BED ISSUE
 
 SUMMARY
 
Though by law, durable goods, such as a bed, are to be provided by an HMO upon release of a patient to home care, why would the HMO provide more expensive beds designed for certain types of patients?  Since, some beds cost as much as $125,000, it would seem unlikely that an HMO would freely offer such a bed, if a cheaper bed can be used.  As of today, almost four years later, Buc still does not have the right bed!
HISTORY

When she was released to come home by Maxicare, by law, they were to provide durable goods, inclusive of a bed.  What kind of bed did they come up with?  The cheapest!  The kind used for short term stays.  The kind which has portable applications.  A bed, which appears W.W.II vintage for recovering soldiers.  Not a bed for a long-term, paralyzed patient.

If I were to put a price on this bed, consisting of L-beams, castors and three fractional horsepower electric motors, plastic strips and a masonite headboard, I'd say it could be manufactured in quantity for $500.

Now every bed Buc was in, while staying at her respective hospitals, were far more sophisticated.  Her bed repair technician at UCLA, told me some beds cost over $100,000!

Different patients need different types of beds, particularly burn patients.  There are sand beds, which continually move sand under the patient to prevent pressure points.  There are beds which gently move the patient from side to side, air beds, and beds which can tilt in many different ways.  Buc's doesn't do any of these things, except sag in the middle.

Though I have repeatedly objected, because her bed is described by her provider, Apria Home Health, as fully automatic (yes, it has no hand cranks), the government overseers, see no wrong.  Which brings us to another issue:  the credibility of an individual citizen relative to the preponderance of official, collective and professional challenge.

I say the bed is no good.   They say it is fully automatic.  I say it is hardly fully automatic in comparison to the functions available.  But they believe it is fully automatic, even though its functions are limited.  The paper work says this.  No physician claims otherwise.  The Provider is satisfied.  The carrier is satisfied.  Government agencies overseeing the matter can only provide limited time in the resolution of issues.  All problems are seen as issues.  The Provider accidentally bills me for the bed, a whopping $8564, knowing I will complain to the DOC.  The DOC sees this price tag.  They are then given the opportunity to know the "true" monetary bed value.  Buc's overseeing physician, Dr. Bazoske (Faculty GP in-charge) @ Les Kelley Family Health Center 319-4700, explains to me that they can't order a better bed through MEDICAL, because beds are strictly for comfort;  presumably deceit designed to prevent the extensive issuance of a TAR request, because in truth, beds do have a medical purpose.

I say the bed is no good.  I can't change the illusion; even if it were a fully automatic straw bed, I can't change the illusion.  I can't force the Provider to provide a better bed.  I can't make the carrier insist on a better bed.   I can't really convince anyone the bed is hardly worth $9,000;  they've got the paperwork showing otherwise, and probably inflated bills to match.  I can't convince the government there is a problem, because they've classified it as an issue, and treat it as an issue, an issue being a difference of position.  Even though I might see the bed as a dangerous problem, it will always remain to them only an issue:  an issue between the individual and the collective.  I say the bed is no good;  that it is medically no good.  Who will believe me,  after all, Buc's physician says it is not a medical concern?

Take a good look at these pictures.  Check the bamboo IV stand I rigged up because the providers were unable to give us one.  Look at the bed itself.  Compared to simple institutional gurneys, its design and construction is completely out of the mainstream of acceptability.  It is of crude construction and design.

Check the underside.  No doubt that spring under frame cost a pretty penny to manufacture, and its natural sagging beneficial to the patient;  especially when it comes to moving feces through the alimentary track.

The electric motors driving the multi-functions, are a phenom.  They are very modern and able to go in reverse.  The three motors must of cost a fortune!

I've worked up this chart, itemizing the bed's construction cost:
 

 
BED CONSTRUCTION COST
ITEM
COST
RAILS
125
HEAD BOARD ASSEMBLY
325
FOOT BOARD ASSEMBLY
325
WIRE FRAME
85
MOTOR ONE AND ASSEMBLY FOR RAISING TORSO
250
MOTOR ONE AND ASSEMBLY FOR RAISING TORSO
250
MOTOR ONE AND ASSEMBLY FOR RAISING TORSO
250
TOTAL
1,610
RETAIL
$9,000
 

In time, I begin to recognize, that the individual has little credibility relative to the preponderance of official, collective and professional challenge.  But I did not know that when I wrote my first letter to Warren Foon, Vice President and General Manager of Maxicare of California, Incorporated, regarding the bed.
 
 
 
 
 
 

 
 
 
 
 
 
 
 

From this date to Spring of 1999, Mr. Foon never responded to any of my letters.  In the Spring of 1999, CareAmerica took over Buc's plan.  Though they seemed to show greater concern, very little changed, the "bed" issue, again being raised with a letter to Ms. Monica Sattler at Blue Shield.

On February 15, 1999, in response to their questionnaire, the bed problem was brought to the attention of the Commercial Correspondence Manager at CareAmerica Health Plans:

At this point in time, Blue Shield was interested in the business acquisition of CareAmerica, inclusive of my wife's plan, so some disingenuous concern was beginning to surface as the following phone record indicates:

 

A week later, I received a letter from Carla Spiller, Consumer Services Representative, DOC Health Plan Division, stipulating that I had move a bit more quickly in regard to some of the problems they wanted to resolve, which was not expedited by their confusion of RFAs.

Within days, I received a letter of "sincere apologies".  I felt that this letter from Debbie Fermanian, Supervisor, Grievance Resolution Department of Blue Shield of California was not written to me because of real concern for Buc, but because they were being prodded by the DOC:

In the meantime, during all of this, the DOC again sends medical waivers to me which I am reluctant to sign as explained in the following reply to Ms. Rideau-Cruz, who issued them.

Nothing has happened though, and so the DOC, with this letter from Melissa Moon, Corporations Counsel, with copies going to Maxicare and Francine Woods, Department of Corporations Ombudsperson, in May, reaffirms the bed problem:

 

No bed arrives and almost another month goes by, when I receive a phone call from Ed Mungia about Buc's bed.  He seems really nervous and is obsequious.  The call comes out of nowhere and he doesn't seem to know why he is calling.  Mr. Mungia is with CareAmerica / Blue Shield.

 

A few days later, I receive this letter from CareAmerica / Blue Shield.  It is nothing more than a red herring.

The problem is the right bed, not how well the present bed works.  Ms. Fermanian letter, fueled with Mr. Mungia ineptitude and RFA smokescreens set up by the DOC, infuriate me, as disclosed by my following letter.  They are a calloused lot.  They could really care less about Buc's plight.
By now our elected officials should have known that something very wrong, very bad, was occurring.  But at the time, they did nothing.

Deftly sidestepping the real issue, the problem that a more expensive, very expensive bed was not provided, Blue Shield, quickly in succession tosses in another red herring -- the billing of the bed to the patient.  Against a tired husband and a very sick wife, those business people perform well:

Chafing at the bit and anxious to get this off her docket, the DOC's Ms. Moon conveniently forgets the real bed problem.  We have had several phone calls concerning the matter.  She has little medical knowledge and serves more as a legal consultant,  which gives you a pretty good idea of the DOC's true intentions.  This is one of her follow up letters about the bed.