Increasing Access to Prosthetics: A Beginner's Solution

" In the beginner's mind there are many possibilities, but in the expert's there are few."- Shunryu Suzuki David McGill In case you're wondering, this is not a compliment to experts. I have spent the last decade of my life performing research, drafting appeals, and reading legislation, all of which have somehow resulted in my gaining the title, "insurance expert." And yet, with all my legal training and subsequent experience in and with the insurance industry, I have consistently found that this "expert status" is a double-edged sword. Too often, I have rejected solutions to problems, or failed to see them altogether, because my "expert" mind reflexively filtered out unfamiliar concepts. It is only when I have dropped all pretense of being an "expert" that I have been able to do my most innovative and creative work. Similarly, as an above-knee amputee who receives prosthetic care, I have learned that the best prosthetists are those who can access their "beginner's mind." They constantly modify their socket designs, tinker with their alignments, and utilize new prosthetic components because they are never satisfied with their patient care. Prosthetic Coverage: Insurance Issue But beginner's mind or not, I can't draft a useful appeal, and a CP can't deliver a prosthesis, when the client's insurance company either does not cover prosthetics, or does so with an annual cap so low that it renders coverage illusory. And the "experts'" solution to this problem-"let's roll back the Medicare payment freeze"-is in my view naïve and potentially dangerous because it fails to address the bigger underlying issue: access to appropriate prosthetic care. After all, fee schedules don't mean anything when the insurer won't pay more than $2,500 per year for a new prosthesis. Legislative Solution As chairman of the Amputee Coalition of America's (ACA's) Board of Directors, I am extremely proud to be involved with an organization that is an admitted "beginner" when it comes to this issue. The ACA has worked with healthcare providers, industry, and consumers to formulate a solution that only a beginner would have the audacity to suggest: the passing of legislation to mandate that every amputee with health insurance have access to appropriate prosthetic care. Support the Action Plan! Response to this proposal has been overwhelmingly positive. And yet, support for the Action Plan for People with Limb Loss (APPLL) has been absent in one important and fundamental way: dollars donated. Maybe people think that their donation won't help. Perhaps they believe that legislation can't work. Or they can't conceive of investing in a project that will take years to complete. My response? Every donation, no matter how small, helps. It can work, as several states already have statutes in place, while others have legislation pending. If APPLL succeeds, the donations made today will secure a much better financial tomorrow for prosthetists, while at the same time benefiting their patients. Sometimes, being an expert limits our vision and binds us to the past. We need to start thinking like beginners and live in a world of many possibilities, rather than one where only a few exist. David McGill is the chairman of the Amputee Coalition of America's Board of Directors and the executive director of A Step Ahead Prosthetics & Orthotics in Hicksville, New York. He is a member of the New York State Bar, and an above-knee amputee.

Increasing Access to Prosthetics: A Beginner’s Solution

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