Schooling Senator McCaskill

Posted: September 23, 2009 in Don't Push Me...
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claire

By Mark E. Smith

It’s always striking to me when people try to politicize wheelchairs and scooters – mobility aids, that is. After all, disability doesn’t discriminate – republican, democrat, or other, when you need a mobility aid, you simply need it. A mobility aid stems from a medical necessity, not a political preference – and ideology doesn’t get a vote in the process when you’ve lost the ability to walk independently.

For this reasons, it stunned me when I saw Missouri’s junior Senator, Claire McCaskill, say to Fox News’ Chris Wallace last week that “hundreds of billions of dollars” can be saved by simply not “giving free scooters to Medicare beneficiaries who don’t really need them.”

Her statements went beyond a political gaffe, and into the realm of spiteful, where Senator McCaskill went on national television and did nothing more than make outlandish, prejudice claims, politicizing mobility aids and scapegoating those with disabilities out of pure ignorance.

This wasn’t the first time, however, that Senator McCaskill went on the attack of mobility aids – and those of us who use them. See, in a May 27, 2009, town hall meeting, she noted that mobility aids and citizens with diabetes are taxing our health care system:

…This is the example I love to give. I did it on Charlie Thompson’s radio show this morning. Many of you heard it. And that is, how many of you have seen the ads for scooters? The ads for scooters. You can get a free scooter. Now think about that. It’s not a free scooter. Guess who’s paying for it? We’re paying for it. Now why do we have a system that is marketing and foisting upon many people that may not want ’em a scooter, ’cause it’s free? Well, it’s because we pay to get people scooters. Now, which is healthier? …Walking. So what are we doing? We’re paying for the scooters. …We’ve got to get back to rewarding good outcomes, we’ve got to get back to, and we can do this. We can lower these costs. Diabetes alone is an incredible drain on our tax dollars….

So, what Senator McCaskill directly suggests is that if you’re unable to walk due to disability like me, you’re a senior like my family member who barely gets by with a walker, or you have diabetes like my 12-year-old neighbor, you’re a lazy, “incredible drain” on the system.

As one with a disability, how do her words make you feel?

I’ll tell you in no uncertain terms how I feel about Senator McCaskill’s views: They make me feel like I’m hearing an elected official who’s so out of touch, and lacks such empathy for many of her own constituents – like adults with cerebral palsy, seniors with mobility impairments, and children with diabetes – that she’s not just from Capitol Hill, but void of reality.

All of this leads me to one critical question: What have those with severe disabilities, the elderly, and even children with diabetes done to cause Senator McCaskill to make us her scapegoat for the country’s fiscal crises and health care debate?

The answer is, those with disabilities have done absolutely nothing to be made Senator McCaskill’s target – and the statistics prove that point.

In 2007, Medicare spent approximately $1.2-billion on “power mobility aids,” out of total Medicare spending of $430-billion. Therefore, if Senator McCaskill had her wish and eliminated Medicare coverage of all power mobility aids, it would only save Medicare $1.2-billion out of its $430-billion expenses. Although, $1.2-billion is a lot of money, it’s actually only 0.28% of Medicare’s expenses – proving that Senator McCaskill’s claim that mobility products are taxing the system by “hundreds of billions of dollars” isn’t just exaggerated, it’s ludicrous.

Where the statistics become even more compelling is when one realizes that 67% of Medicare-funded power mobility aids go to the severely disabled, non-elderly – those with paralysis, muscular dystrophy, cerebral palsy, and multiple sclerosis, to name a few. Therefore, Senator McCaskill’s fiscal argument that eliminating scooter funding will save “hundreds of billions of dollars” becomes even more strikingly absurd, where scooters for the elderly are less than 1/3 of the $1.2-billion of power mobility funding. Scooters for the elderly, then, are “budget dust,” as Washington insiders call such small amounts, not a “hundreds of billions of dollars” end-all to health care funding as Senator McCaskill outrageously claims.

It’s also imperative to address Senator McCaskill’s statements that the elderly – and, anyone with a disability, really – get “free scooters” handed to them. Her statement demonstrates her absolute ignorance toward the diagnosis, prescription, and funding process. Scooters and power wheelchairs are FDA-regulated medical devices that must be prescribed, then authorized based on proven medical necessity, before Medicare will fund a mobility aid. Furthermore, in this era – where mobility funding has already been decreased by over 35% in the past five years, and the qualifications have become extremely stringent, including the in-home-use-only provision – it’s tougher than ever before for those with even the most clear-cut needs to obtain a mobility aid. In very simple terms, if you rely on a mobility aid, then you know that the process of getting one involves adjectives like frustrating, time-consuming, disheartening, unjust, and bureaucratic – and Senator McCaskill’s flip use of free isn’t in the equation, insulting those not only struggling to obtain a mobility aid, but also living with disability.

Now, since I’ve dispelled Senator McCaskill’s fiscal absurdities by simply presenting the facts, let me directly address her social concern that the elderly population is exploiting scooter use.

The social reality is, the elderly population isn’t racing out to get scooters as Senator McCaskill states. In fact, seniors who use scooters do so out of medical necessity – that is, they are limited in their ability to walk and require a mobility aid, accordingly. However, where the reality of scooter use among the elderly becomes especially poignant is that many elderly use scooters as a “last resort” due to declines in health, and some refuse to use a scooter even when unquestionably medically needed, as they see it as “giving in.” The elderly in America are a persevering, independent population, and they don’t turn to mobility aids until absolutely necessary.

In my own family, I have a 99-year-old relative who still lives in his own home, going shopping and such with assistance, and uses a walker. I’ve spent a great deal of time with him this summer, and it pains me to see him struggle with basic mobility, barely able to move about with his walker. Not only is he an ideal candidate for a scooter, but I actually got him one. Yet, he refuses to use the scooter, feeling as though it would be “giving up” – an understandable emotion for a man of lifelong physical strength and independence. As positive slants as I’ve put on scooter use in speaking with him – that it will make him more mobile and safer in everyday life – he refuses to use any device beyond his own legs, no matter how weak and limiting they are.

As my own relative demonstrates, contrary to Senator McCaskill’s ignorance, not only isn’t the elderly population exploiting scooter usage, many of age aren’t using mobility aids when they truly need them, so it’s entirely debatable that the elderly population is, in fact, under-served by mobility aids. Further, it can be argued that the under-served elderly population is actually a fiscal liability by not having mobility aids, a risk toward Medicare hospitalization costs. Again, I look at my elderly relative teetering while using a walker, and wonder what one fall – one trip to the emergency room, not to mention a hospital stay or surgery – would cost Medicare? We know that such a hospital visit would cost far more than a preventative $1,200 scooter. In these ways, not only aren’t scooters over-utilized by the elderly, but Senator McCaskill’s wish to restrict their funding even more could most likely increase Medicare costs by not preventing falls and injuries by those who need mobility aids to sustain health and safety.

Lastly, I’d be amiss if I didn’t address Senator McCaskill’s belief that television commercials that advertise scooters and power wheelchairs promote fraudulent use, that such ads encourage those not in need to get a mobility aid through Medicare. Again, people without medical conditions don’t pursue mobility aids. After all, there’s not one argument why a sane, healthy person would see a scooter commercial and decide to pursue a diagnosis and prescription, and try to go through the approval process to get a mobility aid that they don’t need. People without disabilities don’t want to be disabled. By literal comparison, McCaskill’s concern would also suggest that Lipitor commercials encourage those in perfect health to try to convince their doctors to prescribe them the cholesterol-lowering medication even though they don’t need it. The rational fact is that people respond to mobility and medication commercials for the same reason: Existing medical need. If you’re totally healthy, a commercial for a mobility aid or condition-specific medication won’t convince you otherwise. On the other hand, if you have a condition, and you respond to a commercial that advertises a solution, that simply makes you a consumer, not a “fraud” as McCaskill labels beneficiaries who rely on mobility aids.

When one looks at the simple facts – that power mobility aids cost Medicare $1.2-billion annually, not “hundreds of billions” as Senator McCaskill claims; that mobility aids are merely a tiny fraction of Medicare’s annual $430-billion expenditures, not Medicare’s foremost cost as Senator McCaskill suggests; and that the elderly population is reserved toward using mobility aids, not seeking them fraudulently as Senator McCaskill asserts – one truth is evident: Senator McCaskill, of the great state of Missouri, is out of touch, misinformed, and a voice of degradation toward those with disabilities.

Let us hope that the great constituency of Missouri uses its collective voice to reel their junior Senator, Claire McCaskill, back down to Earth, where those with disabilities are respected, not scapegoated for one misguided politician’s hoped personal gain.

Comments
  1. Lenny Robbins says:

    McCaskill and her ilk are simply demagogues playing on fear to favor a political agenda that has nothing whatsoever to do with the medical-care crisis. Unfortunately, repeating a big enough lie often enough seems to make it seem like TRUTH.

    Thanks for your clearly-worded and even-tempered reply to her broadcast. I would have had much more difficulty keeping my cool .

  2. Melissaa H says:

    I have MS. I am not in a wheelchair…yet. I do need one for long distances but if my right leg keeps getting worse, I will need one to get around out side my house. I am only 19. I wish I could be a normal teen and run around as much as my friends, but aparently I don’t need one and are just lazy.

  3. Brad says:

    Been in my chair for nine years but only during the past couple, have people noticed outward signs of disability. Long sleeves and pant legs covered the atrophy in my limbs for the last sixteen years. I needed a scooter for the four years proceeding the chair. Now I’m unable to shake hands, write, turn a page, hug my wife, child or grandchild…and she calls me a “fraud”!

  4. randy says:

    well…i use a w/c full-time myself, but i must say i have wondered about the sudden prevelance of ads touting ‘free’ scooters. this has only been in the last couple years, i’m pretty sure. it does seem to me that these scooter sellers ARE INDEED pushing anyone who concievably COULD qualify for a scooter to get one-from them, of course. it’s not illegal. its not outright fraud. but i doubt that every scooter sold is truly needed by the oldster; tho’ doubtless, some are. mark’s use of figures here is somewhat disingenuous…if 1/3 of 1.2 billion is being spent on these scooters for the elderly, thats about 350 million right there. let’s say half of these machines sit idle and unused, not really needed after all…well that is $150 million in money ill-spent. n0t exactly ‘budget dust’ in my book.

  5. Whidbey says:

    What a well thought out reply, Mark. I can barely think of a thing to add. My experience mirror your own. Many of wait too long to use scooters or chairs and deprive ourselves of more meaningful lives by being isolated and overtaxed physically than we have to be. I bet almost all of us have elderly relatives taking risks with health to avoid using a mobility device. My own father stayed inside for five years because my sister thought he should be walking to get healthier!
    If a politician is looking for a cause, why not go the other direction and advocate for those who are often scapegoats. It would get MORE press, I think.
    It seems to me that raining this discussion itself , as Claire has done, is a way of reducing an important discussion to a question of dollars and trying to get people to react out of a fear that someone is wasting their money.
    Who will shine the light on corporate thievery as the real culprit of lost dollars?
    Great Job , Mark. Please release this to newspapers all over the country!

  6. […] to his article. It's long, but he really pulls it apart and shows the fallacy of her reasoning: Schooling Senator McCaskill It’s always striking to me when people try to politicize wheelchairs a… Because my insurance company chose to follow the Medicare-based requirements for paying for a […]

  7. Sandy Long says:

    Dear Senator McCaskill.

    It was with some dismay that I heard and then read your statements about the availibility of motorized scooters for the elderly and the disabled under Medicare/Medicaid system.

    Having previously sat on the Board of Directors for AccessII, an Independent Living Center resource center http://www.accessii.org/new_missouri_independent_living_cent.htm and worked with disabled advocacy for over 20 years, I know personally the need for mobility devices for many Americans who can no longer walk safely or easily, if at all.

    It appears that you take issue primarily with the TV ads offering a ‘free’ scooter to some people with need. While I do agree that these scooters are not ‘free’ so to speak, I do not agree with the rest of your premise.

    Mobility is at the heart of a person’s quality of life. Without mobility, a person cannot go shopping, seek medical attention, go to church or go to vote much less do anything else. Without mobility a person becomes a virtual prisoner of their homes and in some cases needs be institutionalized at a much higher cost than a scooter.

    Trust me when I say that I know of no person who would choose to obtain a scooter frauduently or who would not be in need of this type of equipment. I believe you have been mis-led by the very ads you reference where they show actors using the device instead of actual disabled people. Of course these actors appear able-bodied, they are actors after all.

    Before the advent of the Americans with Disabilites Act (ADA) disabled people and elderly folk who could no longer walk easily were either warehoused in institutions or held prisoner in their homes due to lack of accessability to businesses and buildings. Getting out to even go to the doctor was a huge chore as other people would have to be found to assist them therefore, many stayed home and basically died if not physically, then mentally.

    Since the ADA, disabled folk have found acceptence and have become viable productive citizens instead of being locked away; the elderly stay active and more vibrant longer and both enjoy a higher quality of life with yes, having access to mobility devices which allow them to continue living independently longer.

    Perhaps you do not have any elderly or disabled folk in your circle, I encourage you to contact the Independent Living Centers found throughout Missouri http://www.accessii.org/new_missouri_independent_living_cent.htm and learn about how important mobility equipment is to both the disabled and elderly.

    While the high cost of Medicare/Medicaid needs be addressed, this should be done in weeding out fraud in the system, expediting claims, and lowering pharmacutical costs; not in reducing benefits to those in need.

    A final thought; admittedly there are some who work the system: People who have multiple children to gain welfare monies and medical care, illegals who come here and milk our health care services, and some who fake disabilities. These are areas that should and need to be addressed and these actions by some need be stopped. In doing this, our Medicare/Medicaid system would work much better and the monies saved would be huge.

    Madam, as a sister Missourian, I ask that you address these issues that actually are being abused and leave the old folk and the disabled who have to use mobility devices alone.

    Thank you,
    Sandra Long

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