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Original material is licensed under a Creative Commons License permitting non-commercial sharing with attribution.
09/15/09
09/15/09
User adoption is a big problem for devices like this, especially with kids who already have hangups about looking or feeling different. I would think that a child with a program like this might end up wanting to use it more simply because its on a device all the other kids are carrying and can be used for other things like music or videos. And from a Medicare cost standpoint, it's obviously cheap. Why should this be an administrative problem?
09/15/09
Ladies and Gents, I present to you a fleeting glimpse of your grandchildrens' future, in dollars, being spent this very second on inane acquisitions like this one.
09/15/09
I go to bat for my patients PERSONALLY each and every day I work, and I will spend 4 hours that I'm not going to get paid for to make sure one patient gets the care they need to save their life.
Will nObama do this for you? Will a lawyer do this for you (4 hours they KNOW they're not getting paid for???). Would a f***ing PLUMBER do this for you?
I would Rx this iphone app, AND the iphone, to most of my autistic kids. Not only the app is useful, but the iphone interface is uniquely suited to really augment their daily life in a really positive way and improve their overall QOL.
Why dontcha y'all vote for ME next time around??
09/15/09
09/15/09
Imagine if they started buying general purpose systems for everyone. They buy good, but inexpensive computers that don't have good support for the disability community.
You can't go to one provider for support - you have to go to Apple if the iPhone fails, the software maker if the software fails - if you can figure out which is which... and so on.
Then the Republicans and anti-government people jump in and start yelling 'entitlements' and how the government is giving poor people 'expensive toys' the rest of us can't afford and so on...
The someone's voicebox is found to have porn on it - and the yelling gets louder and louder...
Ironically, this article itself is kind of why things are the way they are. It's easy to look at something without any surrounding context and make it into a big moral point... but the very act of doing that creates the moral point one complains about.
09/15/09
09/15/09
09/15/09
09/15/09
The devices simply HAVE to be single purpose. They can't do anything else. A lower functioning individual with developmental disabilities has no use for the other features on the phone, and if there was a complicated process for accessing the TTS features, then it defeats the purpose if they don't know how to get to it.
Additionally, my sister was prone to throwing her TTS around when she was upset. See how long an iphone/touch lasts under those conditions. Miraculously, she only went through a couple of them, because they were sturdily built.
You just don't get it.
09/15/09
I think the reason this gets people charged, though, is not that "the iPhone can do it". Though, throwing the collective Apple lust into this argument is probably the worst way to handle it. The real issue, though, is that, as you said, $8000 *is* crazy.
DynaVox, the company that makes this stuff said in the NYTimes article that they charge so much (as much as a 2000 percent markup) because they essentially have to make the software from scratch. And that may be so. Niche software usually costs much more than popular software, admittedly. But if there is that big of a gap between competing products (and they are competing), and the hardware is much the same, one has to ask if there's a better way serve those who need it.
I don't know the solution, but in my experience, there's always a way to save money. This may be one place to look.
09/15/09
Also, the capabilities of touchboards haven't changed much over the years, even though the hardware and technology driving them has. My sister's first board was basically a digital recorder with a large grid of buttons. There's no reason that the vast majority of people using them need much more than this, and that technology is a lot cheaper now than it was 20 years ago. So I have the feeling that these companies upgrade the hardware to keep the costs up, and that's another contributing factor.
but really, most of these boards are "push the button, play a word/phrase"
How hard can it be? Why even bring the iphone into it?
09/15/09
Between the added cost of fraud and investigating said fraud, they *might* end up saving money by just going with the far more expensive option. I'm not saying it does, just that it sounds possible and so I wouldn't want to jump to conclusions.
I'm sure its better anyways, the iphone has an awful small screen and so a proper tablet-sized computer likely is a bit easier to use.
09/15/09
OK, Don't buy the hardware. Just cover the software. That's the part that turns the general-purpose metal into what the patient needs!
09/15/09
09/15/09
the current system is broken. and as much as i like the shiny utopian view of everyone getting equal and fantastic health care, a government health care system will keep doing dumb shit like this and waste my hard earned money. the government is too slow-moving to keep up with technology. medicine needs to be mostly privatized. unfortunately, that means a percentage of the population will get screwed.
life isn't perfect people. both options are far from optimal. if you want my two cents: universal health care is a bad idea.
09/15/09
The fact that you said you'd prefer Medicare spend $8000 because if they only spend $150, autistic kids might have fun.
Or the fact that you said that an $8050 computer is a "good deal, actually".
Or that the iPhone app is not okay because it allows alternative functionality, while the $8050 compy *is* ok for those same reasons.
09/15/09
1) the concern with medicare paying for non uni-function equipment as that there are assholes who will game the system, gaining no medical benefit while getting free products. it's bad enough my money went to bail out non-viable companies and subsidize car purchases (yet i didn't see any of either pot of money, as i work for a business that is run competently and managed to save up for years to buy my dream car on my own. sorry, had to vent a bit). now i'm supposed to buy a computer for everyone who wanders in trying to game the system by claiming to have ADD or something? sounds like bull$hit to me. it's easy to look at one case and say "oh look at the nice little boy, he should have a text-to-speech application and we should use an iPhone because it's cheaper", but there's too many assholes out there to just do that for everyone. make the item of use to only the people it's intended for, and you won't have people cheating the system.
2) in regard to the "good deal", remind me again how much the end user is paying for a fully functional computer? $50. sounds like a pretty good deal to me. i'll take your $50 computer too if you think that's too expensive.
3) the iPhone app is perfectly ok. doesn't do anything but help people communicate. THAT is what the government should be paying for. if you want the convenience of not having to carry around the $8000 pc that the government will supply to you, then you can at least pay the price of an iPod Touch.
09/15/09
If you start covering a multi-functional mobile device like an iPhone w/software for let's say, $300. Very soon the word will be out and the system will be overrun with prior approval claims for an iPhone. 95% of these claims will be denied because people who have no need for them will make claims. But out of that 5% of that get approved for the device, half or more probably didn't really need them. And because these devices are heavily used, they will need to be replaced every 3-5 years.
This is partially why they only approve large, expensive, uni-purpose machines. They last longer on average, and are only requested by people with a legitimate need for one. In the end, it will be less expensive for the program.
Not saying it's perfect by any means, but that's the idea behind these decisions.
09/15/09
09/15/09
09/15/09
Here's a concept, and since you worked for the government I'll use small words. People claiming to need these things who don't are making false claims. You penalize people who make false claims, charge them a couple grand. This will cover the cost of these "cheap" ipods that only last 3-5 years - not like these super $8000 pc's whose hard drives will probably last just as long and need to be replaced. Let's see - $200 (bulk discount - maybe even lower) ipod/iphone - that's 40 ipods. 40 ipods x 3 years is 120 years. So there you go. Any chance of that $8000 computer lasting 120 years? Anyway, your argument is absurd. Its logic falls flat on its face. Just because the government has a rotten system doesn't mean you have to go making excuses for it. Your rotten system is rotten with rotten rules.
09/15/09
Condescension(that means "showing or implying a usually patronizing descent from dignity or superiority") makes any point you might make moot(that means "invalid."). Besides, these "Super $8000 PC's" might not even have hard drives, since a ROM can last for decades and never wear out. The most likely thing to wear out on these devices are the speaker, the battery, and the keyboard.
09/15/09
09/15/09
Sorry, I needed a good rant.
09/15/09
09/15/09
09/15/09
Yeah, we wouldn't want health care for profit. That would be like a Capitalist society!!! Better we go the way of the Soviets... oh wait, they're gone. Yeah, brilliant idea.
09/15/09
09/16/09
09/16/09