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Medicare / Medicaid / SCHIP News

Medical Equipment Prices Highlight Some Of Medicare's Difficulties

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Medical Devices / Diagnostics
Article Date: 22 Jul 2009 - 6:00 PDT

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Prices paid for medical equipment show Medicare inefficiencies and foreshadow difficulties in reforming the system. CNN reports on the issue by focusing on one wheelchair: "Debbie Brown used to process medical and dental forms for a living before a debilitating illness forced her into early disability retirement and left her in a simple, no-frills wheelchair -- a rented wheelchair that has cost taxpayers about $1,200. Brown says the public should be outraged about her wheelchair. Why? She says she could buy a comparable wheelchair on the Internet for $440 if she had the money. It sounded hard to believe that her rented, $1,200 taxpayer-funded wheelchair could be bought for $440, so CNN decided to check -- and instead found an even better deal. CNN went to the same company that charges Medicare for Brown's chair, Apria Healthcare, and bought it for $349 -- about a fourth of what taxpayers' have paid for Brown's rented wheelchair. That's why this slightly built woman, who lives modestly with her husband in Sacramento, California, believes her story and her wheelchair underscore the bigger problem of reforming health care in America."

CNN reports: "Terms like 'affordability,' 'single payer,' 'universal coverage,' and an entire lexicon have become part of the health care buzz lingo. It is a complex issue with so many facets, so many lobbyists and so many special interests that one proposal seems to result in a competing proposal or proposals, or competing parties with concerns of their own. To illustrate how difficult it will be to overhaul America's health care, CNN decided to focus on one item in the nation's health care bill: a basic wheelchair. The wheelchair, in its own small way, CNN discovered, gives a glimpse of the contentious and complex debate swirling around health care reform."

CNN reports: "Wheelchairs are classified as durable medical equipment, along with such items as oxygen tanks and home infusion therapies. Apria is the nation's leading provider of home health care products and services, according to its Web site. The nation's $1 billion annual durable medical cost is only a fraction of Medicare's $444 billion budget last year, but one government officials believe it is time to rein in. That's where this story of the rented wheelchair gets caught between all the interests involved. Congress sets the rates Medicare pays and Congress determined that wheelchairs should be billed on a monthly rate for 13 months -- the renter has to pay 20 percent of the costs. After 13 months, a user can opt to own it -- if the user knows about the rule. Brown, who worked in claims processing for years, said no one ever told her the wheelchair that barely works for her now is hers if she wants it. Instead, now that her rental term has ended, she gets billed by Apria every six months for service. Medicare pays $63 and she pays $16" (Griffin and Johnston, 7/20).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.






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