US Politics: Competitive Bidding for Prosthetics

Wayne Renardson renardwc at ctrvax.Vanderbilt.Edu
Mon Sep 23 12:24:16 PDT 2002


Content-type: Multipart/Alternative; boundary="Alt-Boundary-28821.19541386"

--Alt-Boundary-28821.19541386
Michael Link wrote:

ML>Before this turns into a war of ethics I would like to say that as in all 
debates, the truth lies somewhere in the middle.   

Probably.  

ML> Point #1-We have all seen a leg come into our practice, that we question 
the need and or the intent behind the design.   

I am BK from a 1969 motorcycle accident. In 1972 I walked into Snell 
Orthopedics in Nashville, TN for a new prosthesis. The first prosthetist to 
examine my then PTB, which used a 'wedge' suspension, was flabbergasted 
and invited his colleagues to look at this experimental contraption. They were 
kinda snickering about this rig. Ho ho ho.   

ML> Point #2-Anyone that pays for insurance coverage is well a where just 
how they deal with the increased costs to provide advanced technology to 
people in need.    

I do not know what this means. Do you suggest the reason my insurance 
premiums increase is due to 'needy' people?  I suspect the reasons are far more 
complex.     

ML> The perfect prosthesis does not limit the potential of the amputee, but in 
turn does not grossly exceed it either.  

I am not aware of a 'perfect' prosthesis. What does that mean? A prosthesis 
should be comfortable and allow me to navigate from point A to B without 
discomfort. I suspect all prosthetic devices are compromises and not in any 
way perfect.  

If  by the above you mean to say the attitude or mindset of the amputee is 
more important than any prosthesis, born or unborn, I agree. If an amputee 
with a sterling attitude is however not provided with a comfortable rig, even 
the most solid mindset cannot overcome a poor design or fit.   

ML> The cost of the components is not always directly proportional to the 
function advantages. There are components that cost very little and are not 
appropriate for some amputees, as there are some very expensive options that 
apply to amputees with respectively low potential.   

I once saw on the god-awful, people-exploitive, Murry Povich TV show a 
demo of a myo arm that would allow the user to detect heat and cold. The 
presenter suggested it would allow a BE or AE amputee to "tell if her baby's 
water was too hot to prevent scalding the child."  The audience oooooowed 
and awwwwwed. How wonderful. The arm was a mere $25,000.  

I phoned the program and prosthetist to suggest that amputee women of my 
acquaintance were smart and could use their big toe, or nose, or whatever, to 
test the water to prevent burning their child and the $25K would be far better 
spent on their child's education.     

ML> The choices we make should be defendable to providing a distinct and 
realistic advantage to the amputee.    

By 'we' I will guess you are a prosthetist? I see you're at College Park. Either 
way, the above is a good point.  


Wayne Renardson



--Alt-Boundary-28821.19541386
<body>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">Michael Link wrote:</span></font></div>
<div align="left"><br></div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">ML&gt;Before this turns 
into a war of ethics I would like to say that as in all 
debates, the truth lies somewhere in the middle. &nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">Probably. &nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">ML&gt; Point #1-We have 
all seen a leg come into our practice, that we question 
the need and or the intent behind the design. &nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">I am BK from a 1969 motorcycle 
accident. In 1972 I walked into Snell 
Orthopedics in Nashville, TN for a new prosthesis. The first prosthetist to 
examine my then PTB, which used a 'wedge' suspension, was flabbergasted 
and invited his colleagues to look at this experimental contraption. They were 
kinda snickering about this rig. Ho ho ho. &nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">ML&gt; Point #2-Anyone that 
pays for insurance coverage is well a where just 
how they deal with the increased costs to provide advanced technology to 
people in need. &nbsp;&nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">I do not know what this 
means. Do you suggest the reason my insurance 
premiums increase is due to 'needy' people? &nbsp;I suspect the reasons are far more 
complex. &nbsp;&nbsp;&nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">ML&gt; The perfect prosthesis 
does not limit the potential of the amputee, but in 
turn does not grossly exceed it either. &nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">I am not aware of a 'perfect' 
prosthesis. What does that mean? A prosthesis 
should be comfortable and allow me to navigate from point A to B without 
discomfort. I suspect all prosthetic devices are compromises and not in any 
way perfect. &nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">If &nbsp;by the above you 
mean to say the attitude or mindset of the amputee is 
more important than any prosthesis, born or unborn, I agree. If an amputee 
with a sterling attitude is however not provided with a comfortable rig, even 
the most solid mindset cannot overcome a poor design or fit. &nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">ML&gt; The cost of the components 
is not always directly proportional to the 
function advantages. There are components that cost very little and are not 
appropriate for some amputees, as there are some very expensive options that 
apply to amputees with respectively low potential. &nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">I once saw on the god-awful, 
people-exploitive, Murry Povich TV show a 
demo of a myo arm that would allow the user to detect heat and cold. The 
presenter suggested it would allow a BE or AE amputee to &quot;tell if her baby's 
water was too hot to prevent scalding the child.&quot; &nbsp;The audience oooooowed 
and awwwwwed. How wonderful. The arm was a mere $25,000. &nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">I phoned the program and 
prosthetist to suggest that amputee women of my 
acquaintance were smart and could use their big toe, or nose, or whatever, to 
test the water to prevent burning their child and the $25K would be far better 
spent on their child's education. &nbsp;&nbsp;&nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">ML&gt; The choices we make 
should be defendable to providing a distinct and 
realistic advantage to the amputee. &nbsp;&nbsp;&nbsp;</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">By 'we' I will guess you 
are a prosthetist? I see you're at College Park. Either 
way, the above is a good point. &nbsp;</span></font></div>
<div align="left"><br></div>
<div align="left"><br>
</div>
<div align="left"><font face="Times New Roman"><span style="font-size:12pt">Wayne Renardson</span></font></div>
<div align="left"><br>
</div>
<div align="left"></div>
</body>

--Alt-Boundary-28821.19541386--


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