Personal Wheelchair Budgets

[aksel]

Has anyone in the US ordered parts with an HSA?

[MichaelB]

Other than PIP I am not "entitled" to any benefits, well I am entitled to apply but I won't get them so no choice but to try and work, not easy C3 complete and vented! Just done 3 months working from the bed and hopefully will be back doing some face to face work for a day at a trade show at the NEC next week. I'll not be happy if it causes another pressure sore!

You can't have an NHS which is based upon entitlement linked to contributions and be free of charge for all so there has to be budget limits. They are not magically going to become efficient and actually purchase and spend efficiently, simply too big and little understanding of how to do it so we are stuck with WCS under pressure from CCG's. The challenge is to change that across however many CCG's there are I'm not usually a defeatist but I can't see how it could be achieved in the current economic climate.

Getting PWB's up and going across England uniformly would be a start but doesn't solve the PWB/cost of a chair differential you would still need to find the difference. Fighting for a better chair is an option, I had a Spectra which after a fight was replaced with a Salsa. When that wasn't suitable during my independent assessment it was obvious that my expectations of what I needed were different to their ability to provide it limited by their purchasing methods.

We can all take on individual WCS but it won't change the culture of thinking that they are doing their job by providing a chair irrespective of it being suitable for that person's lifestyle. We are stuck having to fight our own battles.

Steve, if the Spectra doesn't fit your needs complain immediately and keep pushing, it might take time but you should be able to get a better option. Easy to say a lot harder to do!

[Burgerman]

You can't have an NHS which is based upon entitlement linked to contributions and be free of charge for all so there has to be budget limits. They are not magically going to become efficient and actually purchase and spend efficiently, simply too big and little understanding of how to do it so we are stuck with WCS under pressure from CCG's. The challenge is to change that across however many CCG's there are I'm not usually a defeatist but I can't see how it could be achieved in the current economic climate.

Privatise it.

[MichaelB]

Privatise it.

Yeah, let G4S take it on, we'd really come out of that well. Privatise how it is funded as well, reduce NI let everyone contribute to their own healthcare policy. Oh, forgot about those not paying NI, they'll just have to get by.

[steves1977uk]

Steve, if the Spectra doesn't fit your needs complain immediately and keep pushing, it might take time but you should be able to get a better option. Easy to say a lot harder to do!

Oh I will! I'm not a person that gives in easily!

Steve

[Burgerman]

Good. It shouldnt need to be this way but socialist medicine... The best way to waste other peoples cash ever invented.

Remember this.
Knowledge is power. And you already know WAY more about powerchairs than they do. And you obviously know way more about YOU and your clinical, holistic, and lifestyle requirements than they do. So you are in a much better position to assess yourself for a powerchair than they ever can be.

But do it in DETAIL and in writing. Dated, copied, saved, and posted by signed for mail to every related department, as well as handed to the assessor they send. Be sure to go through this with a fine tooth comb. E.g. Why do you need a lift? Because you need to help your carers to transfer you to different height seats, dressing benches, beds, or chairs. And to allow you to be seen and served in busy places, and because your hobby is photography, and you cant see anything in a crowd or because of walls etc. Go through EVERY feature one at a time. E.G. Why to you need a chair YOU can program? Etc etc... Every detail. Leave them nowhere to go.

Explain why 2 pole motors are useless to you. Why small batteries are false economy, dont last, restrict you because of range anxiety etc. Tell them you dont want to have your life restricted any more than you are forced to. Tell them they have to consider your holistic needs, for eg, how does it work on the steep ramps and broken pavements you have no choice but to travel on. So small wheels/casters useless. Etc etc. Write it all down. And be sure they GET IT.

If they say things like we dont supply anything faster than 4mph tell them that they should, since its dangerous outdoors in places where you have nop choice but to join the road, and if needed you will pay the difference to get the 4 pole motors. I had to do this. But only tell them this as a last resort, since I had them pay for mine, (they added the price of a jay back instead to cover the cost). And tell them that if they dont like it, then give you a budget instead since that is what they are SUPPOSED to be doing!

[Burgerman]

How the socialist NHS works. It pushes paper and responsibility, theres nobody with a clue in charge, and its not their money, and many disjointed departments. There is no joined up thinking.

EG ONE.
WCS massive fight to get a 6k cheque for a chair. Took 20 years of arguments and a new personal powerchair budget, and more letters and arguments than I can remember inc the department of health and a lot of stress. This is something I NEED to be able to have a life and fuction unless I spend my full life in bed. Most people are refused or supplied something thats is inadequate and limits their lives meaning more car for shopping and help needed and lower living standards.

EG TWO.
PHYSIOTHERAPY dept. Called for a new nylon sling for my patient lift, 35 uk pounds on ebay... They sent me a mass of OT's, physios, and assessed in a week, and measured me, TWICE, dont ask, and for reasons I dont know also tested my perfectly good patient lift that was used just once in 20 years and then decided to send me a new one... Its been sat in a heated garage on a carpet for 20 years and tested just in case yearly. It was perfectly adequate. 7 days later, I have a new 2k electric fancy electric lift that I told them very firmly that I neither wanted or needed and to spend the money on someone that was dying due to no cancer drugs or stuck on a trolly in a corridor because no beds.Regulations said they couldnt do that. Socialism. Responsibility pushing. ETc.

New 2k lift? It was too short, so hit my chair/bed. So I called to ask them to take it back as not needed and was no use. Amazingly they sent a 2nd bigger one. Another 2k. They didn't want the 1st one back... I tried hard. Not interested. Both of these will never likely be used, and I didnt want them in the first place. Now I have 3. Two of which have a 3 monthly checkup on a long term private service contract, and ones already got a failed battery. So I now have 6k worth of these lifts, 2 service contracts, non of which I wanted and I told them so. I recently gave the oldest one away since it was dusty. Still have 2. Wont probably ever use either. Now, I still have no sling, the very reason I called in the beginning... EBay. I dare not call them again I will just buy one. Or I will end up with yet more assessements end up with another unwanted 2k lift.

This is the contrast between just 2 different departments. 2 doors on the same corridoor!


SUMMARY.
2 departments. One throwing thousands of pounds at me for something I didnt want and wont use. The other refusing to fund a suitable powerchair without a massive ongoing 20 year fight, even where that is their SOLE job! And something I absolutely cannot manage without, and will be used day after day for my life. And refusing others that dont fight as hard even more.


This is why socialism always fails. Its why the NHS has no money. Its not that it doesent GET enough, it just has no clue how to organise or prioritise. Most of it is wasted on beurocracy and paperwork, the rest is used badly. Its not run like a business. Its run like a holiday camp where paper pushing, holidays, badges, qualifications, training courses, responsibility moving, and wages, meetings, and coffee takes priority. Not the patient, not efficient use of funds.

[MichaelB]

Undoubtedly inefficient but privatising isn't necessarily the answer. You will still need the bureaucracy of the NHS to compile the guidelines that any private company will have to comply with, you will need the budgets to pay a private company, probably requiring the CCG to decide on them, you'll need more bureaucracy to check that service standards are met and patients getting what the NHS are paying for. Think CQC.

Who would a private company employ, probably the same people doing the job now so no real change same mentality and mindset. To change that you probably don't want those staff and start with a clean sheet. Where will you find enough people with experience to assess need?

You then need to consider whether the profit a company would take is higher than the inefficiency costs. A private company would do exactly what WCS do getting the best deal with a preferred supplier so no improvement in choice, unless the bureaucrats setting it up change the policy so that a private company has to offer more choice of chairs, then it goes back to checking that they do, back to the CQC checking.

All you would achieve is a change in who delivers the service and they would only be doing it for profit, reducing some waste but that doesn't equate to better service for us.

Look at how PIP assessments were done, private companies trying to reduce people getting PIP and the government now having to redo all those assessments, highly efficient from privation it certainly isn't.

There is no easy solution `:(

[LROBBINS]

"privation" is the right choice of words, whether government or private, we face privation rather than privatization.

[Burgerman]

You will still need the bureaucracy of the NHS to compile the guidelines that any private company will have to comply with, you will need the budgets to pay a private company, probably requiring the CCG to decide on them, you'll need more bureaucracy to check that service standards are met and patients getting what the NHS are paying for. Think CQC.

You dont appear to understand what a private company is, does, means. I am not talking about farming out bits of the socialist NHS but a free capitalist health system. NO NHS! The difference between spacex, and nasa.

There would be no nhs england, and no ccg, and no panels, no nhs paying for anything.

In the same way that when you buy anything, say a lawnmower, the manufacturer isnt run by the government. Or when you employ carpet company to fit a carpet, the goverment dont run anything. YOU pay, and if you cant afford this, then you do so with insurance cover. Which you now CAN afford because the government wont be taxing the country, business, and individuals 116 BILLION per year! YOU are paying for this out of the tax on wages, VAT, fuel, business taxas, etc etc. And no, I dont mean the american system. I mean a capitalist run bunch of health companes, and a fixed "everything covered" as things are now with the NHS via insurance, that any insurer can cover on equal terms. Not the pick and choose US system.

One where each hospital or company and insurer works to a common set of requirements for all and to the same standards. And compete on equal terms.

£116.4 billion. NHS England is mis-managing £101.3 billion of this... Its why I have 3 hoists that I dont need. And endless assessements by gangs of idiots for everything!

Remember:
Spacex launches satellites 10x cheaper than anyone else that is not privately run and controlled. And relands its rockets. And just launched a tesla car to mars orbit for fun. And soon bezos will do the same.
Then Mars... NASA has spent well over 100 billion over 11 years (so far!) with 5 or 6 years at least to go, using old shuttle parts on a NON REUSABLE mars launch system, that still far from finished. It will cost 10 to 30x as much per launch as musks BFR and its less capable.
Musk is doing the same things but privately and from scratch, built in house, with 100x less employees, in just 3 years for 5 to 10 billion max and it is reusable! And it can launch much more mass, and carry ONE HUNDRED people to mars. Socialist nasa V capitalist private spacex. Theres simply no comparison.

[MichaelB]

Good luck with that one, you might need a rather large hammer Biggest issue is how you would separate out taxes linked to the NHS, do you reduce VAT, income tax, NI to give people money to fund a health care package? and would everyone do it or just spend on other essentials? Plus you still don't have a guarantee of getting a better chair for all as you don't have service standards and policies, the health care providers would have to agree that. Definitely not an easy solution! I can't begin to imagine how big a f'ck up the government could make of it.

Oh, when you buy a lawn mower and almost every other product the government have had their fingers in it, they have defined the standard it is made to and the maker has to comply. Government controlling private companies.

[Burgerman]

Biggest issue is how you would separate out taxes linked to the NHS, do you reduce VAT, income tax, NI to give people money to fund a health care package?

You dont have to seperate out a thing. The government decide who and what to tax. Its down to your vote. If you scrap the NHS they will have a budget surplus of 116 BILLION year on year! That means they can CHOOSE to reduce taxes to business (making the country richer through business growth) or to reduce VAT to ZERO since in 2017 the total VAT collected was 117 BILLION. Making every last person in the country some 20% better off. More (much!) actually since it reduces the need for thousands of civil servants and businesses to keep track, paperwork etc. And then more again when the efficiency of a free trade captalist system starts to work. As an example.

and would everyone do it or just spend on other essentials?

Dont understand the question.

Plus you still don't have a guarantee of getting a better chair for all as you don't have service standards and policies, the health care providers would have to agree that. Definitely not an easy solution! I can't begin to imagine how big a f'ck up the government could make of it.

The GOVERNMENT would not be involved. Healthcare providors (hospitals?) dont care either. YOU decide what to spend your insurance money, and your own money on. And who to use to advise you. You!!! Any more than they are involved in such things as the lawnmower you mention below. Purely safety standards. Under a free trade capitalist system, the opposite to the NHS system, standards always rise due to a competitive market. And prices fall. Giving the user more/better choice. Making your insurance cheaper.

Oh, when you buy a lawn mower and almost every other product the government have had their fingers in it, they have defined the standard it is made to and the maker has to comply. Government controlling private companies.

Do they? No. They dont define its design, they dont define the competition, they dont define how efficient the company is, they dont define how well its designed. Free market competition does all this. So for eg there are dozens of super modern lithium battery powered robotic mowers like shaun competing on PRICE and on quality, and features. And on service, reliability. And sit on mowers, hover mowers, traditional petrol cylinder mowers. CHOICE and competition, drives quality, service, reliability etc. The gov are there to ensure that its built to a safe standard so you dont lose a finger (auto cut off devices) and electrically safe, similar rules. Thats ALL they do. Because thats what we voted them to do. Of course in a socialist system, there is no free market competition. You waited 10 years minimum, to see if you could be allocated a used/new moskivich car if you lived in socialist USSR. There were no cheap mass market modern efficient cars, because like the NHS it wasnt interested in the free market or competition. The government decided what was builtt and supplied. This is the absolute point. Its not far from what the NHS do now.

Hospitals and medical care should be run the same way. Free market. Insurers can offer whatever they wish over and above a basic NHS style standard of care for all that is the basic premium level. If you choose a policy that covers you to say 20k per 3 years for a powerchair then you had the choice. If you chose one that covers you to up to 3k for powerchairs if needed, then you saved money, and now it costs you. YOU decide. But innovative companies will offer better deals. If the END USER is the one running around with the cash, powerchair companies will need to compete as they do for cars, bikes. With attractive products, service, and better pricing than the competition. Its called capitalism. Its the opposite to the old moskavich.

[ICEUK]

If you were disabled you wouldnt get insurance and if it did it would cost you more than 20% of your income. Fit and healthy and young not a problem, old, disabled your on your own!

[Burgerman]

If you were disabled you wouldnt get insurance and if it did it would cost you more than 20% of your income. Fit and healthy and young not a problem, old, disabled your on your own!

Wrong. I said same price to all. Being disabled and 90 years old will cost the same as a 20 year old able bodied. All premiums are the same standards and no personal data is included. Just the average across the population is used in calculations. Like now. You pay the same as everyone else. Some insurance may be cheaper, or offer perks like better chairs and get more business at lower margins. Thats their choice. Capitalism. Otherwise you get the screwed up US system. A level playing field. Like insuring your keys, or house central heating insurance. And the benefits system knows the cost of the cheapest basic premiums and so if unabled to work it will be allowed for. In the same way they allow enough to cover disability related expenses for carpets, or gardening. Ie you get a higher rate income if severely disabled to cover extra stuff you cant do. You can still shop around, or buy more comprehensive cover if you wish. But all policies must include the same basic NHS level cover by law. The rest is up to the individual companies and hospitals. Just like buying a lawnmower. And again, you will already be at least 20 percent better off. As will everyone else.

The actual cost per person at the wasteful NHS rates is £1420.57 per person per year. (100 billion div by the population) Capitalism will reduce that through competition over time, and increase quality. That figure also includes all the home care and other current money the NHS spends as well as the personal budgets etc.

[biscuit]

Maybe it would work better if the personal wheelchair budget were more like the PIP. You spend that as you wish, so with a wheelchair budget call it something else like a "mobility budget" and people can spend it on video games or whatever, if they prefer not to get a wheelchair. Or they can save it up and get what they like. (Wow, just like real life!) People getting PIP can get involved with the Motability scheme, if that is how they like to spend their money. It's "buyer beware" for everything one buys including Motability with PIP, and there are many who would not like that if it was for wheelchairs, so rather call it a "mobility budget". Any assessing the NHS does is to minimise their costs. They say it's not, but I think it's unrealistic to think they don't have a budget in mind when they assess one. So let the DWP do it, then the NHS can be patient advocates, like they're meant to be.

[Burgerman]

That IS eactly how it is. They assess. Give the money to you.

If you spend it on , then crawl everywhere, you are stupid, but then thats then your own problem.

[biscuit]

It's not done that way at all! With PIP they give you the money according to your assessment, purely a bean-counting assessment (and not a popular one) and don't care how you spend it. That's what I meant in the post above. With the personal wheelchair budget they faff around telling you what motors and whether you may get a manual chair etc. In my case the NHS supplier started their assessment of me with how much pain do I get using a rollator... the OT might as well not have referred me. I don't actually know where to begin with the NHS, they want me to run around in circles and I just don't have the energy for that. They pretend to assess you for your assistance, but actually they are assessing you to try and save money. If they turned the budget into what I described above, they would be assessing people for what they said they are assessing people for, not having to cover up a pretence. And they could then set some kind of ceiling on their wheelchair expenses, too.

[MichaelB]

Unfortunately reducing VAT or income tax does little for those not earning and only just getting by, essentials like food are VAT free. They wouldn't be 20% richer and even if they were 20% of very little won't cover the cost of the health care insurance. All it would do is make the rich wealthier.

and would everyone do it or just spend on other essentials? if you give people more money there is no guarantee that they will purchase health insurance some would blow it on and fags. What do you do about those?

If you decide the level of cover for every element of your care policy it would be beyond the comprehension of the average person, you can't predict what will happen to you and have enough cover. I didn't expect to be paralysed from the neck down and breathing via a ventilator. Probably wouldn't have ticked those boxes.

To radically change a system like the NHS would require the government to do it. People would have to be told what will change and the government would have to produce the documents and explain it. It would need to be voted on in Commons and Lords and you might get some tough questions. Given the way people protect the NHS MP's might have some pressure applied to stop it

The government set safety and consumer standards and when designing you take these into account, you have no choice given that your PL insurer won't be too happy to find out in the middle of a liability claim that you don't have a CEN certificate. The standard might limit material choice, ability to survive a crash and the really pedantic parts like what goes on the sticker attached to the product. Partly why there is little advancement in wheelchairs. The costs of getting certification are high which can limit the viability of a product. In theory competition should improve design and price, the reality for many products is that marketing is what decides. Look at the worlds biggest company Apple, I'm a fan know that there are better, cheaper options but buy Apple. Free trade is good and I won't disagree that

Government does have influence simply from the ability to alter tax structure, remove tax from development costs, increase it on profit. Their decisions influence business decisions, look no further than Trump and MAGA.

I'll not disagree that there are more effective ways to provide health care but everything above would need resolving before it could happen and I can't see that being achieved. You are talking about 1.5m employees changing employers, that is a lot of people to TUPE without taking into account the logistics of the NHS property and equipment.

The theory might be valid but putting it into practice has some big challenges.

An interesting debate anyway, must get back to doing some work to get a bike design through CEN

[Burgerman]

Unfortunately reducing VAT or income tax does little for those not earning and only just getting by, essentials like food are VAT free. They wouldn't be 20% richer and even if they were 20% of very little won't cover the cost of the health care insurance. All it would do is make the rich wealthier.

So you believe in the rich paying for the poor? Wealth redistribution? You are a socialist. It doesent work that way. Take a look how well the poor end up in any socialist country. Like venuzuala... Wealth redistribution (such as the NHS model) results in everyone being poorer, which especially effects the poor. Long term.

and would everyone do it or just spend on other essentials? if you give people more money there is no guarantee that they will purchase health insurance some would blow it on and fags. What do you do about those?

Then thats their problem. Its not the states job (the taxpayers job) to tell stupid people how to look after themselves. Rather waste your money on ? Your choice. Good luck with that. Its evolution in action. Why are they the problem of the sane rational people? Those are the darwin award specials...

If you decide the level of cover for every element of your care policy it would be beyond the comprehension of the average person, you can't predict what will happen to you and have enough cover. I didn't expect to be paralysed from the neck down and breathing via a ventilator. Probably wouldn't have ticked those boxes.

I already said, you dont have to do that. Basic cover = nhs level of care as we have today.

To radically change a system like the NHS would require the government to do it. People would have to be told what will change and the government would have to produce the documents and explain it. It would need to be voted on in Commons and Lords and you might get some tough questions. Given the way people protect the NHS MP's might have some pressure applied to stop it

Tha government would not be involved. Other than switch off of the current NHS as per the voters choice. Click. And to make a set of rules every insurer has to comply with as a minimum NHS style cover.

[Burgerman]

It's not done that way at all! With PIP they give you the money according to your assessment, purely a bean-counting assessment (and not a popular one) and don't care how you spend it. That's what I meant in the post above. With the personal wheelchair budget they faff around telling you what motors and whether you may get a manual chair etc. In my case the NHS supplier started their assessment of me with how much pain do I get using a rollator... the OT might as well not have referred me.

Those are both assessements, and if the wheelchair services dont do their assessement correctly, dont accept it I never do. And in both case once you have the money you can do what you want with it. No difference. Both are the same. If anything PIP is more intrusive.

[biscuit]

So you believe in the rich paying for the poor? Wealth redistribution? You are a socialist. It doesent work that way.

Insurance works that way. Not because it's socialist, but because everybody who buys in pays a small amount, and a small number of those receive a large amount. It's not compulsory to be insured. With the exception of National Insurance.

Then thats their problem. Its not the states job (the taxpayers job) to tell stupid people how to look after themselves. Rather waste your money on ? Your choice. Good luck with that. Its evolution in action. Why are they the problem of the sane rational people? Those are the darwin award specials...

I think we're more civilized than that! Imagine, all the stupid people in the country with no money living on the street. It's not that simple, spending taxpayers' money on what is worthwhile to the society, versus frittering it away.

[Burgerman]

Insurance works that way. Not because it's socialist, but because everybody who buys in pays a small amount, and a small number of those receive a large amount. It's not compulsory to be insured. With the exception of National Insurance.

Correct. Its a choice YOU have to make. Instead of relying on a nanny state to bail you out using other peoples money. If you are not interested in your own health care, why should I pay for you? Thats SOCIALISM!

Burgerman wrote:
Then thats their problem. Its not the states job (the taxpayers job) to tell stupid people how to look after themselves. Rather waste your money on ? Your choice. Good luck with that. Its evolution in action. Why are they the problem of the sane rational people? Those are the darwin award specials...

I think we're more civilized than that! Imagine, all the stupid people in the country with no money living on the street. It's not that simple, spending taxpayers' money on what is worthwhile to the society, versus frittering it away.

Spending taxpayers money (esp those that are the most sensible, those that employ others, those that subsequently earn more, and give more to society) on all those that couldnt care less about their own healthcare and would rather blow it on cigarettes/alcohol/movie channels/iphones/whatever is called SOCIALISM. The redistribution of wealth. It penalises the sensible and hard working to support the idiots in society. Thats why we have whole areas of britain that are generations of rapidly breeding never worked, socially housed, all paid for by those that work hard. And its wrong. Worse, it makes the country poorer, as happens in all socialist economies that try to support the bottom of society by taxing the top. The result is east germany, the soviet union, and venuzuala today. They managed to bankrupt themselves due to socialism (wealth redistribution) in 15 years. Now the poor are equal. Eaqually hungry, cold and fleeing the country.

[biscuit]

It is civilized to care as a society for those individuals that do not care for themselves. Who knows why they don't? There's millions of possible reasons and they are often not obvious. They could be depressed, or mentally retarded, or have a really bad background - do we just ignore them and let them end up on the street? Do we pry into their private lives to help them, or is that just interfering?

[Burgerman]

It is civilized to care as a society for those individuals that do not care for themselves.

Then why should we care, and why should we fund their alcohol and drug lifestyles? Genuine cases that want to help themselves with real medical problems yes. Thats a safety net. Massive council estates, social housing, lifestyle unemployed, all claiming benefits, with extended families for generations as we see in all the deprived areas? NO! Screw them.

Who knows why they don't? There's millions of possible reasons and they are often not obvious. They could be depressed, or mentally retarded, or have a really bad background - do we just ignore them and let them end up on the street?

Thats up to them to decide. If they ASK for help, and have genuine ilnesses then yes. But only so far. Its other peoples money. If they choose to blow it on drugs, alcohol, gamboling, never pay the rent, live like animals, then thats not societies responsibility. Help once. If they just keep repeating the same thing, thats their problem. Not everyone is the same. Many like that way of life. Its not your place to stop them by spending my money.

Do we pry into their private lives to help them, or is that just interfering?

If THEY ask you to, otherwise yes it is. But you must know details if they want help, or you should not or can not help them. You also must understand that many of these people would still be no better off even if they won the national lottery. Some people cannot be helped no matter what you do.

[steves1977uk]

Here's a copy of my own assessment, I know it's not professional looking but it's the best I can come up with. Feel free to criticise/offer advice on any improvements I can make to it.

Steve

[Burgerman]

My verdict? Its a start. But...


Thats a very short polite begging letter of about 2 paragraphs, that does not assess your needs or chair requirements at all. This POST is longer and more detailed. Mine was 25x as long, after spending several hours shortening it and condensing it to the essential bullet points. Adressed every need in detail, and suggested the solution, explained the tech reasons why x feature, and z need had to be addressed in each case. Making sure that I showed why the chair they suggested was not suitable and why. And supplied a list of chairs that met this requirement in each case. And only 1 chair that met them all, complete with specs, options, and a fillied in manufacturers prescription form. Leave them nowhere to go.

And it mine was not polite! And your "opinions" dont count. Only facts. No need to be rude. Logic offends them plenty good enough! For EG I never mentioned speed. They dont like that. You are offering them another get out excuse!!! But I did explain why I needed the torque for safe control, which meant 4 pole motors and high amp controller were essential. And I gave a detailed tech explanation to show why. And explained why a weak controller, and 2 pole motors, and a set of small batteries in that cheap solution they offered you will not work. And that means 6mph but dont actually say that... It will likely be PROGRAMMED down to 4 when you get it as they are terrified of giving you 6... And theres no budget!!! Dont say that. You are arming them for another get out escape route, which side are you on?

You can mention in a summary of your additional wants and holistic needs at the end after your clinical requirements are adressed, that you dont consider 4 mph is safe for a variety of reasons and give them, and that you cant transfer to a different chair yourself if you need food or to go to a bank or a doctor. So adequate safe and comfortable outdoor occasional use is absolutely essential. And explain why. And then explain that this is why the wheelchair budgets are being rolled out nationwide that many like me are already on since wheelchair services have failed for decades to provide adequate choice or solutions. So you can choose a chair that suits your needs.

That letter will achieve nothing as it is written. You are not writing to a freind. Quite the opposite. You are writing to someone trying not to spend any money on you if they can get away with it. You need a detailed tech assessement of your daily needs and requirenments on a one by one basis. Start at ardvark and end at xzylaphone. (I cant spell that!). Make a long detailed list. Then adress each point. Dont be polite. Thats the tool they use to make you comply...So you dont make waves. You need to make very big waves. Explain that what they offered is in no way suitable and if needed you will buy your own chair that does adress your needs, and sue them for the money very publically.

[sacharlie]

Thats RIP SNORTIN advice!
I like that.
Go get em.

[Burgerman]

Works for me.

[LROBBINS]

The same approach worked for Rachi years ago when dealing with U.S. insurers. We had particular trouble getting funding for a speech-output computer (I always called it a voice prosthesis), but after going through that I knew that a power chair would need detailed justification - for the chair itself, the specialized seating and cushion, the Soft3 headrest and on and on. I wrote it, and had the "prescribing specialist physician" (who knew squat, but was willing) sign it. Did the same thing in Italy years later, and it worked here too, remarkable because we actually went outside the health service's normal procurement route. (Of course, our U.S. insurer covered about 90% and the national health had to cover only the remainder.) I don't know if I still have a copy of the American letter of medical necessity, but certainly have the one in Italian. If you'd like a copy of either, let me know and I'll try to find them.

[Burgerman]

Does Rachi still get assessed and chairs funded?

Of would that involve "the fight" all over again?

Its a shame that be it in the US, UK, or Italy that this kind of fight has to happen at all, and that many that cant, dont have the mental strength or knowledge to do so, end up with unsuitable equipment and dont know any different. And those that are prepared for a fight can get what is needed quite within their rights.