If you ask any American today if we need healthcare reform you’d be hard pressed to find anyone answering that healthcare in this country does not need dramatic change. But with all the rhetoric and debates going on with trying to pass healthcare reform it’s difficult to think our government will solve the issue as things stand now.  Would we be be best served if the healthcare solution comes from private industry instead of government bureaucrats? Do we need more layers of red tape and solutions that are wired in regulation and inefficiency? Have we  lost sight of practicality and  some of the real problems facing people everyday?  Is incorporating more layers of government into a system that relies more on regulations than on solving the needs of the people that it’s supposed to serve helpful? Every day it seems we hear more about the the struggles of the everyday person as they navigate through the maze of paperwork and “rules” that stand in the way of citizens getting their healthcare needs met in a way that won’t break the budget.

toilet Take for example, the example of Claudia Burrows, a woman with amyotrophic lateral sclerosis, or ALS, which is a  progressive neurogenerative disease that has affected her ability to speak. Burrows’ dilemma brought to light some of the issues that still plague Medicare. And in creating a new healthcare plan,  perhaps we should look at some of the things that are broken within our current system, before trying to come up with a plan for a new one.

Understandably, Medicare has “rules” for what it will and will not pay. But you would think when the rules don’t “fit” the situation, that there would be someone within the Medicare system or our government who still has at least a little bit of common sense.   In the case of Burrows, 48 years old,  and a resident of Muncie, Indiana, she found that if she purchased an IPod touch, and a program called Proloquo2Go, she could use the IPod to type out her words on the screen and the IPod would speak them for her, which would enable her to communicate. The cost for this device was $375 which Burrows paid out of her own pocket because Medicare won’t pay for it. Burrows can use the device not only for communication purposes, but also to keep track of her medication schedules and as a note-taking device. 

Medicare will however, pay for a dedicated device that costs $8,000.00 because it is designed for a specific medical purpose, and a friend of Burrows’ got one of these devices through the Medicare program, but Burrows’ friend found the $8,000.00 unit too  bulky and difficult to use so Burrows’ friend got an IPhone instead.

Medicare’s rationale for not paying for the $375 item that actually works better than the $8,000.00 device was that the IPod and other devices like them are designed for the “general public” and as such were not covered because they are not for a “specific medical purpose”.  We’ve all heard about the  government spending fiasco that resulted in a $9,600 wrench and a $640 toilet seat from years past. You would think that after the last year with all the chaos within our financial markets and our handing out dollars to bank executives who instead of using that money as it was intended, took bonuses for themselves, that we would have learned something more about  smart spending.  Are we heading for more of the same where we say as a nation we must “act quickly” without fully considering the repercussions of our actions? We currently have a stimulus package where our Federal Government is spending “tens of millions of stimulus dollars to repair and build toilets across the nation,’” according to the New York Times.   We used to be a country that thrived on innovation and used technology to it’s fullest.  Now, when we tell a patient that they have to purchase an $8,000 device that is non-functional, instead of spending $375 on a device that is used by millions successfully, we are truly throwing money down the toilet. And the worst part of all of this is that patients like Claudia Burrows who should be rewarded for their innovation and ingenuity for coming up with a solution to help both herself and other patients who may be in the same situation, are ignored and told that it’s not important if the device works or not. Results or functionality doesn’t matter. It’s black and white—paid or not paid.   When we create systems that take the human element and common sense out of making healthcare decisions and rely solely on what some page in a manual says—we all lose in a big way.

Your comments? What do you think? Should Medicare pay for Claudia Burrow’s IPod device?