One of the platforms I have preached for many years is that there are far too few standards for products offered to Medicare beneficiaries. The price CMS pays to DME dealers usually is the same for a quality walker as it is for a cheap knockoff. Invariably, the knockoff may look the same as the quality unit, but that is normally as far as it goes. The knockoffs often break down, and many do not have the same life expectancy as the quality items. Can you compare a walker that may cost the dealer $50 (or more) with one that is sold to him for $15 or less? We need standards, and they should be strict and enforceable.
To push for standards, I recommend that every dealer belong to the American Association for Homecare as well as to their state DME association. These organizations make your voice heard, but they need your support.
Competitive Bidding
I have been carefully studying some of the changes coming down the pike with Medicare reform, particularly regarding competitive bidding.
I have been against competitive bidding since its inception. All competitive bidding really does is limit where a beneficiary can go for supplies and force many smaller dealers out of the system. Our government has always espoused free enterprise, and a competitive bid is certainly not that.
As things stand now, the top 10 metropolitan areas are scheduled for competitive bidding to begin in 2007, with 80 metropolitan areas to be included after that. What frightens me is that eventually the Centers for Medicare and Medicaid Services can use the results of these projects to create a new reimbursement schedule throughout the country. The bids will be run in three-year cycles, and then those dealers who have been losers can enter the competition again. But how many of them will be left?
The Young Generation
I hear much talk about the next few generations — how the one following the baby boomers will be the first not to earn more, or a least the same, as their parents. Some people say they have no inkling about what is happening politically. They point to use of drugs, a lack of responsibility and every other fault imaginable. Well, I take exception.
This morning I watched a few young teenagers who live in my subdivision walking to the school bus stop. Their sneakers looked so large that I wondered how they could lift their feet. Their jeans were so baggy that I thought if one of them sneezed, their pants would fall below their knees.
But were we any different? I once wore a zoot suit with a jacket so long it could have been a topcoat and a key chain that reached almost to the ground. My elders were concerned about what would happen to our country when we became adults.
When you speak to today's kids, you will be impressed. They know what is happening, and they have some very valuable opinions about politics. They have made choices at an early age and do not hesitate to express themselves.
I suggest you speak with them and listen to what they will tell you. I am comfortable about the future of our country. I want you to feel the same. Talk to the kids — they want to be heard.
A Good Balance
On Dec. 15, 2003, CMS Administrator Tom Scully left for greener fields. As I report this, the search is on for his permanent replacement. What I would like to see is a new administrator who will consider not just beneficiaries or providers but who has the ability to balance the needs of both in making recommendations.
Perhaps the future holds such a person for us.
Sheldon “Shelly” Prial is based in Melbourne, Fla., with Prial Consulting and also serves as the director of government relations for Atlanta-based Graham-Field Health Products. In 1987, he founded the Homecare Providers Co-Op, now part of The VGM Group. He can be reached by e-mail at shelly.prial@worldnet.att.net or by phone at 321/255-3885.
