The problem with most forms of activism is that when a perceived threat or issue appears to be addressed or eliminated, activism and support dwindles. It reminds me of a bacterial infection; when the patient begins to feel better and stops taking medicine. The infection remains, but is stronger than before, more likely that it can withstand future treatment with that medicine.
This analogy can be applied to the current struggle we face during the current proposed Medicare DME LCD changes. We have raised awareness within our community of amputees, some of our friends and family. However, unless we continue to make our voices heard, the struggle will fail.We have to reach out to our co-workers, to those we meet in the street, and most especially those that have any sort of influence with others and make them understand that this issue is much much deeper than simply care for amputees.
While we are affected most severely, due to the impact on our independence, in the proposed DME changes, there are many others that are going to be affected also. Those with MS, CP and other medical conditions that limit mobility are affected right alongside of us. The machines that they require to gain any independence will be stripped away from all who do not have the immediate wherewithal to pay out of pocket. I don't know about you, but I know that as a median ranged individual with pretty decent medical coverage and an above average income, my medical bills are eating most of my disposable income. I don't have anything left over to drop several thousand or tens of thousands of dollars on a new foot or leg.
Private insurance tends to mimic what Medicare will pay. The Medicare guidelines provide a solid baseline that the insurance companies can use to determine exactly what they will cover, and what percentages above that line that they will be willing to spend. If we allow the Medicare guidelines to be lowered to the point that simply obtaining a new socket is prohibitive, then we will all be fighting that battle.
In my opinion, there are two portions of the prosthetic device proposed changes that need to be amended. First and foremost would be to reintroduce the word POTENTIAL. In most cases, the potentiality of improvement is a fairly easy assessment. It would be obvious that a 600 lb 65 year old male diabetic below knee amputee would have a hard time being evaluated as a K4 initially, however without the word potential at each step, he would have no motivation what so ever to improve his condition. For example, lets take a hard look at me. Prior to the amputation: a 50 year old white male, approximate weight 310 lbs, primarily sedentary with a severe foot wound and MRSA. Below knee amputation required to save the patients life. Without the condition of POTENTIAL involved, my doctor would have been required to mark me at K2, with little hope of being able to progress. I have since lost weight down to about 240 lbs and walk about 2-5 miles per day. My goal is to progress to jogging and enter a 10k fun run before the end of the year. I am a solid K3, with the potential to reach K4.
Secondly I think that the prosthesist should be allowed to continue to assess and evaluate the patients ability and potentiality. Quite honestly, my primary care physician, while good at diagnosing and treating standard maladies is very quick to pass on consultations to those who are better versed in a particular field. He knows the limits of his own knowledge and defers to the expertise of others. The surgeon that amputated my leg has more knowledge of wounds and wound care but not nearly as much as the technician at my O&P office. I would rather have someone knowledgeable in the specifics of my abilities make that evaluation and assess me properly.
The bottom line is that we need to keep the pressure up on all of our congressmen, senators and any other policy makers out there. We need to organize and maintain a constant barrage of social media streams until a final decision has been made on the LCD DME changes. Whether they directly affect us now, or indirectly affect our insurance coverage later is what we need to remember. It is far easier to make a stand before the change occurs than wait for years of congressional wrangling to get basic coverage restored.
In order to find your congressmen and senators you can click HERE
If you have not signed the petition yet - GO SIGN IT!! Click HERE to do it.
You can post to twitter using the hashtag #notaluxury and use it to connect and follow others that are helping the cause. You can lend your support to those that are lobbying in congress and with the hearings and committees involved. We are the antibiotic, and we have to be used until the infection of this LCD to our DME has been eradicated.