Ak lifetime costs #2

Ak lifetime costs #2

Aryeh

2/12/2001

We have been asked a number of times to provide a future care cost from
our facility in Toroto Canada. Our Ontario O+P association has also
given some pointer or outlines for doing these things. I think that you
will be doing the client a disservice if you make the assumtion that
tecknology will remain static. We always allow for advances in
prothetics as a closing line to indicate that the sum of money required
is in fact very difficult to pin down....also we have a government
program for funding that we always state may not be around in the future
if this is an applicible situation for you. Our government program
allows for a complete device to be replaced every three years and a
socket replacement every 1.5 years. so we go with that as a standard,
then add the specialty devices for swiming and sports if applicable(18
year old definitly) and 10% per year repair costs + consumables (socks
+/or liners creams and stuff) and you've got a good guess at costs
involved -- good luck


check <URL Redacted>


Hi Aryeh,
I am sure you will get an avalanche of e-mail regarding this, but for my
two-cents...


For a guy that age I would say that he will get a socket replacement at
least once a year for the first three or four years, and then once every
2-3 years from then on. If he uses a Gel liner/ Silicon liner then you
are looking at 3-4 per yer while he is young and active.
The big thing will be componentry...The next generation of knee joints
are just coming onto the market. (Computer controlled hydraulics) These
will be undergoing a great deal of development and will be the best
knees available. They will also be very
expensive, with a lifespan of maybe 7 years. (Otto Bock have lead the
field in this, and they offer a 5 year warranty...I work for the company.)


Best of Luck with the lawyers.


Consider a C-Leg, FlexFoot, and the additional cost for clothing due to
the wear from the prosthesis. You should also allow for replacement of
sockets, outer covers, and knee unit maintenance. As he gets older the
odds are he will increase in weight, even if he tries to stay trim, so
you will need to replace sockets and frames even though they are not worn
out. I would use a replacement cost of the prosthesis, add a ten percent
yearly inflation
increase, and then figure you will replace the limb every three years
until he reaches 40, then figure every five years. To this you add the
projected
cost of maintenance and consumable. Its all a guess, I have never seen a
scientific analysis of this problem. If someone has done it I am sure
the list would love to see it.


i am a amputee who has been a a/k now for 40+ yrs and i make my own limbs
in my garage now because of so many problems with fittings. i was very
active and required a good fit to remain active. i probably averaged
approx 1 prosthesis a year. i now maintain a winter and summer socket
size because of my activity level from the two seasons which change my
weight approx 10 pounds. this results in having to make less limbs since
i just change the
sockets and use the rest of the existing prosthesis.


Feel free to contact me. I do a fair amount of consulting and life care
planning.


i have to do something similar for a patient / client of mine for a law
suite - i was told that there may be a study done but can't find it -
please forward any useful information you receive to me thanks in advance


Boy, I'd try to stay clear of this whole issue. I always respond that I
may be trained as a prosthetist, but I am not trained as a actuary and I
cannot provide this information.


By way of illustration, I know an amputee who lost his leg below the knee
in a sawmill back in 1970. The insurance reasoned as follows: you will
need a new leg every 5 years, and we will allow 25% of the cost of a leg
for repairs during that 5 year period. You are 30, and ought to live to
age 75, so you will need 9 limbs.


A prosthesis cost $550 then. $550 X 9 = $4,950. An additional 25% of
that amount for repairs adds $1235.50. The total settlement of this part
of his claim was settled for $6,187.50, and they wrote him a check for
it, and he bought a Chevy pickup truck with the money. Even if he had
invested it, he would have run out of funds long since! This wasn't a
very smart negotiation, for sure, but even if they had offered a
prosthesis every 3 years and figured in the inflation at the 1970 rate of
3% per year, the settlement would have been woefully inadequate.


I don't even respond to the question How long should a prosthesis last.
I don't know this person's future! I could speculate on a reasonable
average - I bet you can too - but why should I be the one responsible for
this figure? Let the insurance company do their own job, and let the
patient be dissatisfied with THEM if their decision is wrong.


There is a newly-formed professional group who claims to do just this
sort of work. I've forgotten the name they use, but they are trained to
do just this, and I know that I am not. Let the insurance company employ
just such a professional rather than let you do the job for free.


I think the sentence that really lit up my eyes was that of assuming the
technology will remain static. Look at the last decade and all the
changes there. Look at Bock's new C-leg. Technology will NOT remain
static and with these improvements will be extreme cost- the C-Leg is
what? $40,000 for that component alone?. This 18 year old would be
extremely foolish to settle. And if you are estimating a cost based on
today's technology, you are doing this 18 year old a disservice. This is
not an easy task and I would personally decline because there is no way
to determine costs or technology 20 years from now. My advice would be
to estimate extremely high and explain these facts. Enclose literature
about the C-leg, for example, and mention that cost.


You might want to contact Rick Riley C.P at Hanger Orthopedics in Reno,
NV... Rick has given seminars in exactly what you are interested in. I
don't have the phone Number but it should not be hard to find.


End of replies