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More Medicare Will Fix Medicare (Pt 2)

From the remarkably unsubtle New York Times:

Kara Lynn, with her 5-year-old son, Aiden, uses an iPhone to run text-to-speech software.

Insurers Fight Speech-Impairment Remedy


September 15, 2009

SAN FRANCISCO — Kara Lynn has amyotrophic lateral sclerosis, or A.L.S., which has attacked the muscles around her mouth and throat, removing her ability to speak. A couple of years ago, she spent more than $8,000 to buy a computer, approved by Medicare, that turns typed words into speech that her family, friends and doctors can hear.

Under government insurance requirements, the maker of the PC, which ran ordinary Microsoft Windows software, had to block any nonspeech functions, like sending e-mail or browsing the Web.

Dismayed by the PC’s limitations and clunky design, Ms. Lynn turned to a $300 iPhone 3G from Apple running $150 text-to-speech software. Ms. Lynn, who is 48 and lives in Poughkeepsie, N.Y., said it worked better and let her “wear her voice” around her neck while snuggling with her 5-year-old son, Aiden, who has Down syndrome.

Medicare and private health insurers decline to cover cheap devices like iPhones and netbook PCs that can help the speech-impaired, despite their usefulness and lower cost.

Instead, public and private insurers insist that, if Ms. Lynn and others like her want insurance to pay, they must spend 10 to 20 times as much for dedicated, proprietary devices that can do far less.

The logic: Insurance is supposed to cover medical devices, and smartphones or PCs can be used for nonmedical purposes, like playing video games or Web browsing.

“We would not cover the iPhones and netbooks with speech-generating software capabilities because they are useful in the absence of an illness or injury,” said Peter Ashkenaz, a spokesman for the federal Centers for Medicare and Medicaid Services. Private insurers tend to follow the government’s lead in matters of coverage. Two years ago, iPhones and netbooks barely existed, so it may not be surprising that the industry has yet to consider their role as medical devices…

At the same time, current policies mean that the government and private insurers may be spending unnecessary dollars on specialty machines…

In the meantime, people with speech disabilities have a choice: pay for a cheaper product from their own pockets, try to borrow one from a private assistance group or spend their insurer’s money on a specialty device from a company like DynaVox Mayer-Johnson or Prentke Romich.

DynaVox, a leading maker of devices for the speech-impaired, has computers that start at $8,000 and run Windows, just like 90 percent of all PCs…

The proprietary devices have some special qualities. They are sturdier than typical computers and have better speakers and links to support services.

But the prices may seem hard to justify based on components alone…

Betsy Caporale, a speech language pathologist in Danville, Calif., has tested various devices and software with children who have Down syndrome and autism.

“The iPhone has been a runaway success with these kids,” she said. “It takes them about 10 minutes to learn how to use the iPhone, and there is this cool factor for them.”

Ms. Lynn, from Poughkeepsie, would like to see insurers loosen their rules to accommodate general-purpose devices and give people like her more financial flexibility. Since insurers will typically cover only one device every five years, people with degenerative conditions like A.L.S. often hold off any claims until their condition worsens, and they really need an expensive specialty product that can track their eye and head movements.

Perhaps the government could set a certain dollar limit and then let patients find the products that fit their needs, Ms. Lynn suggested. “I really would like to see Medicare do away with the dedicated-device rule and the one-device limit,” she said by e-mail…

Apparently it isn’t enough that the New York Times has created a new blog (called ‘Prescriptions’ ) to argue full time for Mr. Obama’s healthcare reforms. They have to publish a series of articles about how inept the current Medicare system is.

Their earlier article, which we posted yesterday, is remarkably like the one above, except it is about Medicare paying for expensive kidney transplant operations, instead of cheaper prescription medications. Whereas today’s article is about Medicare buying expensive PCs being used instead of cheaper iPods.

Of course, in typical New York Times tradition, their solution is that we need more Medicare. For what is Mr. Obama’s healthcare reform but the expansion of Medicare to cover anyone who wants to opt into it?

And who can doubt that making Medicare even larger will make it far more effective? We all know that the bigger the bureaucracy, the more careful they are with their choices.

And speaking of expansion, both this article and the remarkably similar from yesterday are about women who are well below the usual age requirement for Medicare. (While The Times is careful not to spell out whether Ms. Lynn is on Medicare or with a private insurer, it sure sounds as if she is on Medicare.)

Did we miss the memo? When did Medicare get expanded to cover everyone?

And if it has been expanded so much that people like these are covered, why do we even need Obama-care?

And once again, notice how we have another case of someone who is complaining because they don’t want to pay for something out of their own pocket that they claim is vital to their lives.

Even something as inexpensive as a $300 iPhone.

They want someone else — meaning, you and me — to pay for it.

This article was posted by Steve on Tuesday, September 15th, 2009. Comments are currently closed.

13 Responses to “More Medicare Will Fix Medicare (Pt 2)”

  1. jaywills says:

    I’m not sure that demonstrating how screwed up Medicare is will convince many people that the government should be allowed to concoct another massive “health-care system.”

    • Rusty Shackleford says:

      You underestimate the wisdom of the average liberal “gimmee” personality. All they hear is “free healthcare”. While people like you, me and those with critical thinking skills, or those who have experienced government-run medicine in any form, are keen to realize what SHOULD be obvious.

      However, in a hypothetical scenario, I can see a conversation matriculating down the path of absurdity with a liberal.

      “You actually believe that more government intervention/control is the answer?”

      “Well, they have to….to fix all the things they screwed up”

      “And how will that help?”

      “Well, it’s obvious, they will take better control and have a better ability to see what’s going on”

      “So, more personnel, with the potential for more ineptitude and compartmentalization of duties, and if the supervisor’s on vacation or sick that day, nobody can help you?”

      “Well, they would have people to take care of it, I’m sure”

      “You’re SURE?”

      “Well, yeah…I mean, it’s the government, right? They wouldn’t leave me hanging.”

      “Have you even heard of the IRS, the USPS, the DMV, the Parks and Recreation Commission?”

      “Yeah….what’s that got to do with anything? It’s FREE healthcare, man”

      At which point you feel you must give up. It would be far more interesting to count the waves coming on from the sea…and more relaxing. I have had these conversations…and all they do is to remind me not to talk to zealots, the ignorant or the stupid. They won’t appreciate my position and I will have wasted precious oxygen trying to have them see logic.

  2. But isn’t Ms. Lynn one of those perpetually ill and infirm persons who cost our health care system too much money? Wouldn’t it be better if she just shuffled off to a hospice, popped a few pain pills, and died quickly — saving us, and the system, money?

    ALS is a horrible disease. My mother-in-law was diagnosed with it last fall, and has been in assisted living since the beginning of this year. Those living with ALS can live for years with the disease as it progresses and takes away their independence and mobility. But there isn’t a doubt in my mind that, under Obamacare, my mother-in-law would be taken off her ventilator (she is still conscious and cognizant, but has difficulty breathing independently – she can do it, but it frightens her) and told to go away, die, leave.

    Under our current system, she has wonderful care in a facility with a good reputation. We can visit her and she was around to see the birth of her 6th grandchild – my son born August 27th. She can still talk to us, still offer advice, and is still the same sweet woman who welcomed me into her family (and was thrilled to hand off her bachelor son to someone :-) ! ) But she is still a human being, with dignity and family who will miss her dearly when she is called Home. Obama would expedite the process and tell us all to suck it up and deal.

    • WendyB says:

      You’re right, englishqueen, the cynicism of the lefty media using people as examples who would be the first to go under Obamacare is shocking (no, not really, they stopped shocking us a long time ago. Now they just disgust us). The ability of liberals to ignore facts and logic is still breathtaking, however. And thank you for your account of your brave mother-in-law. Human life is a precious gift from God and liberals, with their callous disregard of that fact in their quest for power, must be stopped.

  3. GetBackJack says:

    OMG! Fire! FIRE!

    ‘Quick, throw this gasoline on it!

  4. wardmama4 says:

    They have to publish a series of articles about how inept the current Medicare system is

    I must dash over there and send them an email to say how insulting it is to imply that an inept (government) system will somehow be helped by expanding & creating an even bigger government system?

    What a bunch of bs

    BTW, this is what I’ve written about in regards to my son’s burn (2001) – the current survival rate ( Overall burn survival rate) 96 percent shows that innovation, technology, perseverance and dedication are what make it happen. And to put this into real HR3200 (or whatever is presented) translation – the Government coverage we had said No. Hopeless. There is nothing we can do (even their burn center BAMC – which in 2002 still listed 50% burn as fatal). But Shriners Burns Institute in Galveston took him and he survived – not on our insurance money (they said no to all until Rehab), not on our dime – but on the contributions of everyday Americans. [Aside Shriners have had hospitals (Orthopaedic (18) & Burn Centers (4)) up and going since 1922 (Orthopaedic) and 1966 (Burn) – all on charitable donations!]

    [Another aside -Medicare covers -people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant) straight from their Am I Eligible link on the Website]

    Get rid of them all – Sorry Social Programs were nice but – look at the billions – about 8% of the GDP – imagine what each person could do for themselves and their family with that money that is not wasted on fraud, corruption, paybacks and graft?

    Might they then be able to pay for their own insurance – we already know that only about 0.04% of the American population – can not afford insurance but are not covered by any of the existing programs (SCHIP, Medicaid, Medicare, Public Health Services & Veterans Administration) – so let’s find a cheaper, less invasive way to fund that program, if we must.

    1) First there is the Insurance Problem – once again Government (i.e. Congress who makes the laws) mucked up the system by requiring mandates, encouraging (WWII era – a tax benefit for employers created by – wait, wait it’s coming to me – yes, liberals) employer based health care coverage which starts to create a two-headed monster – group buying that forces insurance prices up for the individual purchaser and of course no more portability. Fix that – not the entire system.

    2) And of course all the State mandates on what must be covered and one can only purchase within the State are also part of what keeps insurance costs high and Insurance options limited. Fix that – not the entire system.

    3) HSA – of course the unwanted step-child of the system – how about real encouragement/tax benefits. Fix that – not the entire system.

    4) Tort Reform – another ‘rising cost of healthcare’ cause which suspiciously is rarely ever mentioned by just about anyone in power. Now I wonder why that is? Perhaps their lobbyists are so effective? Or perhaps it is because we now have a Congress with more than 50% who hold a JD or advanced law degree? Fix this – not the entire system

    5) And finally – perhaps if we deport the ______fill in the blank with your chosen (12, 20, 40 since I’ve seen all three numbers as to how many illegals in are in the US) number of Illegal Aliens – the costs & problems would be greatly reduced. As would the need as 12 million of them are among the imaginary 47 million without insurance. Of course they are without insurance – they don’t get jobs legally therefore they can’t get employee benefits nor make the kind of money to purchase their own – so basically we pay for them with rising insurance/health care costs (right now) or forced to by our rising tax dollars. How about none of the above – Deport Them Now and we save a couple/several billion right off the top. Fix this – not the entire system.

    Wow 5 biggies – took up less than a page. Elect Wardmama4 to Congress and I can Fix This – Not the Entire System in bills readable by any American – not just those who have days & a couple of lawyers at hand!

    Of course the Most Corrupt Congress in American History would have a harder time of it – if the msm wasn’t doing the propaganda for them day in and day out.

  5. proreason says:

    “Perhaps the government could set a certain dollar limit and then let patients find the products that fit their needs, Ms. Lynn suggested.”

    Despite herself, Ms. Lynn can easily come up with simple and practical ideas to make government more efficient and effective.

    So why has’t it happened?

    Perhaps because controlling an $8,000 device is much more satisfying for a bureaucrate than controlling a $300 device. But, although true, that probably isn’t the underlying issue in this case.

    The innate, unavoidable, underlying issue is the inflexibility of any government-run system.

    Because changing a government system requires an act of Congress, whereas changing a private system requires a mid-level manager to say “ok”. Quite a difference isn’t it?

    You might consider that if you have a yen to get your health care from the government.

    • wardmama4 says:

      No Proreason – and I was going to mention it in my post but alas got carried away on listing a solutions list.

      As one who has traveled the road of many & varied health/injury situations – two things exist within government run systems (also complicated by a third this has to do with financing).
      1) is innovation and tech is not a government priority at all – they see way too much (in the medical/health care sphere) as ‘experimental’ – such as the new age treatments that saved my son’s life – which is why they denied it – but a couple of decades ago it was something as simple as a birth control pill that almost killed me – the stupid Dr who just wanted to go home & start his holiday didn’t even bother to see what kind of bcp I was on – and ordered the standard one – as I said it almost killed me, but the good to come out of that is I got the medical ‘ok’ to never take a bcp again.
      2) one size fits all is the answer to everything – which is why some Army hospitals are known for their take two Tylenol and call us never approach to ER care. There is no encouragement to think outside the box, go beyond to help a patient or even give a damn. Just do your clinic hours (or ER rotation) and get out and away – your reward will be you won’t have to deploy or even go overseas – if you don’t want to, never face a lawsuit, never finance the office/clinic equipment (or have to meet a payroll) and never suffer the consequences of your crappy medical care. At. All.

      The third one – is the mantra of all government entities (which is why there is so much waste, fraud and abuse) Spend it before the End of the Fiscal Year or you won’t get as much next year syndrome. So of course older more expensive worthless stuff is much more coveted than newer, cheaper and more bells & whistles stuff – got pad those budgets so that we can request even more next year!

      Repeal the 16th Amendment – hit ’em where it matters and hurts – in the wallet!

    • proreason says:

      The key difference between private enterprise and government enterprise is competition.

      Governments can’t go out of business and have no reason to be efficient, effective, innovative or cost-conscious….other than the good intentions of some people who work there.

      The benefits of competition easily overcome the cost of “profits”, which should be renamed “owner’s income” or “owner’s pay”.

      Other than enterprises like the military and police and a few other critical public services, the government should get out of every business.

      You are correct, wardmama, the 16th amendment is the plague that has brought our country to it’s knees.

  6. MinnesotaRush says:

    “And once again, notice how we have another case of someone who is complaining because they don’t want to pay for something out of their own pocket that they claim is vital to their lives.”

    “Even something as inexpensive as a $300 iPhone.”

    Bravo, Steve! Bravo!

    I’m still of the absolute conviction, people don’t want national health care .. they want FREE health care and goodies.

    • catie says:

      Yeah, I’d sure like an I-phone myself. But I can’t afford it because I’m too busy paying for her and that chick in LaJolla’s insurance through taxes.
      If I was either one of those chicks, I wouldn’t be so hot to get the “free insurance”. As others have said, they’ll be first in line for the death panels.

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