Editor's Note

Homecare’s Citizen Soldiers

Finding balance between surviving and reversing bad policies.

• By David Kopf
• May 01, 2010

So, I’m watching the recently debuted HBO mini-series “The Pacific,” and I have to admit that I am completely hooked. The program tells the story of young men who join the marines to fight the Pacific Ocean “island hopping” campaign during the Second World War, and, in a disturbing sense, it reminds me of the home medical equipment industry to no small degree.

In “The Pacific,” these young men are shipped in claustrophobic troop transports and forced to storm desolate coral rocks covered in jungle and enemies. There, they must strike a balance between trying to survive the wretched, malaria-plagued conditions of their camps, and terrifying battles with their enemies from the Empire of Japan. Their situation is both harrowing and pitiful.

Juggling Hand Grenades

But no, that nightmarish juggling act is not why the show reminds me of the HME industry. (I’m not that pessimistic.) That said, I do have to admit that providers are being forced to strike a balance between surviving bad public policy while fighting to have those policies reversed.

For example, oxygen providers have had to alter their businesses in order to survive the 36-month rental cap, while working to reform the oxygen benefi t so that the system for reimbursement recognizes the costs of the support services they provide their patients.

Similarly, in the wake of recently passed healthcare reform legislation, mobility providers now face the removal of the first-month purchase option and a forced 13-month rental period for standard power mobility; the expansion of Round Two of competitive bidding (which impacts standard power mobility); and an excise tax on manufacturers that will ostensibly impact the product options mobility providers will have to offer patients. Somehow they must survive this policy onslaught while working to repeal these policies. (Read more about how healthcare reform will impact mobility providers, and what they must do to reverse these policies, in this month's feature story, “A Rough Road Ahead.”)

However, like I said, that struggle to survive and fight isn’t the aspect of the show that reminds me of the HME industry. What reminds me is the fact that these are regular, ordinary folks being forced to resolve a monstrously difficult situation.

Doing the Right Thing

HME providers remind me of the concept of the “citizen solider,” an old ideal from the early days of our country re-popularized by late historian Stephen Ambrose. The notion is that the people who fight our nation’s battles aren’t some sort of special caste or class of people whose lives are devoted to warfare. Rather, they are regular people who put their lives on hold to do what they think is right — even if that means risking everything.

That, to me, is what the homecare industry is going through at this very moment. HME providers are regular business owners who are devoted to supporting for their patients, but must somehow fi ght to reverse public policies that undermine their best patient-care efforts.

They must work to more finely tune their business and operations performance (for example, read our feature on how providers can leverage software to benchmark their businesses) while engaging in efforts like lobbying to get lawmakers to co-sponsor legislation to stop competitive bidding. And those efforts are paying off. H.R. 3790, the House bill that aims to repeal competitive bidding, is now past 200 co-sponsors (click here to read more).

I find that sort of struggle as compelling and inspiring as it is frustrating. True, in a sane world, providers shouldn’t even have to deal with foolishness like requiring them to rent wheelchairs for 13 months to patients with lifelong conditions. But providers simply carry on and fight for their patients’ care. That deserves a medal.

This article originally appeared in the May 2010 issue of HME Business.