Author Topic: Costs  (Read 3811 times)

Offline annieg

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Costs
« on: July 16, 2009, 10:24:52 PM »
I just received a bill for $1582 for 2 socket inserts with lock mechanism (sleeves?).  No wonder our insurance costs are so high.  That seems to be a lot of money.  Am I wrong to think prices for our components are outrageous?  I have Medicare and they paid $1139.  I will have to pick up the rest.  I feel lucky to have coverage.  What do people without insurance do?  Annieg
He who limps, still walks.

Offline pegleg jack

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Re: Costs
« Reply #1 on: July 17, 2009, 08:31:38 AM »
annieg, i think i put this one once before but here go agian, as you have read i had a new pair of legs made this year, went with the OOW LIMB-LOGIC VS,  and RENEGADE FEET, here is what they billed MEDICARE and what they recieved and my cost out of pocket, cause my insurance and medicare only take care of 90%

1. they billed medicare to the amount of 48211.10 and got 36972.86 and my out of pocket is to the amount of 2734.19 and we are not completely finished yet, have had to buy some space  management pads at around 26.00 per set of pads and a couple more sleeves at 137.00 each, and that come out my pocket.
you-all have a great day.

Offline naseigfried

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Re: Costs
« Reply #2 on: July 19, 2009, 02:43:16 PM »
It is outrageous. Spacer socks can cost $20 each. A friend of ours is a breast cancer survivor. She was telling me last night that her bras, which Medicare allows 4 per year, cost $50 each.

Just ridiculous, but we have to have them. I don't want socialized medicine though. I've met a guy online who lost his leg recently in South Africa. Though he is totally healed, he has to wait up to 6 months for a prosthesis.
LBK since April 2004

Offline herb

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Re: Costs
« Reply #3 on: July 19, 2009, 07:46:36 PM »
Hi Neal - he may have to wait 6 months, but at least he can get a leg. In our country we have millions of people with no health insurance who die or do without needed medical care and equipment. I have talked to many people in countries with socialized medicine who get fast care and are very pleased with their system. Two years ago my sister was skiing in Germany and broke her leg. She was worried that they would not take her insurance. She had surgery in a state of the art hospital. When she was discharged she asked if the bill would be covered by her insurance. There was no bill for her treatment. Have you seen the movie " Sicko" ? it is an eyeopener about medical care. Our system is by far the most expensive in the world and it is far from the best. Herb

Offline Dick Stevens

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Re: Costs
« Reply #4 on: July 20, 2009, 11:03:36 AM »
Herb:

I have to agree with you 100& on the healthcare issue.  In America, the ones who are cleaning up on the system are the medical (and DME) profession, the insurance industry, and Big Pharma.  Of course, they want to see the US system stay the way it is - what a cash cow they are protecting.  So, of course, they work hard to convince Americans that any socialized medicine is horrible, be it UK, Canada, Germany, France, or whereever.

I still think that tying healthcare to employment a big mistake - both for healthcare AND for jobs.  It gives companies a big incentive to do thir hiring off-shore, hence Americans lose jobs.  Rather, let's tie the cost of healthcare to corporate net profits [not payroll] (as well as other taxes?)  That way, a company that makes big profits selling to Americans, doesn't avoid paying their fair share for healthcare by firing Americans and hiring overseas.  With our present system, we Americans are shooting ourselves in the foot!


Dick Stevens, DBKA in PA

Offline Dick Stevens

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Re: Costs
« Reply #5 on: July 20, 2009, 11:18:37 AM »
PL Jack:

At $48K or 36K for a pair of prostheses, was that for BK or AK? 

I am a bilateral BK, and mine cost about $30K for the pair a few years ago.  I have "plain vanilla" fake hoofs, no knee assemblies, no electronics, no bells n' whistles.

Another example:  wheelchair company wants over $5 for a single replacement bolt.  I can buy 'em by the dozen for less than that at Lowe's or Home Depot. 
Dick Stevens, DBKA in PA

Offline Michael

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Re: Costs
« Reply #6 on: July 20, 2009, 11:24:35 AM »
Pegleg,
You are a bilateral below knee amputee, correct?  You paid $48211 for two bk prostheses!  Sounds a little strange to me....actually very strange.  Could you email me the exact details of the bill?  Better yet, fax me a copy of them at 585 343 8101. 

Offline chrysochloridae

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Re: Costs
« Reply #7 on: July 20, 2009, 03:28:32 PM »

Offline Tigertatts

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Re: Costs
« Reply #8 on: July 20, 2009, 04:26:01 PM »
I'd like to know why the sales of prosthetic parts is a closed loop system (monopoly) to prosthetists only and why these parts can't be found for sale new on the open market?. It sure appears to be a you scratch my back I'll scratch yours system covering the ridiculous mark ups and profit margins placed on prosthetic equipment so that manufactures, distributers and prosthetist can profit greatly because of this monopoly. The material cost alone into a socket is only about 20 US dollars yet we are charged 5000.00 per socket. Even if it took an entire 40 hour week to make and fit just one socket that's still one hell of a great hourly wage ($125/hour).

Offline herb

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Re: Costs
« Reply #9 on: July 20, 2009, 06:22:19 PM »
Hi Tigertatts - I recently had to replace an above knee socket and 1 liner. The cost was over $12k. I have been off my leg for around 6 months and my residual leg swelled to where the fit was tight in my socket. I thought a few shrinker socks would cost $10 or so and ordered 2 from my prosthetist. The are a 24" long spandex tube with a plastic ring. Thge material looks like an ace bandage. They cost around $150. I was a bit shocked. Herb

Offline uScott

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Re: Costs
« Reply #10 on: July 21, 2009, 02:03:01 PM »
I'd like to know why the sales of prosthetic parts is a closed loop system (monopoly) to prosthetists only and why these parts can't be found for sale new on the open market?. It sure appears to be a you scratch my back I'll scratch yours system covering the ridiculous mark ups and profit margins placed on prosthetic equipment so that manufactures, distributers and prosthetist can profit greatly because of this monopoly. The material cost alone into a socket is only about 20 US dollars yet we are charged 5000.00 per socket. Even if it took an entire 40 hour week to make and fit just one socket that's still one hell of a great hourly wage ($125/hour).

I think most of the "margin" goes to pay for insurance.  The US is so lawsuit-crazy that nobody dares to - nor can they for long - operate without a boatload of liability insurance, from the limb shop all the way up through the manufacturing chain to the raw material suppliers.  Lawyers, sea floor, good start, etc.   >:(  The lack of direct sales is another liability thing; your prosthetist hardly dares to touch a part that doesn't have a pedigree, and if you got it off of eBay from someone who got it at an estate sale, who knows what's been done to it.  Reminds me a lot of the aviation parts industry....

That's going to be the greatest challenge to nationalizing US health care, is getting costs under control.  It's just batsnot crazy that a $1 bolt has to cost $23 because somebody might sue you if it breaks, and crazier still that they might actually win a jackpot judgment all out of proportion to their actual damages.  Malpractice yes, liability yes, but we've got to stop it being a lottery that everyone wants to play, because then everyone loses big.


Offline Tigertatts

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Re: Costs
« Reply #11 on: July 21, 2009, 04:23:52 PM »
 In California I can tell you for a fact that you can only sue a doctor or other medical office for a maximum of 250,000 and in most cases you can't get a lawyer to even touch a medical mal case for that kind of money (if you do know one please let me know  ;) )  so in this state their really aren't that many doctors getting sued on a regular basis unless they really need to be sued.  You can't begin to tell me that insurance rates are costing prosthetist 50-100 dollars and hour to stay in buisness. And if a foot or knee were to fail they'd just pass the buck to the manufacture then you'd have two parties pointing fingers at each other claiming it was the others fault again creating a situation NO LAWYER on earth would begin to touch for 40% of 250k.

 There is no "good" reason why the public can't go dirrectly to a manufacture or distributer and buy a foot or a knee for a reasonable price. Would be like saying you can ONLY buy your plumbing parts from a plumber and your lights and ceiling fans from an electrician or that you have to take your car to the mechanic every time you need to hang a new air freshner on your mirror. This system is a corrupt monopoly period.

Offline chrysochloridae

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Re: Costs
« Reply #12 on: July 21, 2009, 04:46:18 PM »
The reason that you can't buy directly from manufacturers is because a prosthesis is classed as a medical device and has to be prescribed by a qualified professional in the same way that you'd have to be prescribed drug from a doctor.

On the cost issue though, the reason the parts are so expensive is to cover the cost of huge warranties and the cost of research and development.

I agree that the cost of a new sockets seems expensive, but there are a lot of overheads e.g. insurance and the huge  cost of setting up a limb service as well as the huge amount of time that it takes to assess the patient, take a cast, modify it, manufacture it, fit and deliver it. I'm not saying that i agree with it, just trying to explain why i think the costs are so high.

If its any consolation, the prosthetists and technicians in the UK get paid next to nothing and don't get huge bonuses... I should set up a sideline for ATC forum users 'The Chrysochloridae Discount Prosthetic Co' - "Quality Prosthetics, Mates Rates!" LOL

 

Offline Tigertatts

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Re: Costs
« Reply #13 on: July 21, 2009, 09:04:51 PM »
HEHE you might just have yourself a new start up buisness, WHY NOT -- there's internet drug companies all over the place and they will "confirm" your need for a prescription with a simple email. No prescription? NO PROBLEM, just talk to one of our doctors (with a degree in a 3rd world country, or printed off the internet) and they will be glad to get the right prescription for you.

Offline pegleg jack

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Re: Costs
« Reply #14 on: July 22, 2009, 09:07:19 AM »
to me it is a waste of time and money to go and get a prescription for my legs when my doctor didnot even know what i was talking about and i had to show her by taking my old set of legs off and explaining how each and  every piece worked and then she wrote me the necessary paper work to have my new ones made, in the mean time the expience of me driving to my doctor and  the price of the appointment just to get this done, and this is passed on to the insurance companies to pay, and a nother thing that burns me is according to the AMA. FDA, then cannot reuse any of the parts for some one else and also frown on us reusing for our own use. and have also been told that it is agiansst the law to sell them or donate them to some in need here in the states, OH  we can send them to a third world county and they can be used over there, but not here,

If i am wrong on anything i have said here, feel free to let me know
you-all have a great day.