How Will 'Health Care for All' Affect the Disabled?

Universal health care, health care for all, whatever you want to call it or however it comes about and the logistics behind it, is long in coming.

Call me idealistic, I've been called worse in life, but yes, I DO feel it is a basic human right to have accessible health care.

Just like I feel food and water are basic human rights.

And being treated with dignity.

I hope more doctors will be able to see that this can be an opportunity for huge advancements in the health care field. I also hope that more doctors can join the grassroots efforts in seeing just how big this can really be.

There could be huge life-changing advances made for currently healthy individuals and disabled individuals alike.

A healthier society is a more productive society. More people can work and pay into the 'system' for longer. Preventative diseases could be just a minor setback in an individual's life, instead of mushrooming into devastating prognoses that end up draining the system from and for the un and under-insured.

Preventative care has always been the key.

But since money became the basis for healthcare and not the Hippocratic oath or basic human dignity, it screwed everything up. Don't think for a minute I'm forgetting about insurance companies! And that includes Medicare and Medicaid and even CBAs and CDSs (community based alternative and consumer direct services). Tho the latter two are more in line of what individuals seek for health care, (especially among disabled) they afford the user more discretion on how and where their healthcare comes from, they are still under the same broken umbrella that has holes in it.

With less restrictions, even some in our disabled community could become more productive, as long as healthcare for all is all-inclusive and takes ADA seriously.

Right now under current Medicare/government insurance programs an individual can receive a power wheelchair every 5 years.

Wow! Sounds generous, doesn't it?

But how many of you know the hoops a disabled person must jump through just to get basic maintenance on one of those power wheelchairs?

It's quite counter-productive, exhausting to a disabled person mentally and sometimes physically, and just plain un-dignified.

And it's a foreseen danger or hazard at times that is shameful!

Let me explain.

A disabled person has to fill out (or have filled out) 'x' papers proving their disability, proving that disability hasn't improved and may have even worsened. This includes visits to their primary or pain management doctor, follow-up visits with their caseworkers, nurses etc, sometimes even judges. Yes, cases need to be reviewed and updated and monitored to protect the client and to protect agencies and insurance companies from fraud. If we could have a database that follows this person maybe he/she wouldn't have to jump through so many hoops, and it would be cost-effective. And until even bigger strides (stem cell or other research) comes to be the norm, maybe a person with MD or some other disease or impairment won't have to keep showing "see, I haven't been cured overnight, I'm still sick and as is the nature of my disability it's not going away". There's always going to be unscrupulous people that try and take advantage of things, but that should not be setting precedent for how one is cared for. It should be the other way around.

Further, a person with a disability that requires a power wheelchair should not be denied maintenance on said chair. (I'm using power wheelchairs as an example in this piece because of the maintenance issues, versus a manual chair that is less complicated, thus cheaper to maintain. Plus, not all disabled people are able to use a manual chair- it depends on their DISABILITY!).

We're right back to the preventative care (maintenance ) issue.

Wanna hear something really stupid? Keep reading.

If a disabled person is too 'active' (uses their power chair too much for shopping, visiting friends etc), you know, doing things mobile people do and take for granted every day, they can be denied certain maintenance on their power chair because they are using said chair "excessively"!!!

Wait- it gets even more ridiculous!!!

I even had a client that was told by the provider of their power wheelchair that their power wheelchair was not made to take the abuses of riding over non-maintained roads! This is the same company that has made almost every service call to my client while "out on the road"! For wheels that fell off, wheels that incurred 'bigwheel-flat-tire-syndrome"- you know, where one side of the wheel goes smooth causing a "clunk-clunk, clunk-clunk" while riding. Pretty painful for the person that is disabled and in chronic pain, let alone it causes it's own pain to healthier persons in a chair. So if this chair could not take the "abuse" and you know your client is out and about alot- why was this chair recommended by YOU?!?!?!!!

Sometimes a claim for maintenance has to be denied by Medicare for it to then go through a CBA, which includes another visit to the doctor for an actual prescription for said part needed. This is such a huge waste of time, effort, paper etc. Maintenance should be a built-in cost without review or restrictions. It's a no-brainer. Client calls BEK or whatever their supply provider is tells them the dilemma they come out and they can actually SEE that said part needs to be fixed they fix it then and there or asap and they document the incident to receive their payment from Medicare or whoever. Simple.

A power chair maintained is a client maintained. A chair taken care of is a client taken care of. A client taken care of is more productive and has a higher quality of life. Quality of life and equal access go hand-in-hand.

Denying maintenance or prolonging or making it a hassle to get maintenance on a power chair is the direct opposite of the ADA Act. Unlawful and shameful.

I would like to see many changes in the way persons with disabilities are cared for, from the process to the product. (And that includes recognizing and compensating proven personal care/home health care aides as the important link they are)

Does anyone remember the big hoopla over the IBOT? It was a power chair that worked on the gyro-scope theory. It was able to maneuver stairs and also could bring the individual using it up to the height of counters to wash dishes or up to eye-level with people they were speaking to, etc. It wasn't the end-all and couldn't be used by all people with disablities, and there were still some kinks to be worked out. But it sure did a helluva lot for alot of people! And just the concept is so exciting and mind-boggling! It sort of fell by the wayside because of the expense, though each year it was in production it became more and more affordable. But so many Medicare patients and poor people were denied the use of this chair because it had too many bells and whistles!!!

Yes, it was labelled as more of a luxury item than a quality of life item! Guess the government didn't want the disabled community to get too used to having an even playing field. I mean, heck, if you're sick then act sick and BE sick, don't ask for all these other extras that might give you some dignity!!! (sarcasm)

If health care for all is to be truly inclusive it must address these issues and many more with the disabled community.

Like also changing the laws that say that only a friend, sibling, boy/girlfriend, neighbor, mother, father, or stranger can care for a disabled person and be compensated. Husbands and wives, probably THE most important and in-tune person involved in the care of a disabled person are excluded from being compensated for their care! It is expected from the husband and wife to care for that person, but to the point of exclusion. So a husband/wife will most likely have to work outside of the home for their income which is time spent away from the beloved disabled person. It should be a choice between the husband/wife and the disabled husband/wife who cares for them and not the government. There should still be caseworkers/managers etc that check in and evaluate situations their client may get into, but also depending on the nature of the disability the choice and supervision should still be in the clients' hands if they are capable for such objective evaluation.. I know, many times than not when there are abuses the family or spouse is looked at more closely than strangers, that is why I am all for some kind of evaluation/supervision even for the spouse as a caretaker.

So the field is wide open for improvement, technology, entrepeneurship. Competition can still be a driving force in health care for all. We NEED more research on diseases and impairments. We need better eqiupment.We need people to think outside the box.

Power wheelchairs need to be sturdier and be able to do more for the client to improve quality of life. Communities need to become more in-tuned and involved with improving roads, sidewalks, general accessibility. Grandfather laws denying access to the disabled should have been addressed and abolished with Obama's stimulus plans. Transition for more accessibility in our communities has been on the books for many years and the original timetable for making these improvements is long overdue.

I hope that doctors become the disabled communities biggest advocates.

And while I'm hoping and wishing, I hope that it really is 'Time for Change'.