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

["Robert Carnegie" <Robert.Carnegie@seemis.gov.uk>]

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 PCıs 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
> governmentıs 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 Mooreıs 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 Gehrigıs 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 industryıs 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. ³Weıre
> 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 insurerıs 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 companyıs 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. ³Weıre building the devices
> here in Pittsburgh from scratch.²
>
> In addition, the do-it-yourself approach isnıt 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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