Re: [UACCESS-L] FW: Insurers Fight Speech-Impairment Remedy

[covici@ccs.covici.com]

Should have him with Hitler's voice, just  like the mustash.

Robert Carnegie <Robert.Carnegie@seemis.gov.uk> wrote:

> Can I run it with President Obama's voice on hardware that can inflict physical pain on 
>medical insurers - either a laptop big enough to beat them around the head with, or some 
>other way?  I don't have the particular need the product addresses, or even a personal 
>beef with the insurers, I just feel like joining in.  (I would appreciate a keystroke 
>speaker for desktop PC, but products exist for that.)
> 
> -----Original Message-----
> From: uaccess-l-admin@trace.wisc.edu [mailto:uaccess-l-admin@trace.wisc.edu] On Behalf 
>Of Steve Jacobs
> Sent: 15 September 2009 17:42
> To: Larry Goldberg
> Cc: Uaccess-L
> Subject: Re: [UACCESS-L] FW: Insurers Fight Speech-Impairment Remedy
> 
> The lunacy exhibited in the article below is what motivated us to 
> develop the following applications for the Android platform:
> 
> Speaking Pad (free):
> A talking notepad (37 languages) for Android. This notepad will speak 
> what you type.
> See: http://www.cyrket.com/package/com.ideal.speakingpad
> See: http://apps4android.org/speaking_pad.htm
> 
> iAugComm ($4.99):
> iAugComm transforms the Android phones into a powerful, high-quality, 
> low-cost augmentative and alternative communication (AAC) device, which 
> can enable individuals who are non-verbal or whose speech is difficult 
> to understand to communicate easily and effectively using a simple, 
> icon-based interface.
> See: http://www.cyrket.com/package/com.ideal.iaugcomm
> See: http://apps4android.org/iaugcomm.htm
> 
> Steve Jacobs
> IDEAL Group, INc.
> Apps4Android
> 
> 
>  Larry Goldberg wrote:
> > FYI.
> >
> > ... Larry ...
> >
> > ------ Forwarded Message
> >
> > September 15, 2009
> > Insurers Fight Speech-Impairment Remedy
> > By ASHLEE VANCE
> >
> > SAN FRANCISCO < Kara Lynn has amyotrophic lateral sclerosis, or A.L.S.,
> > which has attacked the muscles around her mouth and throat, removing her
> > ability to speak. A couple of years ago, she spent more than $8,000 to buy a
> > computer, approved by Medicare, that turns typed words into speech that her
> > family, friends and doctors can hear.
> >
> > Under government insurance requirements, the maker of the PC, which ran
> > ordinary Microsoft Windows software, had to block any nonspeech functions,
> > like sending e-mail or browsing the Web.
> >
> > Dismayed by the PC¹s limitations and clunky design, Ms. Lynn turned to a
> > $300 iPhone 3G from Apple running $150 text-to-speech software. Ms. Lynn,
> > who is 48 and lives in Poughkeepsie, N.Y., said it worked better and let her
> > ³wear her voice² around her neck while snuggling with her 5-year-old son,
> > Aiden, who has Down syndrome.
> >
> > Medicare and private health insurers decline to cover cheap devices like
> > iPhones and netbook PCs that can help the speech-impaired, despite their
> > usefulness and lower cost.
> >
> > Instead, public and private insurers insist that, if Ms. Lynn and others
> > like her want insurance to pay, they must spend 10 to 20 times as much for
> > dedicated, proprietary devices that can do far less.
> >
> > The logic: Insurance is supposed to cover medical devices, and smartphones
> > or PCs can be used for nonmedical purposes, like playing video games or Web
> > browsing.
> >
> > ³We would not cover the iPhones and netbooks with speech-generating software
> > capabilities because they are useful in the absence of an illness or
> > injury,² said Peter Ashkenaz, a spokesman for the federal Centers for
> > Medicare and Medicaid Services. Private insurers tend to follow the
> > government¹s lead in matters of coverage. Two years ago, iPhones and
> > netbooks barely existed, so it may not be surprising that the industry has
> > yet to consider their role as medical devices.
> >
> > But the health care system has long had trouble keeping up with Moore¹s Law,
> > the principle that computing power rapidly increases even as costs fall
> > sharply.
> >
> > Doctors must still bring a patient into their offices instead of, say,
> > inspecting an e-mailed photo of a rash if they want most insurers to pay for
> > the consultation. Digitizing medical records is such a vast undertaking that
> > the government is now spending billions of dollars to jump-start it.
> >
> > In the case of A.L.S., also called Lou Gehrig¹s disease, advocates spent
> > years fighting to have any speech-specific devices covered by insurance,
> > finally succeeding in 2001.
> >
> > For the millions of Americans with A.L.S., Down syndrome, autism, strokes
> > and other speech-impairing conditions, the insurance industry¹s aversion to
> > covering mainstream devices adds to the challenges they face. Advocates say
> > using an everyday device to communicate can ease the stigma and fear of
> > making the adjustment.
> >
> > At the same time, current policies mean that the government and private
> > insurers may be spending unnecessary dollars on specialty machines.
> >
> > Dr. Stanley E. Harris, who helps set device coverage policies for Horizon
> > Blue Cross Blue Shield of New Jersey, said that if enough patients requested
> > new types of devices, the insurer would study their usefulness. ³We¹re
> > looking for evidence-based data to support the effectiveness of whatever is
> > being requested,² he said.
> >
> > In the meantime, people with speech disabilities have a choice: pay for a
> > cheaper product from their own pockets, try to borrow one from a private
> > assistance group or spend their insurer¹s money on a specialty device from a
> > company like DynaVox Mayer-Johnson or Prentke Romich.
> >
> > DynaVox, a leading maker of devices for the speech-impaired, has computers
> > that start at $8,000 and run Windows, just like 90 percent of all PCs. To
> > meet insurance rules, DynaVox disables the general computing tools. After
> > the insurer pays, customers can pay $50 to DynaVox to reactivate the full
> > functions.
> >
> > The proprietary devices have some special qualities. They are sturdier than
> > typical computers and have better speakers and links to support services.
> >
> > But the prices may seem hard to justify based on components alone. One
> > $5,000 DynaVox product is essentially the speech software bundled with a
> > two-pound keyboard that has a six-inch screen. And the manufacturers mark up
> > standard accessories by as much as 2,000 percent. Prentke Romich, for
> > example, charges $250 for a Bluetooth wireless adapter similar to those that
> > cost $20 in stores.
> >
> > Jim Shea, vice president for marketing at DynaVox, says his company¹s prices
> > run high because it must do a lot of custom work and research to serve a
> > niche that mainstream companies ignore. ³We are not riding the wave of
> > consumer electronics in terms of cost,² he said. ³We¹re building the devices
> > here in Pittsburgh from scratch.²
> >
> > In addition, the do-it-yourself approach isn¹t for everybody, he said. ³You
> > have to be somewhat savvy, get the software and set it up,² he said.
> >
> > Disease experts say companies like DynaVox and Prentke Romich make many
> > sophisticated, helpful products. Still, advocates argue, advances in
> > computing and easy-to use speech software have opened doors to use cheap
> > mainstream alternatives. Indeed, the price drops have made it possible for
> > A.L.S. assistance groups to buy dozens of netbooks, install specialized
> > software like Proloquo2Go and lend them to clients.
> >
> > Betsy Caporale, a speech language pathologist in Danville, Calif., has
> > tested various devices and software with children who have Down syndrome and
> > autism.
> >
> > ³The iPhone has been a runaway success with these kids,² she said. ³It takes
> > them about 10 minutes to learn how to use the iPhone, and there is this cool
> > factor for them.²
> >
> > Ms. Lynn, from Poughkeepsie, would like to see insurers loosen their rules
> > to accommodate general-purpose devices and give people like her more
> > financial flexibility. Since insurers will typically cover only one device
> > every five years, people with degenerative conditions like A.L.S. often hold
> > off any claims until their condition worsens, and they really need an
> > expensive specialty product that can track their eye and head movements.
> >
> > Perhaps the government could set a certain dollar limit and then let
> > patients find the products that fit their needs, Ms. Lynn suggested. ³I
> > really would like to see Medicare do away with the dedicated-device rule and
> > the one-device limit,² she said by e-mail.
> >
> > But so far, government and private insurers are not swayed. ³We look at
> > determining the effectiveness of the technology < and not the cost < first,²
> > Mr. Harris said.
> >
> > For Ms. Lynn, the iPhone, with the special software, is cheaper, more
> > effective and essential. ³Technology has become as important to me as air,
> > food, water,² she wrote.
> >
> > ------ End of Forwarded Message
> >
> >
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-- 
Your life is like a penny.  You're going to lose it.  The question is:
How do
you spend it?

         John Covici
         covici@ccs.covici.com