but then we're relegated to usual consumer laws that are inadequate to cover our needs? Makes no sense but believe me we're the only ones who will be motivated to change it - not anyone else.

We need programs to help afford the often inflated prices - or laws to reduce and control the prices. We need to reconsider alternatives to denial of insurer payments toward equipment - perhaps negotiate a middle ground where they issue a check toward partial payment of an ultralightweight wheelchair in lieu of buying one like they used to rather than offering a useless heavyweight wheelchair as a take it or leave it deal. Again, no one else will be motivated to work toward these changes.

We need to speak up. We need to address inequities for those on Medicare and Medicaid and other programs who are curtailed by unreasonable rules. Our system is no longer humane.

Where is our protection?


Anonymous said...

You're right - we do need lobbyists.

One of the problems as I see it is that the word disabled is being bandied about too much by those who are looking for equipment who could manage without. Restricting equipment to those who really need it has to be included in this equation too. Those who do have the means to buy it should buy it for themselves. I buy my own and I can afford it. But I see your point that if you can't afford it it's not right to have no access.


hotwheelz said...

Maybe some of the companies selling this equipment could lobby with the insurance issue. Won't it affect their sales? Seems their self interest is at stake too.