I want to hear from you

Since we're in the midst of the health care debate and prosthetic parity, I would like to hear from amputees about what is or is not covered in their state or in their country. What is it like in Germany, Thailand, Switzerland, etc?

If you live in a state where parity has passed, has it made a difference?

Write by leaving a comment here or write me at katmanjo@gmail.com

Health Care Reform...I want to believe...

The debate is heating up. Every night there is news of some congressman or woman getting jeered and booed over the health care debate. I'm not sure where I fall but here's what I learned over the last year and a half.

I have read many stories about amputees denied C-legs. In nearly every case that dealt with private insurance companies, the amputee was ultimately provided a C-leg. Usually the amputee had to provide proof of need, proof of ability, scientific evidence that the C-leg performed better than the alternative and sometimes they had to drag in a Congressman or State Insurance Commissioner, but in most cases with private insurance, the amputee finally won their case.

My case is different because I'm not dealing with private insurance. I'm dealing with government at the state level. In other words, I see the future and it ain't pretty! I already have government run insurance. A Health Care Commission appointed by the governor decides my fate. They have no obligation to respond to my letters, my requests, my evidence, my Doctor, my proof. They pawn this off on the insurance company that manages the state contract. The neutered insurance company conveys the one syllable communication (NO) but they're powerless puppets of the HCC and they admit as much by saying, "The state calls the shots. They control the purse strings."

The State Insurance Commissioner, the only person with the courtesy to reply, said that they have no jurisdiction over the government run Health Care Commission, and besides, the Insurance Commissioner is also a member of the Health Care Commission. Uh-oh! Fox in the henhouse!

Another State government committee decides that providing coverage for my health care needs will cost the government too much money, so it will not be covered this year or next or the next year unless something gives.

So...How do I feel about government run health care? At the moment, not good. Not good at all. I have ample evidence that they don't provide and they don't respond to need or to evidence based logic.

Still, the "government" provides C-legs for war veterans, Medicare and Medicaid recipients. The State provides for Medicaid recipients too. State Employees just fall between the cracks.

On the flip side, I also don't understand why a computerised knee with a plastic and carbon fiber socket costs more than a car. Why does a bilateral above knee amputee have to come up with $120,000 to walk? A familiar cry is, "Arms and legs are not a luxury!" Then why are prosthetics priced like luxury items? Why are prosthetics priced out of the reach of the very people who need them? Are the materials, the technology really that expensive? I'm sure it cost a lot to research and develop the C-leg, but it's been on the market for nearly 10 years. The R&D costs haven't been recovered yet?

Does the market need more competition? A resounding YES is the obvious answer. Functional, affordable high quality prosthetics. What a novel idea.

Lots to think about...

State Gives Employee the Finger: No Leg

Former Governor Sebelius, now the US Health and Human Services Secretary is making the rounds trying to sell the proposed health care plan put forth by the Obama administration. Now - I'll be the first to admit that our health care system is in a sorry state. I have personally experienced it, ironically, at the hands of Kathleen Sebelius.

For sheer entertainment value, watch the video below and listen carefully to her words. "Excuse me, excuse me. The federal employee health system would stay in place, as would other employer based coverage." Then she waves the microphone around as if to say, "Are you people clueless? Why are all these people booing me?"

I'll tell you why, Secretary Sebelius - because you aren't getting it. Where were you when for over a year, you and your Health Care-less Commission received letters from all over the US and the world asking to provide the same prosthetic standard of care to your State Employees that you provide for the nonworking Kansans? Why did you never respond to a single letter, not even a courtesy call? Why, after all those letters, was the contract language changed to become more arbitrary, exclusive, even denying State Employee amputees anything that might provide "comfort and convenience?" All I asked for, after losing my leg, was the prosthesis that my Doctor prescribed. The leg that would allow me to do my job properly. The leg that our service men and women use, the same old leg that's been around for over 10 years that anyone on Medicaid can get.

What I got instead was the finger.

That's why people are booing, Kathleen. Actions speak louder than your hollow words. I've had a taste of your state employee health system and if all you're offering is more of the same disparity, then you can keep it.

Here's how it's done...

Here's a story about a nice man in Florida who worked for the city for more than 25 years. A little over a year ago, he lost his leg due to an infection. All he wanted to do after that was go back to work, but his city insurance only covered 1/10th of the cost of a prosthetic leg. He spent over a year asking for a leg. He said that the 10 months not working were "tougher than the surgery."

The prosthetic company gave him a leg made out of used parts but it didn't work very well but he didn't mind too much because he could at least return to work.

Then, compassionate people, people who "put themselves in his shoes" stepped up to the plate and found a solution. They worked with the City, looked into the cost for the City and found that to provide this dedicated worker with the proper prosthetic leg, the one prescribed for him, would cost so little that they increased the coverage and this nice man got the proper leg. He is thrilled to be walking and back to work. "It's like going from a Yugo to a Cadillac," he said of his new leg. "I don't even think. I just go."

In stark contrast we have the State of KS Health Care-less Commission, KS Health Policy Authority and Employee Advisory Committee who, after 18 months of wrangling, claim that it will cost the state a half-million dollars a year to provide complete prosthetic coverage for state employees. They're still dodging prosthetic parity and continue to deny "comfort and convenience" for state employee amputees. They say, "You'll get a Yugo and like it" or "You can have a Cadillac without the motor and by the way, your insurance premiums are going to increase next year."

Well, good for you, City of St. Petersburg! Good for you. You found what all the other states that have passed prosthetic parity into law - that it costs literally pennies to keep people active, working and healthy.