Event Announcement: Elderblogger PhoneCon ‘06
Songs of a Long-Ago Childhood

Medicare Changes (and Poll)

category_bug_journal2.gif Among the differences I have discovered, since moving, between New York City and Portland, Maine is a much larger number of people in Portland who use power wheelchairs and scooters. I can’t prove that statement, but it appears to be so.

Hardly a day goes by that I don’t see elders and disabled people tootin’ along in the supermarket, the mall, Home Depot, Target and smaller stores too, and on sidewalks flat and steep. Many have baskets to carry belongings and purchases, and I noticed one with an umbrella attached in case it rains.

If you have ever been even temporarily disabled due to a broken leg or knee surgery or a foot injury, you know how maddening it is to be dependent on others for such simple acts as going to the kitchen for a glass of water, answering the telephone or, most difficult of all, to get the shopping done. For those who are permanently disabled, motorized scooters and wheelchairs help them remain as independent as possible, handle many of their own needs, and continue to be part of and contribute to their communities.

Now, on 1 October, new Medicare rules go into effect that some say will limit beneficiaries to low-powered, inexpensive wheelchair and scooter models that will not meet the needs of disabled people.

"’These changes will impact the thousands of people who will need power wheelchairs and scooters,’ Andrew Imparato, president and CEO of the American Association of People with Disabilities, said in a statement. ‘As Baby Boomers grow older, there will be an increased need to meet their mobility needs, but Medicare won't be there for them.’"
- Forbes, 12 September 2006

Ellen Griffith-Cohen, a public affairs specialist at the Centers for Medicare and Medicaid Services, said in a telephone interview that the new rules are an improvement, beneficiaries will get the equipment they need and some beneficiaries will pay less under the new rules (all pay 20 percent of the cost of the equipment).

That’s because, she says, the new payment rates and billing codes that go into effect on 1 October have been refined to more accurately reflect what wheelchair and scooter models are available in the marketplace making it easier to match a wheelchair to a beneficiary’s needs. And with these changes, says Ms. Griffith-Cohen, some people will save money on their 20 percent co-pay if, for example, a $2,500 wheelchair will do the job instead of a $5,000 wheelchair.

Geoff Swindle, the founder and president of Cirrus Data, an online customer acquisition company for the healthcare industry, said in an email interview:

“…no one will know how the changes in Medicare rules affecting mobility equipment will play out until some time has gone by. Equipment providers may not be able to afford the level of service they have delivered in the past, but in the longer term, they will improve efficiency and their ability to get the needed equipment to consumers in the same manner and at the same cost as in the past should not be disrupted.”

[Disclosure: Cirrus Data pays Time Goes By a fee for the power wheelchair and scooter advertisement in the right sidebar.]

It’s difficult to have an opinion on this change in Medicare, but I suspect that more rules will change as the number of baby boomers swell the ranks of beneficiaries in coming years. Two things are important: that beneficiaries get the care and equipment they need, and that costs be carefully monitored and contained when possible.

All bureaucracies are cumbersome, slow-moving and sometimes their decisions seem arbitrary. Bureaucrat-bashing is favorite pastime of anyone who has ever dealt with a governmental agency and often with good reason.

But I was impressed with Ms. Griffith-Cohen’s knowledge of the issue when I called, her eagerness to track down the correct answers to my questions – and, she passed on this useful bit of advice for all Medicare beneficiaries:

Whenever you have questions, a dispute, complaint or bureaucratic snafu regarding your care, go first to your Medicare carrier – the insurance company. If your issue is not resolved, then contact your regional office of the Centers for Medicare and Medicaid Services (CMS). They are the people charged with gathering information on what works and what doesn’t to help improve service and will follow up to resolve your problem.

On the issue of scooters, I believe there needs to be a policy change from the top. Medicare currently covers few scooters, which are meant primarily for outdoor use, because Medicare does not pay for durable medical equipment unless it is required inside the home.

As our population ages, the more we as a society can do to keep people mobile and independent for as long as possible will save untold billions of dollars in institutional care and homecare, and allow elders to continue to participate fully in the life of their communities.

Elderblogger PhoneCon Poll
I was surprised at the small response to yesterday’s announcement of Elderblogger PhoneCon on 24 October. I had expected that most regular readers of TGB would be interested in the opportunity to talk with one another, add another kind of conversation to the community and get to know one another a bit better. But maybe I’m mistaken. So let’s have a poll:

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Comments

the poll would get my participation if it included a third choice: I'm intrigued, tell me more!

interested in adding audio to my site for interviewing others, i'm drawn to the idea. what would be the focus be of the october phoneCon?

The conference calls that I have participated in with FEMA and the Red Cross may have 20 to upwards of 100 people on at any given time, and cost in the order of $10,000 - $20,000, each. They work pretty well if everyone knows who is speaking and what their position is. I'm sure that a smaller conference call will work well--particularly if each speaker remembers to give his/her name when they pick up the thread. That said, I am not one who enjoys talking on a telephone.

Being one who places perhaps 3 or 4 phone calls per month, I could live without the handset and just use the line for getting my computer online and be happy. (And, no, I have no use for the mini-cams, etc. Written words suffice for my communications.)

I'm interested, but Oct 24 is a long time away to plan for. I was thinking about it but want to wait until later to make a firm decision when I know more about my schedule. I'm in the middle of writing the second Integrated HTML and CSS book. I'm living, breathing and dreaming tech stuff, a topic people on the call would not be interested in talking about, so I'm not sure I'd have much to contribute, either.

Perhaps your poll needs a third catagory of "I'm flat out too busy." Which I am.

How about a poll of what we elders do with our days.

Septuagent's immediate reaction on seeing "Elderblogger PhoneCon" was to interpret "con" in the sense of "confidence trick". (That is what it would be in the media in UK - "ElderBloggers in heartless phone con"). Only on further inspection did he find out what it was all about. Thus it may be that your perceived lack of response was because other people reacted the same way ? Perhaps "PhoneChat" might have been better ? Or is it something to do with the difference between American English and English English ?

I've been so behind on my blog reading lately that I didn't catch this when first posted...I'll try and be there if it fits with my part time work schedule. Sounds like fun.

I am on a lot of conference calls and some of them work and others are boring at best. A question I would offer to organize the call is 'what is an elder?" While I am new to the TGB conversation and a new blogger my answer is on my blog today at:

http://sereneambition.wordpress.com

I'd love you read your comments on my point of view that 'elder' has more to do with relatiionship than age.

Onward.

I have participated in conference calls that have 10 attendees. It was bedlam. No one identified themselves and I had no idea who was talking most of the time. I used to set my phone on mute and do other work while wearing a headset. If my name was mentioned, I'd click on the phone and try to sound alert. I hope you all have fun, but I know I wouldn't.

The idea seems to me, has the potential for being an interesting and fun event.

I'm holding off on responding as not sure of many things including my availability, effects of time differences, whether or not this was an event for bloggers only.

Thought there would likely be more information as the time drew closer, and would watch your blog for up dates.

As for the power chairs and scooters, I see a lot of them in the community where I live, too. They are, indeed, a godsend for mobility, keeping people active in the community.

For those who can venture out from inside their homes with an electric wheelchair, scooter, or cart, on their own, or with others, I would suggest their state of mind is greatly enhanced, thus their overall physical well-being. I wouldn't be at all surprised if savings in medical expenses i.e. less depression medications is realized in the Medicare dollar simply from the socialization aspects this mobility provides.

I can certainly vouch for that being true with individuals who have gone in to even skilled nursing facilities, bringing their motorized wheelchairs and scooters with them. They are more able to be as independent as possible within the facility, often going out of the facility with family/friend/staff/private duty aides/volunteers assisting.

Independence is probably the one aspect of our lives we are most likely to not want to relinquish -- or, at least, that's true for me.

I see more and more motorized carts available for use by customers in our local supermarkets, warehouse type gardening, hardware, discount stores. For those who can still walk those blocks within the store, it's best. For many others, it's the difference between being able to shop in such stores or not.

Count me in...if everyone can stand to listen to my twang...

Several years ago a neighbor died and her partner wanted to sell her scooter. While I was still mobile, I knew things were not going to get better so I bought it. It has enabled me to go to the grocery store as I am now no longer able to walk that distance. Being dependent on others is extremely hard and I try to remain as independent as I can. My scooter is old and I hope Medicare will allow me to buy a new one when it gives out.
As to the conference call, I will be unable to participate due to a severe hearing loss. In all honesty, I don't think I would like it anyhow. That said, I agree with those who think the options are limited. I don't think it's the worst idea I have ever heard, but I wouldn't be counted in either.

I was busy yesterday & didn't get a chance to reply -- I'd love to participate if it doesn't interfere with my work schedule. Nothing was mentioned about the time frame. Voices to go with pixels is a good thing.

Sorry -- I'm in the "hate conference calls" group. I have to do them regularly for work and like Cecile above, I mostly use the time slot to do other work. So the idea doesn't attract.

hmmm...
I'm not an either/or kind of person; I need another choice. :)

I've done tele-seminars, class work in conference calls, and family chats. Really liked them all!
But I don't 'chat' on the phone ordinarily.
I would gladly call in to listen, and weigh in if the subject turned out to have particular interest, and have actually marked my calendar to be available that day.
But six hours...? just to 'chat'?
hmmm...
still haven't made up my mind.

Count me as a "definite maybe." I have a commitment on the 24th that won't let me hang out very long, but I expect I'll be able to pop in from time to time and see how things are going.

If you like, at the end of the day I could lead those gathered in an a capella rendition of the chorus from David Grisman's famous song, "Old and in the Way."

I wasn't clear if non-elders should join in or not. I am also not clear on exactly what time(s) the call would be running at; perhaps I missed that. I got the date, but I assume it is not a 24-hour marathon for you....

I wish I could convince my mother to get one - she uses a walker and is constantly falling and hurting herself.

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