Mr. Barr and List,
>Patients/consumers requiring custom prostheses and orthoses would certainly
>not benefit from this proposal since it does not take into considerations
>of qualifications of the provider nor the freedom of their choice of
>providers.
I have a feeling that the choice of provider will be maintained after the
bid-winning price is established. If not, we’ll call the ACLU. Also, I
think there will be qualifications in place for a provider to submit a valid
bid. The issue is, what will the qualifications be… as the proposal calls
for the secretary to determine who is capable (negotiated rulemaking outcome
perhaps will come into play here???)
Patients would benefit through reduced co-pay amounts, as their 20 would be
due on a smaller piece of pie. Taxpayers will benefit through reduced
government spending (maybe the tax $$$avings will just buy other things!)
Practitioners will not benefit because our paychecks will be smaller, which
brings me to a question which was kicked around our office a little…
would practitioners still happily plug along in P&O if we were paid on a
similar scale to public school teachers? Would product R&D survive under
less-favorable reimbursement schedules?
>What about other non custom products and services?
>Competitive bidding for silicon/gel liners,stump sock and other supplies
>may help affordability and consumers?
This is a great point… it would be great for our patients to be able to go
to a store (or bid winner) and purchase socks, liners, and other supplies at
a “normal” price, but I suspect that is a long way off. If my socks wear
out, I can select a new pair at my leisure, why do our patients have to go
get a Rx, and spend too much of their own or their insurance $$$? I would
like to see a real consumer-driven movement among (or really advocating for)
the amputee population, a group that really and truly has the best interest
of the people using our products and services at heart. That, I think will
suss out the true “evil-doers”!!!
Justin Foster
Still a Prosthetic Resident
CIRS – Palo Alto
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