Medicare Rule Doesn't Have a Leg to Stand On

If your notion of the current status of people with disabilities in our culture is that all of that discrimination jazz -- not to mention just plain stupidity -- can be summarized as foolish facts o

Jun 15, 2005 at 2:06 pm

If your notion of the current status of people with disabilities in our culture is that all of that discrimination jazz — not to mention just plain stupidity — can be summarized as foolish facts of the distant past, think again.

Yes, it's true that a few thousand years ago babies born with visible disabilities were left on the hillside to die or be devoured by beasts. Yes, it's true that people with mental or physical disabilities were, until not so very long ago, held captive in institutions — once called asylums — for little reason beyond that they couldn't do anything to stop it. Yes, some of the adults you now know and love or work with or see at the local pub who grew up with disabilities as recently as 30 years ago might well have been told to stay home, as there was no place (or access) for their kind in the neighborhood middle school.

Some historic atrocities are far more gruesome than any of these few outlined here. But the point is, just when you think we're pretty much moving forward along the road of tolerance and common sense, a bit of incredible stupidity dribbles out of Washington.

Here's the deal: Millions of Americans who are elderly and/or have disabilities depend on Medicare coverage to pay for supplies and equipment. Among such equipment, obviously, would be mobility devices such as wheelchairs and scooters.

Let's say that your disability is such that you can push yourself up off the sofa and walk to the kitchen by supporting yourself on a chair here, leaning against a wall there and going at a slow and measured pace. Maybe you're tired from the journey by the time you reach the refrigerator, but it seems worth the effort.

A little walking is better than no walking, so you cling to the limited independent movement.

But for longer jaunts, to go out to dinner or shopping or to church or to your nephew's high school performance of Hamlet — walking, in other words, for more than 20 or 30 steps at a time — walking in the typical way is out of the question. No problem. The marketplace is bursting with an array of versatile user-friendly wheelchairs.

But Medicare's "in the home" restriction says that's too bad. You're out of luck. Wheelchairs are only to be covered if needed in the home environment.

If it weren't so scary, this kind of thinking would just be fodder for gusty guffaws. But apparently some people actually view this as humane and rational. Of course. We get it. If you have a disability, you should just stay home. You should be confined to your own exciting personal space.

If you can't walk on your own two feet to get somewhere, one might interpret the Medicare guideline, well, maybe you just don't deserve to get out. Or does the idea stem from the belief that less-than-perfect people shouldn't be mingling in the public arena?

The good news is that two clear-thinking congressmen, Jim Langevin (D-R.I.) and Charlie Bass (R-N.H.), have been circulating a "Dear Colleague" letter among their peers in an attempt to redirect this particular absurdity. The plan is that the letter will be submitted to Health and Human Services Secretary Michael Leavitt next week, and the possibly not-so-good news is that thus far there are only 39 signatures. Two of those, happily, are the signatures of Ohio Congressmen Ted Strickland (D-Marietta) and Sherrod Brown (D-Akron).

Since Langevin is himself a wheelchair user for all mobility throughout the Capitol and elsewhere, I'm hoping that his colleagues in the House of Representatives don't have to scratch their heads for long to understand how a person who is paraplegic or quadriplegic might have a life beyond the four walls of home. Many members will sign because they have a personal experience with someone with a disability or simply the capacity to imagine "walking" around in another's skin, so to speak.

What's more than a little troubling is the direction this kind of modification represents. If it's OK not to support the purchase of a wheelchair for someone who can't get out of the house without it, then maybe it's really OK that 70 percent of people with disabilities are unemployed and a growing number uninsured. Maybe it's OK not to provide an adequate education for a kid with a disability or to worry about whether an adult with a disability can get into your restaurant.

As far as we've come in the last few decades, maybe such musings seem preposterous. But as funding is diminished and removed from one human service after another and services altered or eliminated and as judicial vacancies are filled by people with known track records for lamenting the nuisance of disability rights — well, paying attention might be smarter than not.

To learn more about the Langevin-Bass "In the Home Restriction" letter or to encourage more members of the House of Representatives to support it, visit

contact Deborah Kendrick: [email protected]