Letter to Prosthetists and Prosthetic Companies in MO

The following fundraising letter to Certified Prosthetists and Prosthetic Companies in Missouri was sent out Tuesday. I will be following up in the week to come.

[An alternative for those who wish to donate but cannot afford to give the recommended $250 or $2,000 for a company would be to pledge to raise the same amount. Prosthetists could raise $25 from ten friends or host an informational coffee night at their home. Prosthetic companies could host an open house and invite local doctors, therapists, politicians, and friends.]

Last year, the Missouri Coalition for People with Limb Loss (MCPLL) began its efforts to make sure your hard-working patients get the health insurance coverage they deserve. Now, we are asking for your help to guarantee that their voices get heard in the 2009 Missouri General Assembly.

You know better than anyone how ordinary people are being taken advantage of. They never imagined they would become amputees, but they did know they had health insurance for a reason: they paid into a system they thought would take care of them just in case a sudden trauma or unexpected diagnosis hit them out of the blue. You know that prosthetic coverage is not an unnecessary peripheral benefit, an extra, an add-on, or a luxury. Artificial arms and legs are the very things that health insurance exists to cover, because without them people cannot complete their rehabilitation from injury and amputation, and they cannot go back to work or lead an active, healthy lifestyle.

Prosthetic parity laws have now been enacted in eleven states, and all remaining thirty-nine states will file next year. Here in Missouri, we’ve already been through one trial run. During 2008 we learned the ropes, hired a fantastic lobbyist, testified at two hearings, and saw our bill pass out of the Senate Health Insurance Committee.

Now it’s time for everyone across the Show-Me State who genuinely cares about this issue to get involved. We are asking you to give $250 and for your company to give $2,000; check can be made payable to “Missouri Coalition for People with Limb Loss.” Every little bit helps, but these ballpark figures will help us reach our goal of $70,000 by January 1, 2009. Already we have more than 10% raised, and more has been pledged! These funds will go toward paying our lobbyist, Kent Gaines, as well as paying for letter-writing campaigns, publication of brochures and flyers, and trips to Jefferson City so that real amputees can meet with legislators. In the coming weeks, I will be contacting you to see if you are ready to join us in this cause.

Best wishes for your business and for the health of your patients,

Bill McLellan
Fundraising Chair
Missouri Coalition for People with Limb Loss
314-779-4641

Lacy Clay Supports Federal Prosthetic Parity Bill

U.S. Representative from St. Louis Wm. Lacy Clay supports the Federal Prosthetic Parity Bill and will even sign on as a co-sponsor, he told MCPLL Chair Jeff Damerall during the ACA's National Lobby Day in Washington D.C. last week.

Besides the oppressive 100 degree heat, Jeff and his wife had a fun time seeing the sights and meeting with law makers, including Missouri Senator Claire McCaskill and staffers for Senator Kit Bond.

A Leg for Louie (or Why South Carolina Needs a Parity Law...)

SUMMERVILLE, South Carolina — Amputee John Lewis loves volunteering for the Pine Ridge Fire Department, but charging into action on an old artificial leg can leave him weary and worn by the end of a call.

The prosthetic limb Lewis keeps in his fire boot is 15 years old, with a crack up the side and a knee socket that's falling apart. It rubs his shortened right leg raw over time.

"I ain't had to sit out any fires, but it's sure had me sore," said Lewis, who lost his leg in a motorcycle crash 29 years ago.

Lewis, 51, has another prosthetic limb for daily use, but that one has about five years of wear and tear on it. He's reluctant to take that one into a fire because his health insurance won't cover the cost of a new artificial leg. He figured he would have to make do.

That didn't sit right with his friend Angela Prosser. She figured if Lewis was willing to risk his life to help others, he should at least have a decent leg under him for support.

Prosser last week launched the "Leg for Louie" fundraising campaign to buy Lewis a new prosthetic limb. Models and prices vary, but she estimates that about $15,000 should get Lewis the leg he needs. "I think there will definitely will be an outpouring of support for something like that," she said.

The effort got a boost from North Charleston-based Floyd Brace Co., which offered to help cover about half of the cost of a new leg, Prosser said.

Larry Wiley, co-owner of the company, said he has known Lewis for years and considers him to be a true inspiration.

"Many who suffer limb loss look to others for safety and security. Louie dons his fire suit and his prosthetic leg and puts himself in harm's way to provide safety and security to our community," he said. "Truly amazing."

June 17, 2008 in Amputation | Permalink | Comments (0)

Summer BBQ and Washer Toss

The MCPLL will be holding a summer barbeque and washer toss August 9, from 4:00-8:00, at Des Peres Park near the corner of Manchester and Ballas Roads. The BBQ is one of two fundraisers we are hosting before the 2009 legislative session begins in January, and we hope to raise about $5,000 to help us get a prosthetic parity bill passed in MO.

Food and fun are free to the public, but donations are greatly appreciated!

Amputees fight caps in coverage for prosthetics

By DAVE GRAM
Associated Press Writer

SOUTH BURLINGTON, Vt. (AP) -- After bone cancer forced the amputation of her right leg below the knee, Eileen Casey got even more bad news: Her insurer told her that she had spent her $10,000 lifetime coverage limit on her temporary limb and that the company wouldn't pay for a permanent one.

"It was shocking to find out I was going to have to take out a loan to buy myself a leg so I could keep working and living independently," Casey said. At the bank, she said, she burst into tears when they asked what the loan was for.

Since then, Casey has joined a nationwide fight by amputees and the prosthetics industry to get the states and Congress to require fuller coverage for artificial limbs. The insurance industry is fighting the effort, saying such mandates drive up costs and reduce the flexibility customers want.

"The cumulative effect of several mandates can price employers out of the market altogether," said Mohit Ghose, who was a spokesman for America's Health Insurance Plans, an industry lobbying group, when he was interviewed recently for this story. He left the organization three weeks ago.

Vermont Gov. Jim Douglas recently signed into law a bill making Vermont the 10th state to require insurance companies to cover prosthetics as fully as they do other medical procedures. A similar measure is pending in Congress.

These laws say that if an insurance policy covers, say, 80 percent of the cost of any other medical procedure - whether a doctor's office visit or open-heart surgery - it must do the same for prosthetic limbs.

Just under 2 million Americans have lost a limb, with the largest number of amputations due to diabetes, said Paddy Rossbach, president and chief executive of the Amputee Coalition of America.

Simple prosthetic limbs range in cost from about $3,000 to $15,000. Those that are more mechanically advanced, or come with embedded computer chips, can cost up to $40,000. Expenses can grow further because many patients need new artificial limbs or sockets when the stump to which the prosthetic arm or leg is attached shrinks or otherwise changes shape. This is especially a problem in children.

While many private insurers have strict limits on the devices, government programs tend to be more generous. Medicare, the government health insurance program for the elderly, covers 80 percent of prosthetic costs and, unlike many private insurers, does not consider the more expensive mechanical or computerized limbs to be experimental.

The Veterans Affairs Department, which is seeing a growing number of amputees returning from Iraq and Afghanistan, provides prosthetic care without limits, said VA spokesman Terry Jemison. Anyone eligible for VA benefits - from a young soldier wounded in combat to an older veteran who has developed diabetes late in life - "will receive the latest in technology without limits on cost," Jemison said.

Rossbach argues that the health insurance industry's talk of mandates driving up costs is overblown. She said studies in six states that have passed these laws showed that increased coverage for prosthetics had added 12 to 25 cents a month to the average insurance premium.

She added that insurance companies' slowness to cover prosthetics can increase other health care costs in the long run, because patients' immobility often leads to other ills.

"If people have a very sedentary life, then they are going to be at risk for secondary conditions - diabetes, obesity, depression, some forms of cancer," Rossbach said.

Still, mandates are not the answer, America's Health Insurance Plans argues.

"Mandates misallocate resources by requiring consumers - or their employers - to spend available funds on benefits that they would otherwise not purchase," it says on its Web site. "They also limit consumer choice by not allowing health insurance plans to make innovative and efficient products available to employers and individuals, including mandate-free policies."

Many health insurers lump prosthetics under the category of durable medical equipment, which includes less-expensive items such as crutches and back braces. Many people do not realize until it is too late that they have signed up for coverage limits that won't come close to paying for prosthetics, Rossbach said.

To Casey, who sells advertising for a Burlington-area TV station, the result seems arbitrary and unfair.

"If I had breast cancer and had a double mastectomy, they would cover breast reconstruction, yet I can't have a leg? This makes absolutely no sense," she said.