competitive bidding--questions for yourself
Donnie Priest
Description
Collection
Title:
competitive bidding--questions for yourself
Creator:
Donnie Priest
Date:
9/23/2002
Text:
Competitive Bidding
After reading many ideas and discussions on competitive bidding, I have been
persuaded enough to take the time from my extremely busy schedule in order
to enlighten people to my beliefs and hopefully change some opinions; at
minimum, I hope to cause people to think. However, this concept is complex,
so it will take some time to not only read my words, but also understand the
meaning behind them.
Definition and understanding:
Competitive bidding is the concept regarding Medicare only. Medicare is
the federal government�s mandatory insurance for all working people with
very few exceptions. Social security taxes are paid by both employers and
employees that are automatically deducted from paychecks. The federal
government�s insurance company is questioning why they do not have the
lowest price for services considering that providers have entered into
contracts with other insurance companies for lower prices. In the Medicare
billing schedule, the price of a prosthetic or orthotic has the office
visits, practitioner provided physical therapy and gait training,
psychological consultations, repairs, and necessary revisions included in
the price.
The real question is what is a fair price for each service preformed. A
secondary question is whether a person or the insurance company has the
choice of where to seek services. The tertiary question is whether the
services provided to different patients are equal or different considering
different payment schedules.
What it is not:
Competitive bidding is not whether a practitioner or company makes enough
money. It also is not how expensive parts are. It is not whether ABC or
BOC is better. It is not whether small companies need more help than big
companies. It is not whether small companies are better than big companies.
While these are all valid concerns and other issues in our field, they
should have a bearing on this issue. Many of these issues are mainly due to
economics and the fact that the prosthetist or orthotist is likely a small
unconnected individual trying to survive between two oligopolies (suppliers
and insurance companies) where the oligopolies have the majority of the
power because the people in the middle are not unified.
Some issues involved:
The first and most important issues that every person related to the field
should be aware of is that we are talking about a person, happiness, and
lifestyle. One does not talk about a prosthesis or orthotic by itself; the
discussion is what is done with that piece once it is attached and
incorporated into a person. Yes, it does become part of the person and his
or her self-image. Does a person who has had no choice in the purchasing of
health insurance and retirement benefits have a choice in who provides
necessary medical services? (I cannot answer this for you, you must decide
for yourself).
The second aspect is whether the services incorporated into different
contracts are equal, even though the prices of the contracts differ. Is a
provider willing to do more for someone paying more? Is a provider willing
to state this and have the ability to back it up? Realize that answering
this question may cause potential litigation from those receiving fewer
services for the same product. Explaining this to the person mentioned in
the first idea is likely harder than explaining it to an insurance company.
The third aspect is the price of services. It is moot that social security
and Medicare will be bankrupt by the time I am entitled to collect. The
real question is where does the responsibility for the difference lie and
who should sacrifice for the discrepancy. Is it that those deciding did not
collect enough or invest those funds collected wisely, or is it that the
person receiving those benefits is using too much or abusing the system? It
could also be that the vendors are charging too much, but realize that it is
the same insurance company that is paying that has determined the prices.
How much have the prices increased for the same product over the past 5, 10,
or 20 years? How does this compare to the price of inflation and cost
associated with doing business?
A fourth aspect is what drives the field to maintain quality products and
services. Is it consumer driven and based upon the patients, doctors,
physical therapists, and other referral sources and repeat customers? Is it
based solely upon price and contracting with insurance companies without
regard for the patient? Is it based upon the distributors and suppliers
providing research and development? Is it based upon technology used in
other fields and then incorporated? Is it based upon practitioners noticing
something and their desire to change and improve someone else�s life? Or,
is it a combination of all of these factors with some factors being more
important than others?
The implications and future:
For those people producing a high quality product please remember that
those with money will always have money and likely will be willing to
purchase items that improves their life with their own funds, even if
insurance will not cover it. Medicare is only one insurance company, and
there are others out there. Choose whether or not you want to think and try
and influence others about your own personal choice.
I will leave this with a hypothetical question to ponder. Should the
demand for lower prices become great enough, lots of changes may occur. How
would one feel if the government established a prosthetic and orthotic
school and taught those whose heart�s desires were not in the field (such as
welfare-to-work, prison inmates for central fab instead of license plates,
and other unemployed persons). How would one feel if all of the Medicare
patients were and could only be serviced by a government owned hospital
system? If the salaries are supplemented by outside forces, can a private
company really compete? What do you think will happen to the person wearing
the prosthesis or orthotic device? Where is the oversight for quality and
the consumer? Is there a balance? Can the services incorporated into the
price of a prosthesis be maintained or will those be the first to be
eliminated? What safeguards are in place?
What is the best choice? Are we talking about a product, a service, a
dollar, or a person and rebuilding happiness? You be the choice and think
for yourself. Once this is done, try and influence someone else as to your
beliefs and check to see if your reasoning is valid or if it contains
fallacies. Keep an open mind and be willing to listen to others
perspectives.
Sincerely,
Donnie Priest
I am myself. For those who do not know me, I am also a Prosthetic resident,
bilateral amputee, and most importantly, a person who can think for himself.
_________________________________________________________________
Send and receive Hotmail on your mobile device: <URL Redacted>
After reading many ideas and discussions on competitive bidding, I have been
persuaded enough to take the time from my extremely busy schedule in order
to enlighten people to my beliefs and hopefully change some opinions; at
minimum, I hope to cause people to think. However, this concept is complex,
so it will take some time to not only read my words, but also understand the
meaning behind them.
Definition and understanding:
Competitive bidding is the concept regarding Medicare only. Medicare is
the federal government�s mandatory insurance for all working people with
very few exceptions. Social security taxes are paid by both employers and
employees that are automatically deducted from paychecks. The federal
government�s insurance company is questioning why they do not have the
lowest price for services considering that providers have entered into
contracts with other insurance companies for lower prices. In the Medicare
billing schedule, the price of a prosthetic or orthotic has the office
visits, practitioner provided physical therapy and gait training,
psychological consultations, repairs, and necessary revisions included in
the price.
The real question is what is a fair price for each service preformed. A
secondary question is whether a person or the insurance company has the
choice of where to seek services. The tertiary question is whether the
services provided to different patients are equal or different considering
different payment schedules.
What it is not:
Competitive bidding is not whether a practitioner or company makes enough
money. It also is not how expensive parts are. It is not whether ABC or
BOC is better. It is not whether small companies need more help than big
companies. It is not whether small companies are better than big companies.
While these are all valid concerns and other issues in our field, they
should have a bearing on this issue. Many of these issues are mainly due to
economics and the fact that the prosthetist or orthotist is likely a small
unconnected individual trying to survive between two oligopolies (suppliers
and insurance companies) where the oligopolies have the majority of the
power because the people in the middle are not unified.
Some issues involved:
The first and most important issues that every person related to the field
should be aware of is that we are talking about a person, happiness, and
lifestyle. One does not talk about a prosthesis or orthotic by itself; the
discussion is what is done with that piece once it is attached and
incorporated into a person. Yes, it does become part of the person and his
or her self-image. Does a person who has had no choice in the purchasing of
health insurance and retirement benefits have a choice in who provides
necessary medical services? (I cannot answer this for you, you must decide
for yourself).
The second aspect is whether the services incorporated into different
contracts are equal, even though the prices of the contracts differ. Is a
provider willing to do more for someone paying more? Is a provider willing
to state this and have the ability to back it up? Realize that answering
this question may cause potential litigation from those receiving fewer
services for the same product. Explaining this to the person mentioned in
the first idea is likely harder than explaining it to an insurance company.
The third aspect is the price of services. It is moot that social security
and Medicare will be bankrupt by the time I am entitled to collect. The
real question is where does the responsibility for the difference lie and
who should sacrifice for the discrepancy. Is it that those deciding did not
collect enough or invest those funds collected wisely, or is it that the
person receiving those benefits is using too much or abusing the system? It
could also be that the vendors are charging too much, but realize that it is
the same insurance company that is paying that has determined the prices.
How much have the prices increased for the same product over the past 5, 10,
or 20 years? How does this compare to the price of inflation and cost
associated with doing business?
A fourth aspect is what drives the field to maintain quality products and
services. Is it consumer driven and based upon the patients, doctors,
physical therapists, and other referral sources and repeat customers? Is it
based solely upon price and contracting with insurance companies without
regard for the patient? Is it based upon the distributors and suppliers
providing research and development? Is it based upon technology used in
other fields and then incorporated? Is it based upon practitioners noticing
something and their desire to change and improve someone else�s life? Or,
is it a combination of all of these factors with some factors being more
important than others?
The implications and future:
For those people producing a high quality product please remember that
those with money will always have money and likely will be willing to
purchase items that improves their life with their own funds, even if
insurance will not cover it. Medicare is only one insurance company, and
there are others out there. Choose whether or not you want to think and try
and influence others about your own personal choice.
I will leave this with a hypothetical question to ponder. Should the
demand for lower prices become great enough, lots of changes may occur. How
would one feel if the government established a prosthetic and orthotic
school and taught those whose heart�s desires were not in the field (such as
welfare-to-work, prison inmates for central fab instead of license plates,
and other unemployed persons). How would one feel if all of the Medicare
patients were and could only be serviced by a government owned hospital
system? If the salaries are supplemented by outside forces, can a private
company really compete? What do you think will happen to the person wearing
the prosthesis or orthotic device? Where is the oversight for quality and
the consumer? Is there a balance? Can the services incorporated into the
price of a prosthesis be maintained or will those be the first to be
eliminated? What safeguards are in place?
What is the best choice? Are we talking about a product, a service, a
dollar, or a person and rebuilding happiness? You be the choice and think
for yourself. Once this is done, try and influence someone else as to your
beliefs and check to see if your reasoning is valid or if it contains
fallacies. Keep an open mind and be willing to listen to others
perspectives.
Sincerely,
Donnie Priest
I am myself. For those who do not know me, I am also a Prosthetic resident,
bilateral amputee, and most importantly, a person who can think for himself.
_________________________________________________________________
Send and receive Hotmail on your mobile device: <URL Redacted>
Citation
Donnie Priest, “competitive bidding--questions for yourself,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/219586.
