Dodging Bullets

The first thing this industry has to do is to start feeling better about itself.

For those who are slaves to form, I realize that the subtitle and the first line of this article are exactly the same. But this is a point I want to make sure does not get overlooked.

I became very worried when I read the comments of fellow suppliers earlier this year following the most recent round of oxygen cuts. The Centers for Medicare and Medicaid Services compared apples and oranges, cranked out fruit salad and determined that an 8 percent average cut was reasonable, fair and just. And as providers, our response was, “We really dodged the bullet on that one.”

This sounds like the same rhetoric we responded with in 1998 when we got a 25 percent cut in oxygen followed by 5 percent the following year. The rumors flew within the industry: “They're going to cut us 50 percent;” “I heard it was going to 65 percent.” It turned out to be a total of 30 percent over two years, and “We really dodged the bullet on that one.”

Not once was there an outcry from the industry that maybe 30 percent was too much and just plain wrong.

I can only speak for myself, but I'm getting way too old to do much more bullet-dodging. If I wanted to dodge bullets, I would be wearing a whole lot better protection than a scrub shirt covering a heart filled with good intentions. I'm certain I'm not alone.

COLA Is Not My Favorite Beverage

At least when the Six Point Plan was instituted and oxygen was attacked (where our company is located in Florida, payment fell from about $290 per month to about $200), there was a sliding scale built in that would allow for re-establishment of a sufficient reimbursement for oxygen over the ensuing years. It was about that time someone in Washington said, “I don't think so,” capped the oxygen reimbursement and froze our cost of living adjustment.

COLA may seem an innocuous term when put in all caps and bandied about, but it has a dramatic impact on our bottom line. As an industry, we have not had a pay raise in 15 years, though the cost of doing business has been rapidly increasing, at times exceeding the rate of economic growth.