Letters to the editor

Sunday, April 30, 2006

I read the editorial "Casualties of war" in the April issue of HME News. While I am not a fan of the president's proposed cuts that affect the medical equipment industry, I do support him in the war in Iraq. Your comments that few have had to make sacrifices is true. We are blessed in that way. Make no mistake, these are not easy times, but this country is doing well--all things considered. I do not agree with you or your tone when you say, "It's sort of like, well, invading a foreign country without any exit strategy. The result is chaos and unnecessary sacrifice, even death." The exit strategy is to win the war and protect freedom. You cannot honestly compare the war in Iraq with these Medicare cuts can you? I hope not. I am proud of this country, its brave military and our president for making the hard choices. How many casualties would there be here in America if we stood by and did nothing?
- Mike Bales, former U.S. Marine, Bluefield, W.Va.


I noticed with interest the comment made by an "industry source" that downplaying reduced access to care with the proposed oxygen cap. This remark took me by surprise: "...it's the smaller, regional providers with three or four branches that use RTs." I do know that at least two of the big national HME providers make extensive use of RTs in their daily operations. Respiratory assessments, patient and physician/referral follow-up, patient education and therapeutic compliance visits, oximetry, et al. are all necessary aspects of our clinical services--as it was with the smaller companies I worked for.
I was struck by the seemingly offhand dismissal of a major part of the valuable and value-added programs and services that most companies provide in this area.
- Ian Pagan, clinical account specialist, Apria Healthcare, Orlando, Fla.


I am contacting you about the Deficit Reduction Act that caps oxygen reimbursement at 36 months and transfers ownership of the equipment to the patient at that time. This change makes me so mad. It puts an undue burden on the patient to maintain these pieces of equipment, and they can't and won't do it.
The government is not thinking these things through for the final outcome to the patients. I am a manufacturer representative who sells this type of equipment to homecare providers. These oxygen machines take time, know how and money to maintain after they are paid for. This is not cheap and beneficiaries have a tough time just paying for the 20% co-pay. Now we are asking them to maintain something that will cost them more money out-of-pocket.
I live in Colorado and I would like to support the many dealers who buy my equipment in trying to get this bill changed. This bill really hurts the patients medically by putting more stress on them to keep these machines working and to make sure they are working correctly. They don't need this type of problem or expense in their lives.
Whatever I can do to help, I'm willing to do.
- Bob Gunner, owner, Gunner Medical Sales, Aurora, Colo.



Coding for home oxygen should be on therapy, not equipment. We, the home oxygen equipment providers, manage not only the equipment but also the patient's home oxygen therapy. The equipment is only part of the process and every patient's needs are different.
The industry has used the payment on the E1390 (stationary unit) to manage the patient and now it looks, to someone outside of the industry, like we get paid on a piece of equipment forever. What they don't see is how often we are in a patient's home for re-education, changing liter flow, doing refills, servicing equipment, replenishing supplies, performing oximetry testing, etc.
Even when we aren't getting paid on the E0431 (portable unit), we provide one because a back-up unit is required. Every service we provide for an oxygen patient is based on the payment of the E1390.
For an outsider looking in, it is hard to understand (that), and for an insider looking out, it is hard to explain. Maybe instead of fighting caps, we should push for a change in coding.
- Jerry Hall, Hall-Moore Medical Supplies, Jacksonville, Fla.

<a href=&#39;http://www.hmenews.com/index.php?p=article&id=hm200604p1SQYf&#39;>Casualties of war</a>