Truly Blessed

ALS patient James Martin shares his journey.

Binding the Invisible Hand

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James Martin
Saturday, March 16, 2013

This past week I met with my speech therapist in anticipation of losing the ability to communicate. ALS will ultimately take away the agility to move my fingers for typing and the ability to speak. Thanks to modern technology, communication will still be possible utilizing eye movement to control a computer cursor. In essence, my eyes will control the mouse enabling me to type, surf the net and use a program to speak. That is the good news.

The bad news is that the invisible hand of capitalism, which promotes competition and drives prices down, is bound by third parties that promote price gouging by taking the consumer out of the cost equation. We, as tax payers and insurance purchasers, are being manipulated into paying outrageous prices because the incentive to be cost conscious is denied to patients.

We have seen the invisible hand of capitalist competition at work with lasik and cosmetic surgery which are not covered by Medicare or most insurance policies. These procedures have increased innovation and decreased cost due to competition that is absent when government and the heavily regulated insurance industry are involved. In my lone situation, the bloated cost of their involvement is staggering.

The "communication tool" is a tablet computer similar to an I-pad. The cost of my I-pad was about $400. The cost of the "communication tool" is $8,000. But just like on t.v., there's more. It does not come with the eye gaze camera for hand's free use. That USB add-on requires another approval and costs an additional $7,000. I found similar technology for $100. The total of the government approved device with attachment is $15,000.00. (Competitor products are similarly priced.) There's still more: if my breathing is too far gone the approval will be denied because the Medicare/insurance rules cannot justify paying so much for the device if I am too close to death. I guess I should brush up on my morse code so I can blink out words.

Medicare will pay 80% of the $15,000 cost of this tool. So taxpayers pay $12,000 for just one of these systems. Extrapolating this waste out to every Medicare/Medicaid patient it is no wonder that our Medicare/Medicaid entitlements are driving us to bankruptcy. Because the vast majority of the population is oblivious to this gouging, and without the ability and incentive to shop around, the gouging continues.

Now I am sure some of you naively believe Obamacare will fix this abuse. Such belief is understandable in Washington and Colorado where marijuana is legal, but all the sober people know better. Why would government Obamacare be any better than government Medicare? Keep in mind also, that under Obamacare, there is a new tax on medical device manufacturers of 2.3% on sales, not profits. That cost will obviously be passed on to the patients and when it is, Medicare will pay 80% of that additional cost. It just keeps getting better.

After my diagnosis I told a friend that it would be interesting to watch if my strong conservative ideology would falter as I entered the Medicare/Social Security entitlement world. I do not believe that it has because this unnecessary and outrageous gouging offends me. I am all for profit, but not for government manipulated profit at the expense of my children and their future due to government overpaying.

Though I do not stand well any longer, I am taking a stand. I refuse to exploit the taxpayers by allowing these companies to gorge on my disability at the government trough. I will not get these devices through Medicare at these unconscionable prices. I am working on a common sense (non government) alternative and will keep you posted.

Last updated: 9:24 am Monday, April 29, 2013

James Martin is a former attorney and graduate of Gonzaga University and Marquette Law School. He lives in Spring Prairie near Burlington. He has been diagnosed with Amyotrophic lateral sclerosis, or ALS. He is married with 6 kids. James is a community blogger and is not a part of The Gazette staff. His opinion is not necessarily that of the Gazette staff or management.

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