The economic term, "opportunity cost," means assessing the value of an opportunity that's discarded to pursue another path - that is, if you choose one decision over another, what are you giving up?
On November 15, 2006, CMS is scheduled to implement its 41% reduction in payment toward rehab power wheelchairs, seemingly realizing a direct cost savings to its budget. However, CMS' decision is not without profound consequences - it's not without opportunity costs - and it's the tangible opportunity costs that prove CMS' 41% cut in power wheelchair funding a strikingly poor socioeconomic decision.
The most fundamental purpose of a power wheelchair is that it preserves health and fosters independence - and the maintaining of one's mobility adds up to tremendous governmental cost savings. Studies show that over the past eight years, among Medicare recipients, power wheelchairs saved the government $10-billion in healthcare costs, showing that, on average, a power wheelchair user required $14,000 less annual healthcare than beneficiaries of comparable demographics and conditions who went without powered mobility. These statistics stem from the fact that power wheelchairs facilitate independent living by reducing physical injuries and foster enhanced mobility required for daily living, decreasing needed support services, such as in-home care. In this light, the fiscal savings realized from Medicare and Medicaid expenditures on power wheelchairs prove a wise investment toward beneficiaries' health.
Among the most debilitating component of CMS' power wheelchair funding cuts is how the policy specifically applies the maximum 41% payment decrease toward the Americans with the most profound disabilities - those with quadriplegia, cerebral palsy, muscular dystrophy, and multiple sclerosis, to name a few - placing them primarily in a $3,800.20 "Group-3" power wheelchair, cut from approximately $6,500. To some, the dollar amounts may not have much meaning, not knowing how much wheelchairs cost or what technology they entail. However, in real terms for those with severe disabilities, $6,500 means a power wheelchair that's capable of carrying special, mechanized seating that alternates, shifting the user's body weight throughout the day, preventing pressure sores among those who cannot move; $6,500 means a power wheelchair that allows the interface of specialty control devices to drive the wheelchair when one's only dexterity is in the twitch of a finger, the nod of a head, or even the swish of a tongue, maximizing independence; and, $6,500 means a power wheelchair that has large enough batteries to maintain one's mobility from sunrise till past sundown, keeping one active with family instead of confined to bed. CMS' 41% reduction in Medicare power wheelchair funding, to an allowable of only $3,800.20, is such an inappropriately low amount that it makes obtaining an appropriate power wheelchair impossible for those with severe disabilities, ushering in an escalation of associated healthcare costs and reduced independence across the spectrum.
The question is, if appropriately-prescribed power wheelchairs currently save CMS and taxpayers over $1-billion per year as preventative healthcare, how much will be placing beneficiaries in inappropriate power wheelchairs actually cost the Medicare system? At a 41% decrease in power wheelchair funding, will it cause health-related issues to soar to a correlative $410-million per year of new costs added to the Medicare system? Or will the economic cost be much greater, with alarming decreases in beneficiaries' health, and sharp increases in the need for healthcare and support services?
No one knows. No one knows the true cost of cutting Medicare mobility funding because CMS' policy doesn't take into account the ultimate fiscal ramification of eliminating 41% of health-sustaining power wheelchair funding from the U.S. healthcare system - or, specifically, the devastating effects that it will have on beneficiaries' health and lives.
The facts are clear: Power wheelchairs preserve health, reduce healthcare costs, and foster independence. As constituents, it's imperative that we contact our Congressional Representatives and Senators, expressing our profound concern that CMS is needlessly compromising both the health of its beneficiaries and tax dollars by slashing power wheelchair funding. This decision was made solely by CMS, but the true cost will be paid by all of us - and the cost is too high to ignore.