BUYING YOUR PROSTHESIS
A daunting task indeed!
DIFFERENT METHODS
Each nation differs in the level of care and the method of how to purchase a prosthesis.
Whilst the UK's infamous National Health system in often subject to criticism and budget restraints. One can get a "good deal" in some ALAC's (Artificial Limb and Appliance Centre) and not in others. Private prosthetic care is growing in popularity and quality.
Canada's healthcare system is provincially based and payment for prosthetic limbs varies. Basically, each provincial government will a pay a percentage of the cost (60-70%) with NGA's (non-governmental agencies) and or private health insurance covering the remainder. There is some restriction on quality of products in most provinces.
The US Healthcare system varies from state to state, but in general is heavily dependent on private health insurance. There are some underfunded federal programs especially for war vets. There has been an increased dependence on NGA's.
If you would like to have your nations health care system profiled please email details to Ian Gregson.
Regardless of the status of your nations healthcare system, you as an amputee have the right to best your healthcare system can offer you.
EDUCATION IS THE KEY
As with the purchase of any product, education of available services and products can only help you make the best choice.
Traditionally this choice has been left in the hands of the skilled medical professional (such as a prosthetist or doctor).
However, in the last ten years there has been a trend toward marketing prosthetic products directly at the amputee. This has been accomplished via tradtional routes such as magazine advertising, but also by the sponsorship of amputee related events such as golf tournaments and the teams and individuals at the Paralympics and other international sport events.
The Internet has also played a significant role in "demystifying" prosthetic products. Anyone can access the WEB Pages of Otto Bock, Flex Foot, USMC and other prosthetic companies. In fact many of these companies angle their WEB Pages to the amputee via the use of non technical language.
The popularity of "consumer" groups such as the Amputee Coaltion of America have also enabled the average amputee to access information on prosthetic products and to make educated choices on those products or whether to wear a prosthesis or not.
WHY YOU CAN'T ORDER DIRECT
The whole prosthetic industry is based around the prosthetist being the person with the knowledge and the amputee with a need.
So when you want to order directly from any prosthetic company this indeed would start a somewhat "dangerous" trend. 1. the company is not set up for it and 2. If the prosthetists ever found out about it there would be hell to pay.
I don't know if selling the product directly to the amputee would directly benefit the amputee more than it would not benefit the prosthetist.
The "mark-up" that prosthetists make on all products they deal with is one of the most hotly contested issues. As in any retail trade market forces, rather than a fair deal determine such a "mark-up".
In a market area where the prosthetist is the only facility he/she can charge higher prices for their services. In larger market areas with competition the facility has to keep a check on prices.
However, there is a somewhat alarming trend of cooperation between many facilities. (like gas prices). Plus many facilities realise the consumer is often ignorant of the "market" (other facilities). Many of the prosthetic associations frown on "competitive nature" toward other facilities. But this does not always hold true.
So yes it pays to shop around, talk to the head prosthetist, check their prices in comparision to other facilities. Weigh the cost of travel over possible higher local prices. There is no regulation on "mark-up" so each facility may differ, depends if the facilities are on talking terms with each other.
I paid $59 Cdn each for my Silopos Silosheaths. I received a phone call from a person a few months ago who claimed to have paid $120Cdn for the same product at a facility across town.
So it does pay to shop around especially in this age of uninsured amputees.
YOUR RESPONSIBILTY AS A TAXPAYER AND CONSUMER
Even though you may not be directly paying for your prosthetic products it is your responsibility as a taxpayer and right as a consumer to ensure the prosthetist is not "gouging" the system.
In the US and Canada there are several levels of "bureacracy" in place to ensure the prosthetist provides a "good" service at a "reasonable" cost.
Traditionally, the amputee has had little or no role as a consumer in such bureacracies, unless they happen to be a prosthetist.
Therefore, making waves in such bureacracies has been frowned upon. However, boards such as the American Board of Certification and Canadian Association of Prosthetists and Orthotists are taking a more pro-active role in regard to dealing with complaints.
To contact such committees and boards, discreetly phone your local prosthetist or if they are not cooperative contact some other facility.
Regardless of whether you pay directly for your services and prosthestic limbs or have a third party do so, it is your responsibility to ensure you have ALL paperwork in regard to services rendered.
A prosthetist or facility that "takes liberties" with billing via "double dipping"(charging for a product that has already been sold and brought back) or charging fully for products or services that have not been completed is partly to blame for overall increased healthcare costs.
Although many prosthetists and many amputees DO NOT recognise it; as the consumer, the amputee has the final say in quality of service and billing practices regardless of who pays at the end of the day.
No one is as close to the prosthetist as the amputee and vice versa.
SOME GENERAL TIPS ON GETTING INVOLVED IN THE DECISION MAKING PROCESS
1.Be pro-active but not pushy. You are aiming for cooperative relationship with your prosthetist, not to make an enemy of him or her. Use tact and diplomacy when asking questions, don't belittle the prosthetist or talk down to them. It is their facility and they have as much right to refuse your business as you have a right to take your business elsewere.
2. Ask to see how your prosthesis is serviced and or assembled. Get familiar with the manufacturing process, the tools used, the material used and the time it takes to put it together.
3. Do not sit in a waiting room waiting for your prosthesis to magically appear fixed and ready to go. Get some crutches or a wheelchair and visit the prosthetist at work in the shop or lab. DO NOT let any bitching or whining from the prosthetist stop you from watching him or her work. Its your right. Not being allowed to sit in on a job for insurance purposes is the biggest con since day one. If the prosthetist tells you to stay in "your place" for insurance purposes ask for a copy of the insurance policy and regulations. If he or she refuses to do so, its time to find another prosthetic facility and time to write some letters.
FINAL NOTE
There are many amputees who are also prosthetists. DO NOT expect the amputee prosthetist to have complete empathy with your situation. Prosthetists are prosthetists to make money, regardless if they are an amputee or not. Sometimes amputee prosthetists will put their business needs first. Amputees don't always make the best prosthetists.
