Paul Campos blog entry "Frustrations" part 2

It is now 8:00 PM on Tuesday evening and I just finished eating my breakfast and getting up into my wheelchair. I'm going to write about my harrowing experience today. My personal assistant left early this morning to take my motorized wheelchair to Bethpage, Long Island via subway and the Long Island Railroad. Since I can't use any other wheelchair, I had to lay in bed as one of my other personal assistants took care of me until my wheelchair was returned to me. From my bed, I spent the day calling Invacare (the wheelchair manufacturer) trying to find out about parts. I discovered something quite interesting. If I am not a Vendor (or surgical/medical supply company), they are not allowed to speak to me. Not even to ask any questions. Oh, talk about your free trade in America. I then decided I would call the surgical supply company in Long Island to find out what was going on with my wheelchair and to also find out how we can get me up and running faster. After finding out that they could not fix my wheelchair, I began to speak with a man named Dave about what the next step would be. He said they would have to send the controller module to the manufacturer so that they could evaluate it, repair it if they can, and then ship it back (which would take 21 days). "HCS" could then send "the claim" (along with the price) to Medicare for approval. This could add 7 to 14 days more to the process. In the meantime, HCS doesn't have a loaner chair that would be appropriate for me, one with a headrest, nor a loaner with fiber optic controls which would be the only way for me to operate my chair. I then tried to ask how we could cut through the red tape and I was told that there isn't any way to cut through the red tape. I then asked if it were possible to order a new controller module, especially because I know from experience that when they fix these things, it wouldn't take long before I would have to go through this again. This time, Sonya got on the phone to tell me "absolutely not". She said, "We have to follow procedures (as I just explained above) and that doesn't include putting in the claim for a brand-new controller module". I then asked if someone can purchase the controller on my behalf. "Absolutely not", was her response. I also tried to find out if anyone sells refurbished ones and the answer was no. As you can imagine, my frustration was building to a crescendo.

My exchange with Sonya was the most incredible of all.

After saying that she is the one who handles the claims, she told me insurance has nothing to do with whether or not someone can purchase the item on their own, nothing to do with the procedures, and nothing to do with the speed in which someone can get their wheelchair fixed. If insurance is not the issue here, what would be the reason for not allowing someone to purchase a part for a wheelchair? What would be the reason for not allowing someone to put in "The claim" for a new item through Medicare? Why should it be that we must fix something that is the most important part of this wheelchair instead of buying a new one? I submit to you that they would rather repair the controller module claiming that it costs less to fix than to buy, while all along knowing that a repaired piece of equipment has more of a chance of breaking down again. This means they can try to bill Medicaid again and again probably costing more than if the piece was brand-new. I know it sounds like a conspiracy theory, but everybody knows that medical equipment prices are ballooned because they are deemed medically necessary. Because of that fact, vendors can get away with murder which holds the government (by the cojones), rendering them helpless as to what can be done about it. I remember being told this in 1995, when I went with a group of my coworkers to the headquarters of Senator Bruno in New York City. People with disabilities were protesting cuts in Medicaid (Home Care hours from 24 to just 4 hours a day). This would have sent many to nursing homes, which, in turn, would actually kill many. They wouldn't even talk to us until we formed a wheelchair blockade with the assistance of our friend, Senator Tom Duane, who is both literally and figuratively larger than life. The greatest thing was when some of the employees who worked in the same building tried to walk over and between the wall of wheelchairs, Tom Duane informed them they would have to get through him first. Obviously, they didn't try anything.