The Moral to an Ongoing Story


Some pithy person once said, “There’s no such thing as minor surgery, if it’s being done on you.” I now know the same can be said for seating assessments.

As Congress was heading for a veto showdown with President Bush over H.R. 6331, the bill to reform competitive bidding and stop the program in its tracks (see our Funding Essentials coverage in this issue), my mother was diagnosed with a degenerative spinal condition. Her physical therapist agreed that using a wheelchair cushion could help improve her comfort, sitting tolerance and posture.

Though my mother’s condition is stable and her overall mobility is good, I responded with a flurry of determined activity fueled by worry. I read test results, talked to my mother’s PT, and explained concepts such as pressure distribution and gel/foam/air/ honeycomb cushion media to my parents. I scheduled the RTS appointment, provided background information and drove to my parents’ home on the morning of the appointment so I could watch the evaluation process.

I’d seen seating & mobility evaluations done before, of course, at educational conferences and in RTS offices. But the process takes on a new and brutally emotional dimension when it’s taking place in your childhood home.

It was that experience — not as a part of the industry, but this time as a consumer of it — that led me to pick up the phone and, like many other American voters, call my senators and representative to urge Congress to override what was sure to be a presidential veto on H.R. 6331. I’ve been a journalist since junior high school, and I’ve been taught every step of the way that my job is to report the news, not to help make it. That weighed on my mind as I tried to decide whether or not to urge my legislators to override that upcoming veto.

I also thought about the 9.5-percent Medicare fee cut to DME categories in competitive bidding’s first round: the literal price for stopping the program and reworking it. At an American Association for Homecare meeting at Medtrade Spring in May, suppliers in the room were asked if they favored a fee schedule cut if it would stop or postpone competitive bidding. The response was an overwhelming yes when the theoretical cut was described as 5 percent; when the same question was asked about a 10-percent cut, there was more dissent. Understandably so: Where are suppliers going to find another 10 percent to give back?

Common sense therefore told me that many suppliers would not be happy with that 9.5-percent cut. But legislative experts had also warned that the alternative — plunging ahead with a clearly and terribly flawed competitive bidding program — was even worse, and that eventually those competitive bidding prices would have been adopted by other payors as well. That 9.5-percent cut was extremely painful, those experts argued, but going ahead with competitive bidding and watching those policies and prices spread would be catastrophic.

In the end, I decided that reporter or not, I also was a consumer, not to mention a constituent — and as such, I?have a right to let my legislators know what I think. So I called my representative and told his staffer I was disappointed in how he’d voted when H.R. 6331 came before the House, but hoped he would reconsider if given the chance to vote to override a presidential veto. I called my two senators as well.

Did I make the right move? I don’t yet know, and we don’t yet know how H.R. 6331 will shake out. But we have learned that enough constituents, shouting together, can turn tides. And maybe that’s the ultimate moral to this still-developing story.

This article originally appeared in the September 2008 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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