What Health Insurers Should Know About Assistive Technology

Speech by Gordon Richmond addressing the Developmental Disabilities Commission Forum, Washington, D.C., May 1991.

This article is reprinted from the A.T. Quarterly, Volume 2, Number 6 (1991).

In today's world, technology has a great impact on our society. It improves our public safety by helping us run our airports and streets more effectively. It improves our work force by making our offices more productive and provides more opportunities for leisure time.

For people with disabilities, technology has opened many doors that were once closed. Let me share with you how I use technology in a typical day.

Each morning I get into an electric wheelchair and go outside to catch a bus. I am picked up by a bus equipped with a lift that enables me and my wheelchair to board and be transported to work. Once at work, the electric wheelchair allows me to move freely without assistance to my office. When I arrive at my office door, I enter a combination code on a number panel mounted on the wall outside my office door. After the door automatically opens, I enter and begin my workday at a computer. I am responsible for budgets, making salary recommendations and doing medical searches on Medline. I have held my job for two and one-half years.

While I am working, a keyguard placed on my computer keyboard helps to prevent me from hitting the wrong keys. When I look up something such as a figure or an index, I turn pages in a large notebook. Upon completion of my daily work, I send reports to a printer. At the end of the workday, I push a button mounted above my computer, my office door opens, and I depart.

When I arrive home, I use a combination lock which has been installed on the front door of my condo. This lock automatically opens the front door so I can enter. When I touch a lamp it comes on so I can see where I am going.

I know that you must be asking yourself about the expenses of helping someone physically challenged to become independent and lead a normal productive life. Let us do a cost benefit analysis of this from a different perspective.

First, let us look at the monetary aspect of doing this.

My electric wheelchair cost:  $8,000
My touch talker cost:         $4,000
Office modifications:         $3,000
Home modifications:           $1,500
TOTAL:                        $16,500

Because I am single with no dependents, last year I paid federal and state income taxes totalling $1,600. I am 32 years old and will work about 33 more years, continually paying income tax on a salary that should rise throughout the years. Last year I paid five personal care attendants a total of $3,200. I will need these personal care attendants for the rest of my life. With numbers like these, I ought to be an honorary member of the Birmingham Chamber of Commerce. My taxes and expenses for the next 33 years will total $158,000.

If society did not make the $16,500 investment in my independence as outlined above, I could be in a nursing home. In 1983, the Health Care Financing Administration reported that the average cost of one day in an Alabama nursing home, with a high level of care, was $96.00. It would cost society $1,156,320 to house me in a nursing home for 33 years. This is in 1983 dollars and does not reflect any inflation during the 33 year period. If you look at it like this, I am sure that you would want to make a $16,500 investment and have it return $158,400 rather than to make no investment and have it cost $1,156,320.

Let us look at the sacrifices a family makes when they have a member with a disability living at home. Parents remain in constant fear of the child's welfare. Burdens are placed upon siblings in the event of a catastrophe happening to one or both parents. Family members wonder whether or not they will be their brother's or sister's caregiver, and if so, when will they have to make provisions to care for that person. Expenses are drastically reduced for the essentials of daily living as they await the moment.

But if we invest in someone's independence, fears are greatly reduced. As the family member with a disability becomes more and more independent, the emotional and financial burdens lessen and other family members become free to lead normal lives. I have personally witnessed this as I gained further independence upon the purchase of my condominium two months ago.

Let us also look at the individual aspect of gaining independence. If a person lives at home, he will lead a sheltered life never reaching his or her maximum potential. The emotional cost cannot be measured when a person's dreams of independent living are not fulfilled.

When a person with a disability gains his independence, his human spirit can be unleashed as he tries things he never thought of doing before. He realizes that, God willing, with the assistance of technology, he has unlimited potential to do anything he wants. Contributions to society are an inevitable result.

Is society willing to spend more money on technology to help people achieve independence? I think that the answer should be yes. If you believe as I do, then let's begin to persuade Medicare, Medicaid, and insurance companies to invest in appropriate technological devices for their clients. It is through technology that the dis-spirited gain hope, that the silent can advocate for themselves, and the dependent can become productive citizens of our great nation.

The A.T. Quarterly was a newsletter developed by the RESNA TA Project under a contract with the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (ED). The content, however, does not necessarily reflect the position or policy of NIDRR/ED and no official endorsement of the material should be inferred.

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