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New Healthcare Plan

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    New Healthcare Plan

    There is a lot of discussion going on these days regarding healthcare reform, but I see little information regarding the needs of the disabled. I think it would made sense for this forum to publish a letter for it's members to send to their representative regarding the needs of the disabled. Perhaps that has already happened but I don't remember seeing it. What brought this to mind was a letter I recently received from Craig Hospital in Denver requesting it's patients to send a letter to their congressman on this subject. The letter is as follows:

    I am writing to ask for your serious consideration of reasonable catastrophic injury coverage benefits in whatever federal healthcare reform bill which is likely to be enacted this year. I am concerned that with the complexity of the health care issues at hand, Americans affected by spinal cord and traumatic brain injuries and their rehabilitation needs will go under the radar screen, and such individuals will not reach their potential.level of independence and productivity.

    In addition to the need for such coverage, I have outlined below some perspectives on the positive impact that effective rehabilitation programs can provide to our society.

    The original intent and purpose-of-health insurance following WWII was to protect the American people from financial ruin following catastrophic injuries and illnesses-- to insure. It was not to provide first dollar coverage for routine medical care, which tends to the primary focus of health insurance today. This "reverse principle of insurance" created by managed care over the past twenty years has created what we recently have called "sub-prime insurance". To underscore this," the term insurance has been replaced by "health plans".

    Many health plans today provide little to no insurance coverage for inpatient and outpatient rehabilitation, equipment (wheelchairs, etc.) or home health services. Due to this lack of coverage, patients and their families who are affected by catastrophic injuries,such as spinal cord and traumatic brain injuries, andare forced liquidate their savings and, in many cases go on SSI or Medicaid roles.

    Sixty days of rehabilitation to learn what is needed to function at home costs approximately $130,000. A functional manual wheelchair costs $5,000, and a motorized wheelchair can run upwards of $25,000. Home modifications generally range from $50,000 to $100,000: If the individual should continue to need nursing and attendant care at home, the lifetime cost can range from $500,000 to $4 million. Most of these costs are not covered by insurance policies or Medicare-Medicaid.

    Based on my personal experience, I would strongly encourage you to advocate for those affected by catastrophic injury by insuring that any health care reform bill include a minimum of 60-90 days of inpatient rehabilitation, up to $25,000 for durable medical equipment, outpatient therapy benefits as-medically necessary;- and home health aide benefits with a $2 million lifetime cap.

    As noted above, the cost of intensive rehabilitation for a patient and their families are not inexpensive. It should be noted that rehabilatation is an investment as much as a cost. An effective rehabilitation program can assist someone affected by spinal cord or or traumatic brain injury to a high level of independence that can allow them to return to school and work that ultimately saves money for insurance carriers, employers, and taxpayers. It is also important to note that due to the relatively small number of Americans who do suffer a catastrophic injury, the total cost of our recommended benefit levels as a percentage of the total- bill for health care in this country is minimal, while the impact on an individual suffering such an injury can mean financial ruin.

    Thank you for taking the time to read my letter and for your consideration to advocate for increased benefit coverage for catastrophic injury.