Victim of the Healthcare Industry

I don't pretend that I know every facet of our health care system. As a matter of fact, I knew very little until I transitioned from being a pediatric physical therapist to being an equipment vendor. My eyes were opened to the number of people victimized by our existing health care system.

As a vendor, I worked with people of all ages, diagnosis and socio-economic status. I saw hardship on all levels. For those in poverty, I saw families struggling through the existing Medicaid/Medicare systems trying to get paid-for equipment. After waiting over long periods of time to get approval for their equipment, they were many times denied at the end of the process. Most of them did not have the knowledge or ability to fight the system.

The middle class population is the group that gets most exploited by the insurance agencies. This group consists of people who are working full-time jobs and are usually paying for a portion of their medical benefits. They assume that they have good benefits, but are quickly brought to reality when they get sick. They may normally find that their co-pays and prescriptions may be affordable, but are horrified when they need something like a wheelchair or walker. This type of equipment is called DME (durable medical equipment).

DME includes medical equipment such as: bathroom aids, wheelchairs, rollator walkers, diabetic shoes, lift chairs, patient lifts, compression stockings, etc. Most third party payers do not cover DME items fully (you would be very lucky if you have any coverage for these items). Suprising, isn't it? Most people with good insurance have an 80 percent coverage, but most have 50 percent with a yearly max of $1,000. That does not go very far. There is no dening it, all medical equipment is expensive. However, if a person needs a power wheelchair to get around, it will cost at least $7,000. Therefore, if you have 50 percent coverage and a $1,000 max, you will end up paying around $6,000 for it. Hopefully, you may have Medicaid or Medicare as another paying resource, but most people don't. With Medicare, you must have part B to get any help from them. They usually only cover 80 percent of durable medical equipment, which still can leave you with a large payment.

In regards to our health care system, you don't know how bad it is until you are a victim of it!! Please keep this in mind as you vote and plan for your own healthcare.