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Tuesday, April 27, 2010

The Enigma of Competitive Bidding

by Patrick Boardman


While I am a firm believer in free enterprise, competitive bidding simply isn’t competitive. If it were, there would not be a cap.

Think for a moment about one of your dearest family members. Imagine if you will that the were the unfortunately suddenly in grave need for a wheelchair. They would be unable to be independent without this equipment. Due to lack of sensation your loved one develops pressure ulcers where the bones in their tailbone break through the skin. They are in desperate need of a custom molded seating system and pressure mapping. (Lets keep in mind that pressure mapping is not reimbursable to a vendor. The cost for a system is $12,000).

You are concerned about the ability for a new wheelchair to fit into the various rooms of the house for baths etc.

Competitive bidding happens. You call your clinical facility. You live in Boston. A winning bidder in Seattle contracts another company an hour away in Methuen Ma. to come and do your wheelchair. The person that shows up tells you that you can only have a basic chair because the cost is prohibitive. No mold is done as it costs more to do the mold than the company is reimbursed. You have problems after the sale and are directed to call Seattle office. Seattle office tells you to call the Methuen office. You take a day off from work to wait for the technician to come repair your chair. They never show. Meanwhile your loved one is trapped in bed until the chair is fixed.

Now you could have called the company 10 miles away that has an excellent reputation in the industry. They have qualified, trained ATP’s on staff. They have always been an above board Medicare provider. But you cant call them for your new chair because they didn't bid low enough in a bidding process that attempts to drive reimbursements to a price that is lower than what the dealer pays for the equipment.

We all agree that Healthcare costs are outpacing our ability to contain them. DME and Rehab represents less than 1% of the total Healthcare pie, yet no other arena of the healthcare community has suffered such Draconian measures.

It is my strong belief that competitive bidding will have the following negative results:

1. Ethical Small businesses will be driven out of business.

2. Failure of such businesses will have an adverse impact on client choice and client care.

3. Inferior quality of care will result in higher costs for procedures such as myocutaneous skin graft surgeries, ER visits, and hospital and PCP visits. These unseen and increased expenses will far exceed the original savings sought.

As a member of the small business community my job, the life savings of the owners, and the jobs of my peers are at stake if Competitive Bidding is allowed to be employed. So for the safety, comfort, and care of our patients, please consider ending Competitive Bidding for good.

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