Wednesday December 19, 2012

There was a time, many years ago, when hospitals actually offered used equipment to patients. That would never happen today for a variety of reasons, not the least of which is liability for something going wrong with the equipment.

Imagine if insurance companies designated a person to be an equipment recycler. It could be someone with mechanical skills who could inspect the equipment and decide if it was worthy of reuse. It would save all of us a ton of money.

Consider the fact that, according to the Organization for Economic Cooperation and Development, in 2009, 239,000 total hip and knee replacements were done in the U.S. It is safe to assume that each one of those patients used at least one piece of medical equipment, say a walker or a shower seat, at a cost of at least $100.

I suspect that very few of those 239,000 people paid for their own equipment, so at $100 each we are looking at almost $24 million spent by insurance companies on medical equipment. That is an extremely conservative figure.

That figure is calculated based on the use of one piece of medical equipment, a walker. Most people who use a walker after joint replacement surgery don't exactly wear out the equipment. In most cases, when they are finished with it, it still looks new and is pretty much mechanically perfect, yet it is very difficult to recycle this kind of equipment.

Multiply the $24 million figure by four (perhaps more realistic in terms of actual equipment use) and we are now talking about $96 million. It is a number that will only become larger each year.

Why can't we find the will to take common sense measures and realize that by recycling medical equipment we can save the health care system enough money to solve a lot of serious problems? Americans are sensible people. They like to save money when they can. Why not offer a health insurance discount to people who are willing to use recycled medical equipment? It would not be that complicated for an insurance company to work in collaboration with health care providers and facilities to set up recycling programs.

It would be interesting to see how much money the Medicare and Medicaid programs could save by instituting a recycling program. Perhaps all of the acrimonious haggling over budgets would be less of an issue if politicians could offer programs that could easily save millions of dollars in health care costs.

We can't wait for the big boys to do the right thing and that is why, at least in these parts, we have taken matters into our own hands. A number of local cares groups have decided to create their own medical equipment recycling programs and they are very successful. I haven't been keeping numbers but I suspect that, over the years, these programs have saved insurers many hundreds of thousands of dollars.

I run one of these programs through Guilford Cares. My barn has evolved from a place where goats and a horse used to live to a storage space for used medical equipment. Once the word got out that I was accepting used medical equipment people started donating and they have never stopped.

My barn looks like a Vermont version of Lourdes with hanging quad canes, rows of crutches and walkers, piles of adult diapers, wheelchairs and a large variety of all kinds of large and small pieces of medical equipment including a power scooter and a brand new electric Hoyer lift.

Business is brisk. Since most therapists and institutions know about Guilford Cares equipment, a week does not go by in which I don?t get at least a few requests for equipment. Whenever I talk to people who are either donating or borrowing equipment the conversation usually drifts to the subject of what a disgrace it is that more people don't use recycled medical equipment.

We are doing our part here in this little corner of Vermont to keep medical costs down. Maybe we need to spread the word about how easy it is to create a medical equipment loan program.

Who knows, perhaps someday we will find a way to recycle unused prescription drugs. Then we can save some real money.

Richard Davis is a registered nurse and executive director of Vermont Citizens Campaign for Health. He writes from Guilford and welcomes comments at rbdav@comcast.net.