"The AARP is the second largest employer in Washington D.C. We are screwed."


I had an energetic conversation recently with a guy who called to bend my ear on out-of-control health care spending in the United States and the home medical equipment industry.

I won’t give this person’s identity away, but while he is not part of the HME industry, he has a ton of health care expertise and is someone worth listening to. I like talking to “outsiders” because they often look at HME issues in a different way or confirm what we already suspect. Both perspectives are valuable.

Here are some excerpts from our conversation:

—    “HMEs are catering to an older Medicare reimbursed clientele. I think the real action in the future is going to be in the younger clientele, supplying technologies for use in the home that facilitate home management of chronic conditions or early diagnoses and self treatment.”

—    “As an industry, HME has to have an answer and value proposition where people are focused on wellness, prevention, home monitoring. Is there a way for HME to reach out and be part of that solution rather than be focused on the elderly?”

—    “I walked into a DME suppler for the first time a couple of years ago, and it had that weird, hinkey kind of feeling. If felt kind of old, and walking in here to get a CPAP machine it felt like I just crossed over to being a old person.”

—    “Medicare is $37 trillion in the hole. If I’m a DME provider with 40% of my business in Medicare, what do I do?”

—    “If Medicare goes in and gets a commode, how much does it pay? If you ask the person to pay out of pocket for the whole thing, what would be the price they’d pick? They would not pick a price close to the full price. This should highlight for everybody that we’ve got a fundamental mismatch in the value proposition. Everyone is fine if they are spending other people’s money, but they are fundamentally getting a product that they do not value at its cost. That is unsustainable.”

—    “How many Hoverounds would they sell if people had to pay for them out of pocket? ‘It’s free to you. We’ll process all the paper work.’ It just makes me angry. Because I know my children are paying for that, and my children have no voice in this. The AARP is the second largest employer in Washington D.C. We are screwed.”

—    “I was so damn happy when the reform thing went belly up with Brown getting elected in Massachusetts. Not that we don’t need to change something and have reform, but we don’t need to reform access. We don’t need to add 30 million or 40 million people to a fiscally unsound program. We need to go back and solve the cost problem, It’s all about cost.”

— Mike Moran


He is right in saying we need to change our focus. However, we (HME) can change their focus, but until "wellness, prevention and home montitoring" become reimburseable by insurance (including medicare) will the general population inculding the elderly pay for it themselves? Probably Not. Maybe he should visit some other HME stores, ours is diversified and carries many cash items not for the "elderly" to compensate for the drop in reimbursement, we carry wellness and other items not covered by insurance. And if he thinks that the "elderly" walk in to get a commode, well... If the HME did sell to all walk in customers the prices would be different, but they don't. Agreed - AARP is the the worst representation the HME industry could have, along with the TV ads about getting for free your mobility needs.