Letters to the editor

IT'S TIME TO FIGHT FIRE WITH FIRE Now that Congress has capped Medicare oxygen reimbursement at 36 months and eliminated the capped rental option for DME, I am firm in my belief that we must fight fire with fire. Your December headline said it best, "Industry under siege." We're clearly in a fight for our lives, and HME providers need to get that into their heads. No one says the industry can't keep up its quiet diplomacy and negotiations, but it's clear that that hasn't worked up to this point. We need to inundate CMS and Congress with challenges (legal or otherwise) from every conceivable direction until they become more compromising and reasonable. We need to make Congress understand that our industry improves beneficiary quality of life and safety, prevents further injuries, saves lives and ultimately saves the country money! We are not some overextended pork barrel project as we have been portrayed.We are a small but vitally important part of what is still the world's best healthcare system. Question: Has there ever been one massive summit of all the heavyweights, associations and providers representing our industry? I am speaking of all federal and state associations, chief executive officers, dealers large and small and beneficiaries. There is strength in numbers and the larger and more organized we appear, the more willing members of Congress will be to listen to us and to act on our behalf. Why not call on our industry to hold such a summit in Washington D.C. as soon as possible? Time is running out! We need to get as many people under one roof as possible, put aside our differences, restrategize and go back on the offensive immediately. Provide the forum, and we will come. Additionally, I truly hope your publication becomes much more aggressive with members of Congress who have sought to expedite our industry's demise. They should be outed monthly and copies of your publication should be mailed directly to them and/or to their appropriate staff members. On a final note, I am surprised that organizations like the ACLU and AARP haven't come to our aid since we are an industry that assists our country's most vulnerable and elderly citizens. Perhaps, you can help get them onboard, too. - Steve Landau, owner, Medical Equipment Specialists *** DME SAVINGS ARE MINISCULE I find it interesting that our government will cut products and services to its oldest and neediest and be proud of saving $750 million in DME over the next five years. They then ask for $50 billion over the next nine months for the war in Iraq and another $18 billion over the next nine months for Katrina cleanup. The savings they achieved by cutting DME reimbursement are miniscule compared to what they are spending money on. I have been a supporter of the action in Iraq. I still support it, but I do not believe it should be to the detriment of our oldest and neediest. If we did not have enough money to pay for current Medicare provided products and services, then why would we add a drug benefit? The drug benefit has obviously been one of the biggest debacles in our healthcare system's history. The refusal of Congress to allow negotiations with the drug manufacturers makes one wonder who is being looked out for: the pharmaceutical companies or the American public? The American people will soon get enough of the government taking care of some companies to the detriment of the populace of the United States. It is just a matter of time. The vocal groundswell of support that came from my patients during this last so-called deficit reduction bill was heart warming. We as an industry should be doing weekly mailings and implore our customers to exercise their rights as Americans and insist that their legislators do as the electorate desires. Politicians are supposed to be in Washington to do our bidding. We should be giving our customers specific messages to take to the legislators. Customers will make the calls. - Joel Holland, president, Holland Medical, Nashville, Tenn. *** HME: GOVERNMENT WHIPPING BOY I read the article in the most recent HME News about the "HME Credibility Gap." I believe this gap is quite large. When Congress nailed the HME industry with the passage of the Medicare Reform Act several years back, its message was clear: The feds do not believe that the HME industry has its act together. Our legislators appear to believe that we only tell them about our "best and brightest," but that most medical equipment suppliers are ignorant and indifferent to the rules at best, and incompetent crooks at worst. I know this sounds harsh, and I also know that there are a number of legislators who have personal experience with enough suppliers that they are willing to give us a fair look. But until we can demonstrate consistently that most suppliers understand and care about the reimbursement and regulatory rules, the industry will continue to be subject to too much regulation and too little funding. Why? Because hardly anyone believes us when we tell them we are doing the best we can. Looking at recent initiatives, I believe the quality standard rules for power mobility are extremely nitpicky because of this credibility gap. I worry that the government will continue to make us their whipping boy for homecare funding and quality concerns until mandatory accreditation suggests that we "get it" and take government rules seriously. I am not the only adviser who has been shouting into the wind about the need for a more professional attitude among our industry. We may now be at the point where any supplier who does not take that message seriously will soon find another line of work. - Neil B. Caesar, president, Health Law Center, Greenville, S.C.