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The iBOT wheelchair's larger issues The media has been waxing eloquent about the iBOT wheelchair that can climb stairs and allow a user to rise to a standing position. Its $29,000 cost is usually reported way down below the initial rah-rah opening paragraphs about how the thing works. The cost paragraph also never mentions the fact that most insurance policies will not be covering it. Especially not those that cover the predominately unemployed disability community -- Medicare and Medicaid. The shrinking coverage for durable medical equipment and the requirement that chair users pay an ever-higher portion of the cost is never included in the articles, either.
These pep-rally articles never get into the real truth of how Medicare handles "coverage" -- that there's the stated cost, then the "real" cost set by Medicare -- of which it will then only pay 80 percent. Medicare, if it deigned to cover the iBOT, could set the "real" cost of the iBOT at $15,000. Medicare would then pay 80 percent of that -- so even if Medicare DID cover the iBOT, this spiffy new technological wonder could still cost a wheelchair user $17,000. The "real" number Medicare picks will likely be much lower than the hypothetical number I've used. Most wheelchair users today have to fight to get insurance to pay for the new batteries, lifts and repairs we need after we get the power chairs already on the market. Insurance companies who already resist paying for $400 batteries once a year are not going to be lining up to pay $29,000 for a stairclimbing wheelchair. The user of the iBOT, we've learned, will have to be able to lean in various directions and have a weight limit -- nobody too heavy can use it. They'll also have to have good bladder and bowel control -- once folks know the iBOT's out there, there'll figure there's less need for accessible restrooms in public -- since the iBOT can go anywhere. Why have accessible restrooms on every floor? Why have elevators or ramps anymore? The expectation is that your wheelchair ought to be able to climb those stairs. Do you think the designers of bus lifts, and van lifts, are suddenly going to rush to work with the iBOT creators to standardize their products for the bigger and heavier chair? Yeah, right... Our community already has to deal with wheelchairs, lifts and ramps that cannot be used together because companies are not talking to each other. Think about the damage transportation providers already do to today's much cheaper wheelchairs. Do you think they'll smile and up the amount they'll pay for repairs and replacement simply because your iBOT now costs almost $30,000? Sure, and I have an inacessible, underwater bridge to sell you, too. The iBOT wheelchair seems to presage a return to individual solutions for community-wide access problems. It changes the focus of debate from the stairs themselves to a call for crips to overcome those stairs on their own, with iBOT's Marvel Comics technology. This turn of wheelchair events shows that society is quite willing to continue misnaming the problem -- as an individual medical one, instead of seeing access as the civil rights issue it is. And the blame for that can be laid at the inaccessible door of our Captains of Industry, who continue to shy away from laws that have never been fully tried and applied. Rus Cooper-Dowda is a minister and freelance writer in St. Petersburg, Fla. Posted Nov. 26, 2002
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