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Monday, July 22, 2013
Durable Medical Goods Rip Off: A Series of Posts
I am going to start a regular series of posts about how people with a disability are getting screwed over by the cost of durable medical goods. This is an issue that has bothered me for thirty years and thanks to my good friend Rebecca Garden I am going to start to address the cost of being disabled in a series of blog posts. A bit of background is required. Within months of using a wheelchair I quickly came to two conclusions: first, anything remotely associated with disability was obscenely overpriced, uniformly ugly, and poorly designed. Second, the experts, those charged with prescribing, selling and repairing durable medical goods, were at best incompetent and at worst crooks. For many years I had no choice; Everest & Jennings had a monopoly on the wheelchair market. However in the early 1980s rigid frame wheelchairs were invented. A critical mass of angry wheelchair users alienated by E&J began making and selling rigid frame wheelchairs. Dozens of wheelchair companies popped up and an equal number went out of business. Luckily I found a rigid frame wheelchair and quickly decided to opt out of the system. I have not bought a wheelchair in over 30 years. My only ties to the durable medical goods industry is through my ass. I purchase and replace Roho cushions on a regular basis.
I have a renewed interest in the durable medical goods industry because I am getting older. My wheelchair is indestructible but heavy. I am also not as rough on a wheelchair, and can envision a time when I will need a light-weight wheelchair to preserve my shoulders. I found a wheelchair that I think is revolutionary, a Panthera, made of carbon fiber. It is the lightest practical manual wheelchair manufactured in the world. I tested it and was blown away. It is a revolutionary design. The problem is the Panthera sells for more $10,000. Put this price tag in perspective: I can buy a good used car for $10,000.
So how over priced are disability related items you may ask? I want to start out small. I will discuss mundane items on a wheelchair that will over time break down. I am operating on the assumption the person replacing parts is somewhat naïve, relatively new to disability, and unaware of alternative (cheaper) resources. The costs I will list are generalizations. I have based my price estimates on different disability related websites. There is a degree of guess work involved. I must stress the following: I am not particularly interested in the details of price variation. Instead, I am looking at the bigger picture of how lives are profoundly impacted by the durable goods industry. The savvy buyer, likely a person paralyzed long ago, will know the industry well and find good bargains. Regardless, the price disparity remains startling.
Wheelchair tires and inner tubes. At multiple bike stores on line I can order a pair of tires for $13.99. Inner tubes are $4.95 each. In short for $25 I can buy tires and tubes and get them shipped to my home for free. A person new to paralysis will likely think I need to buy my tires and tubes from the wheelchair manufacturer. Big mistake. Order tires and tubes through Quickie, the dominant wheelchair manufacturer in the USA and one will pay dearly. Tires are $17 each, hence two tires are $34. Inner tubes are $8. Shipping is not free. So cost went from $25 to over $50.
Paint. Few wheelchairs will ever need to be re-painted because they are not designed to last. So let’s say a person went on a trip and the airline chipped the pretty paint job on your wheelchair in a highly visible place. Quickie will be happy to sell you an ounce, yes one ounce, of touch up paint for $75. I scoured the Quickie website and could not find out how much it would cost to paint a frame. Again, it is my contention wheelchairs produced by Quickie are not designed to last hence there is never a need for a new paint job. In sharp contrast, my wheelchair frame was designed to last a life-time. I had three frames made about 25 years ago. One frame has been retired and the other two are in great shape. Every five years or so my wheelchair frame needs to be repainted as do the rims on my rear wheels and the footrest. I bring my frame, rims, and footrest to a powder coater and the entire job takes two days and costs $125. More than an ounce of paint is used.
Wheelchair upholstery: I replace my wheelchair upholstery through a car or boat detailer. This costs about $50. The cost of wheelchair upholstery ranges widely from wheelchair manufacturers but one should expect to pay $100 a piece. A set, back and seat, will cost about $200.
I have begun with the least expensive items and will work my way up the price scale. It is my belief that items deemed durable medical goods will be grossly over priced: the mark up extreme. In the future I will discuss high tickets items such as wheels, manual wheelchairs, lift systems such as hoyer and ceiling tracks, power chairs, portable wheelchair ramps, hand controls, van conversions, beds, home elevators and wheelchair lifts. For each item discussed I will offer an alternative. I will repurpose every day items that one could purchase at a hefty discount. The potential savings are staggering. I will end with one example to wet the readers appetite. A hoyer lift costs at minimum $1,500 and ranges up to over $4,000. The slings for a hoyer lift cost over $150. I have a friend whose hoyer lift broke. Insurance would not pay for a new lift. A rider was added to this person’s health insurance coverage and omitted certain durable medical goods. Such riders are now commonplace (my insurance added a rider last year eliminating coverage for organ transplants). My friend could not afford to spend thousands on a new hoyer lift and instead scoured the automotive section on ebay. This person bought a used engine lift for $125 (it was a cool fire engine red). He made his own sling made of a tarp and a cotton sheet for less than $20. It is the best and most reliable lift my friend has ever owned. It cost less than $150.