D
Don Y
Guest
On 7/26/2020 11:05 AM, Tom Gardner wrote:
It\'s not necessarily going INTO a hospital as much as it is
EXPECTING (and DEMANDING!) \"The best\" treatment -- instead of
the treatment that is most appropriate for the condition with
which you are presenting.
E.g., folks will want an MRI when an ultrasound may be the
more appropriate (initial!) test. Then, complain when/if
the MRI is authorized thereafter, that they wasted all that
time with the US! (THEY aren\'t paying for the procedure...
they figure they have already PAID for it... and, thus,
want Top Shelf)
Yup. A car I owned was vandalized ~40 years ago. In
the process, a window broken. As it was late November (in
New England), I was pretty motivated to get it replaced
promptly!
Trying to get a price quote from the glass company was like
pulling teeth: \"I need to know whether you have glass coverage,
or not, in your insurance policy...\" (yeah, I carry my policy
with me to work every day... uh huh!)
Out of frustration, I asked, \"is it cheaper if I HAVE insurance
or if I *don\'t* have insurance?\" Lady replied, \"cheaper without\".
\"Fine. Assume I *don\'t* have insurance. How much is this going
to cost me and how quickly can I get it done?\"
Yes. So, it behooves them to nudge people into thinking that
more expensive procedures/tests are worthwhile... so, they demand
them which drives up the premiums, etc.
Two batteries that I already mentioned could be purchased for
~250/each.
>> LED light kit 1,233
Two (2 inch dia reflectors) \"headlights\", two red tail
lights and four yellow turn signals. $150/lamp??
This is the actual \"stick\" that slips onto the metal
post that the \"color joystick\" assembly presents. It\'s
a 2.5\" long fob of plastic!!
Two pieces of software that are present always -- just need
to be \"enabled\" in the factory configuration process.
>> ROHO seat cushion (22\") 628
A fancy rubber bladder...
>> Incontinence seat cover 161
A \"pillow case\" for that bladder
I guess they sell them individually in case they have
a one-armed customer!
>> Push handles (so someone can push the chair) 447
This is effectively \"bicycle handlebars\" bolted to the
back of the chair.
>> USB charger 212
A 500mA 5V power supply fed from the 24VDC power bus.
To be fair, there is a lot of \"sales cost\" involved.
You don\'t just take an order over the phone and ship
out a chair. A friend DIED before her chair was ready
for her!
And, the chair has to be \"fitted\" to the occupant.
Imagine if every PC sold had to be \"installed\" in the
buyer\'s home. How much time would be spent doing that
and answering inane questions from the buyer??
One can argue that certain \"features\" (and associated
PRICES) aren\'t \"essential\" to providing the compensation
required. E.g., features (pricing) that reflects
\"vanity\" issues might be arguably not essential.
I spoke with a blind man many years ago regarding the
issues that he considered important in the design of
kit to address blindness. The comment that I remember
most was \"don\'t make it LOOK BLIND\" (!) I.e., many products
look very bland... unsexxy. He considered this a slight
on that population: \"Why can\'t WE have sexxy products?\"
[I mentioned that fancy packaging adds to development
cost which must be absorbed over a relatively small population
so developers opt for \"stock\" enclosures instead of custom
jobs...]
[[The other notable comment was to make products easy to
clean -- so sighted folks don\'t cringe when they see
some bit of kit with lots of dirt/grime ground into
nooks and crannies]]
You\'d buy \"replacement insurance\" in much the same way you\'d
insure your cell phone (from being lost/stolen/dropped)! :-/
I\'d wager the batteries on her scooter are MUCH easier to
replace than those in my chairs! It takes me most of
a morning to get the existing batteries out and throw
a set of replacements in their place (it\'s an intentionally
tight fit -- up over a lip and then slid into a cavity
that fits the size almost exactly -- and the things are
*heavy*)
EVERYTHING about the chairs is difficult to service.
E.g., to install the headlights, I\'d have had to remove
the main drive wheels (to run the cables). As I was
having none of that, I managed to work AROUND them being
in place -- but only because I was determined to do so!
A \"mobility tech\" would just put the chair up on a lift
and pull the wheels as the manual suggests.
Would they remember to put velcro on the bottoms of
the batteries to ensure they don\'t jostle about
when/if accompanying you (but in the hold of an aircraft)?
Given the number of people whining about not being able to
go to a pub or dine out, I suspect their inabilities are
even more fundamental! :>
Note, however, that folks living alone who are dependant on
mobility aids are really up Schitz Creek when/if those
items fail! Perhaps not even able to make their way into
their own bathroom!
On 26/07/20 16:14, Don Y wrote:
On 7/26/2020 7:25 AM, Tom Gardner wrote:
We don\'t have the \"insurance uplift\" problem here, I\'m
very glad to say. Callout fees are ~£60, which is very
reasonable.
It\'s a perverse set of DISincentives! E.g., if you
*qualify* for a chair, then there\'s no incentive for you
to be economical in your selection process
I understand and accept that theory, but in practice
that doesn\'t seem to be an issue here. I\'m not sure why,
but some speculations can be:
- people value and treasure the health service
above most things, to an almost religious extent.
There is a visceral fear of anything like the US
health system. Many Americans simply cannot believe
that, but it is true
- people know the NHS is under-resourced, and don\'t want
to abuse it
- they have economies of bulk purchases, which keeps the
price down
- the NHS will give you what you /need/, as assessed by
skilled individuals that have nothing to gain by over
or underselling. Hence they are trusted, and the
decision is accepted.
I hear folks talk (wrt insurance, in general) with an attitude of
\"I\'ve PAID for this so I\'m going to get the most out of it!\"
Not me! I prefer to stay out of hospitals, and where you
have to repeat purchasing insurance, I presume some of
your payout will be recouped by increased premiums.
It\'s not necessarily going INTO a hospital as much as it is
EXPECTING (and DEMANDING!) \"The best\" treatment -- instead of
the treatment that is most appropriate for the condition with
which you are presenting.
E.g., folks will want an MRI when an ultrasound may be the
more appropriate (initial!) test. Then, complain when/if
the MRI is authorized thereafter, that they wasted all that
time with the US! (THEY aren\'t paying for the procedure...
they figure they have already PAID for it... and, thus,
want Top Shelf)
But then perhaps I\'m too honest. When my car was rear
ended, several times I was asked if I had any neck problems.
I answered no, in the full knowledge that claiming
such problems was a standard way to jack up a payout.
Yup. A car I owned was vandalized ~40 years ago. In
the process, a window broken. As it was late November (in
New England), I was pretty motivated to get it replaced
promptly!
Trying to get a price quote from the glass company was like
pulling teeth: \"I need to know whether you have glass coverage,
or not, in your insurance policy...\" (yeah, I carry my policy
with me to work every day... uh huh!)
Out of frustration, I asked, \"is it cheaper if I HAVE insurance
or if I *don\'t* have insurance?\" Lady replied, \"cheaper without\".
\"Fine. Assume I *don\'t* have insurance. How much is this going
to cost me and how quickly can I get it done?\"
Note that there is also no incentive for insurers to drive costs
down. If health care (or DME) was inexpensive, you\'d never consider
buying insurance to cover those POSSIBLE costs!
Oh, that\'s a perverse incentive (for the insurance companies)
I hadn\'t thought of!
Yes. So, it behooves them to nudge people into thinking that
more expensive procedures/tests are worthwhile... so, they demand
them which drives up the premiums, etc.
If you *don\'t* qualify, then you\'re stuck facing \"list prices\"
that are exhorbitant (my chairs \"list\" for more than many folks\'
annual net pay!)
You can always buy medical treatment/equipment here. The
list prices aren\'t artificially inflated in the way you
outline.
Here\'s the published \"retail price list\" for my chairs (from factory):
https://permobilus.com/wp-content/uploads/2017/04/US-M300-Corpus-HD.pdf
(actually, I don\'t have the HD model but the prices are very comparable)
A crude tabulation of the pertinent line items:
Batteries (pair) 1,002
Two batteries that I already mentioned could be purchased for
~250/each.
>> LED light kit 1,233
Two (2 inch dia reflectors) \"headlights\", two red tail
lights and four yellow turn signals. $150/lamp??
Color Joystick w/lights 1,232
Stick (not included in the above!) 167
This is the actual \"stick\" that slips onto the metal
post that the \"color joystick\" assembly presents. It\'s
a 2.5\" long fob of plastic!!
Memory seat program 132
Legrest linked to recline electronically 50
Two pieces of software that are present always -- just need
to be \"enabled\" in the factory configuration process.
>> ROHO seat cushion (22\") 628
A fancy rubber bladder...
>> Incontinence seat cover 161
A \"pillow case\" for that bladder
Left arm pad (gel) 185
Right arm pad (gel) 185
I guess they sell them individually in case they have
a one-armed customer!
>> Push handles (so someone can push the chair) 447
This is effectively \"bicycle handlebars\" bolted to the
back of the chair.
>> USB charger 212
A 500mA 5V power supply fed from the 24VDC power bus.
Total 45,590
That seems high, but what do I know? I\'ve no idea
of the cost over here.
To be fair, there is a lot of \"sales cost\" involved.
You don\'t just take an order over the phone and ship
out a chair. A friend DIED before her chair was ready
for her!
And, the chair has to be \"fitted\" to the occupant.
Imagine if every PC sold had to be \"installed\" in the
buyer\'s home. How much time would be spent doing that
and answering inane questions from the buyer??
As for deafaids, there are many types on the market, but
at any time the NHS will offer only a very types which
cover the complete spectrum - up to and including cochlear
implants. Presumably the specific types depend on what
they can negotiate from the suppliers this year.
One can argue that certain \"features\" (and associated
PRICES) aren\'t \"essential\" to providing the compensation
required. E.g., features (pricing) that reflects
\"vanity\" issues might be arguably not essential.
I spoke with a blind man many years ago regarding the
issues that he considered important in the design of
kit to address blindness. The comment that I remember
most was \"don\'t make it LOOK BLIND\" (!) I.e., many products
look very bland... unsexxy. He considered this a slight
on that population: \"Why can\'t WE have sexxy products?\"
[I mentioned that fancy packaging adds to development
cost which must be absorbed over a relatively small population
so developers opt for \"stock\" enclosures instead of custom
jobs...]
[[The other notable comment was to make products easy to
clean -- so sighted folks don\'t cringe when they see
some bit of kit with lots of dirt/grime ground into
nooks and crannies]]
I expect that I /could/ get a better hearing aid (whatever
than might mean) privately, but it would probably set me
back >£5000 for both ears. More importantly, I could not
guarantee in advance that they would be significantly
better (and there\'s evidence they wouldn\'t be), and if
I lose or break them I would have to fork out again.
You\'d buy \"replacement insurance\" in much the same way you\'d
insure your cell phone (from being lost/stolen/dropped)! :-/
Finally, the chairs aren\'t designed to make maintenance
easy -- especially for a person who NEEDS such a chair
(and likely can\'t just climb out of it and start working
on it!)
Fortunately my experience is limited to replacing SLAs
and contacts between the battery pack and frame.
Imagine if YOU were the chair\'s user! How easily could
*you* perform those tasks?
frown
Zero chance!
I\'d wager the batteries on her scooter are MUCH easier to
replace than those in my chairs! It takes me most of
a morning to get the existing batteries out and throw
a set of replacements in their place (it\'s an intentionally
tight fit -- up over a lip and then slid into a cavity
that fits the size almost exactly -- and the things are
*heavy*)
EVERYTHING about the chairs is difficult to service.
E.g., to install the headlights, I\'d have had to remove
the main drive wheels (to run the cables). As I was
having none of that, I managed to work AROUND them being
in place -- but only because I was determined to do so!
A \"mobility tech\" would just put the chair up on a lift
and pull the wheels as the manual suggests.
Hell\'s teeth, there are far too many able people that
couldn\'t do it.
Would they remember to put velcro on the bottoms of
the batteries to ensure they don\'t jostle about
when/if accompanying you (but in the hold of an aircraft)?
The way I like to look at it is to realise that the
indigenous people in, say, the Amazon know how to do
everything they need to in order to live. Many people
here can\'t prepare an animal before cooking, or other
everyday things like change a fuse.
Given the number of people whining about not being able to
go to a pub or dine out, I suspect their inabilities are
even more fundamental! :>
Note, however, that folks living alone who are dependant on
mobility aids are really up Schitz Creek when/if those
items fail! Perhaps not even able to make their way into
their own bathroom!
Now, please explain to me which of those is the
\"savage\" and which is \"civilised\"