“We said, you know in our view a wheelchair isn’t that complex. We said, basically we hear what you’re saying ministry, but we’re not convinced. We think you should go back and look at it again.”
The lack of recycling was only one of the problems McCarter found with the way wheelchairs and other mobility devices were dealt with through the ADP, and indeed with other medical aids such as hearing aids, respiratory equipment and insulin pumps, to name a few.
At roughly one-third, or $105 million, of the total program cost, the mobility aids are the single biggest chunk and prone to the conflicts of interest and inflated prices McCarter identified throughout ADP.
The way the system works is patients see their family doctor, a specialist or a therapist who prescribes whatever device is needed. Once authorized through ADP, the patient then gets the device from a vendor, who is supposed to earn a 25% profit.
But McCarter found in too many cases vendor prices were inflated — up to 80% — and many authorizers had a cosy relationship with vendors.
“What can happen is that you can get a medical authorizer — how can I put this? — who can basically encourage people they are approving and say ‘You should go to Bob’s Wheelchair — he’ll give you the best wheelchair and the best deal,'” McCarter said.
“We saw cases where one vendor was getting 90% of their business from one authorizer.”
Pricing is also a significant problem, he said, with set prices that hadn’t been updated since 2006.
“The ministry basically sets the authorized maximum price. But what we were saying to the ministry is surely you should be going out and finding out what does it cost them? How do you know you’re not getting ripped off?
“We actually asked the vendors — I suspect to their great dismay — we wanted copies of their invoices and that’s how we were able to find out some of them were making these huge markups.”
One of the wheelchairs that the government lists at the price of $3,262 is currently listed on an American website for $950 US with free shipping.
David Fisher understands. His mother was 95 when she went into a nursing home this spring.
He was immediately told by the occupational therapist at the home his mother would need a new wheelchair. After getting a quote for up to $1,800, he went ahead with the purchase, only to find when the bill came eight weeks later it was $4,280.
“Nobody, nobody, works on 25% profit,” FIsher said. He’s worked in retail all his life and said maybe only construction companies expect that kind of profit.
“I went up and priced motorized wheelchairs, top of the line, $3,000. Some of the prices they charge are just absolutely ridiculous because they know the government’s going to fund 75% to 80%.”
The chair model that Fisher’s mom used is supposed to be for the “very active user,” according to the health ministry guidelines.
