Roger Ebert adds to health care debate on iPhone, Mac use

[AppleInsider]

Film critic Roger Ebert gave Apple's VoiceOver technology two thumbs up in allowing him to communicate after losing his voice to cancer surgery, but said his health insurance would only offer to cover an $8,000 device that didn't work nearly as well.

Many users with disabilities are barred from choosing cheap, off the shelf technologies by Medicare or private insurance companies who insist on only covering far more expensive devices that don't work as well.

An article in the New York Times profiled Kara Lynn, a mother who lost her voice to ALS. To help her communicate, Medicare paid for an $8,000 Windows PC running speech synthesis software.

Government rules require the PC be disabled from doing anything other than speech, in the fear that Lynn might benefit from features unrelated to her disability, such as web browsing. The Times reported that Medicare's PC vendor, DynaVox, "disables the general computing tools. After the insurer pays, customers can pay $50 to DynaVox to reactivate the full functions."

Instead of using the "clunky" PC, Lynn bought herself a $300 iPhone 3G running a $150 text to speech app. Lynn said that "it worked better and let her 'wear her voice' around her neck while snuggling with her 5-year-old son, Aiden, who has Down syndrome." Medicare won't cover devices like the iPhone however.

Asked why Medicare refused to cover cheaper, better alternatives for users, Peter Ashkenaz, a spokesman for the federal Centers for Medicare and Medicaid Services told the Times, "We would not cover the iPhones and netbooks with speech-generating software capabilities because they are useful in the absence of an illness or injury."

Instead, Medicare reimburses specialty companies who bill it as much as a 2,000% premium on the hardware they provide. "Prentke Romich, for example, charges $250 for a Bluetooth wireless adapter similar to those that cost $20 in stores," the Times reported.

Death Panel Technology

Responding to the article, Ebert wrote a letter to the editor noting that he was similarly offered an $8,000 solution after having lost his ability to speak.

"After trying an $8,000 custom device with little computing power and a small, dim screen, I tried the built-in speech software on my MacBook and found it much more practical," he wrote. "It will read anything aloud, including what I define on a Web page or in an e-mail message. Several voices are built into the computer, and others are downloadable at moderate prices.

"I combine talking and Web surfing — for example, sharing a news headline with my wife," he said. "It’s stupid of insurance companies to insist on an inferior device costing 10 times as much."

The Obama administration is working to enact health care reform efforts to address outdated spending rules and investigate how Medicare can use more efficient and modern technologies. Critics suggest that any cuts to the status quo of Medicare spending, which would impact a variety of connected companies like DynaVox and Prentke Romich, might instead result in a government euthanasia program that uses death panels to slaughter old people.

Others fear that Obama's plans to reform health care will result in Medicare being taken over by the government, unaware that Medicare itself is a single payer, government-run healthcare program and has been since 1965.

Cost savings involved in using low cost, modern technology available in off the shelf devices is a significant component of the Obama's health care plan, which includes a provision to "create an independent Commission, made up of doctors and medical experts, to make recommendations to Congress each year on how to promote greater efficiency and higher quality in Medicare. The Commission will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care."

[crees!]

Others fear that Obama's plans to reform health care will result in Medicare being taken over by the government, unaware that Medicare itself is a single payer, government-run healthcare program and has been since 1965.

What people fear is gov't running private insurers out of business. And there's plenty of audio and video out there that vaildates those fears. Medicare is in such bad shape because Gov't can't run programs effectively, period. All the mandates and regulations are what brings down the system. To quote a wise man, "Everyday Congress meets we lose a little bit more of our liberty."

[ramsey123]

Regardless of anyone's political view, it's good to hear from actual handicapped people that Apple's extra effort in this arena is ahead of the competition. It doesn't surprise me, just good to have confirmation.

[hillstones]

And you would think any insurance plan would be open to cost effective alternatives that provide the solution, rather than an $8,000 piece of junk computer. The company that offers such a computer should be shut down for ripping off the insurance companies with such an outrageous markup.

[justbobf]

Seems like revising Medicare rules would be a step in the right direction.

I have to counter "crees!" 's Republican response. Medicare is a wonderful program. My grandmother was so happy to get in in the 1960s, saying she did not want to be a financial burden to her family. For those against Medicare, think of how your parents would get along if they did not have it. If they would be okay, think of how others who are less fortunate would fare.

Now, it seems to me that if Medicare is paying out more than it takes in now, that is because that there are more older people now and fewer younger people. We all need to be taxed just a little more to counter this temporary trend, and then things can be set back once the old and young populations stabilize, again.

[enzos]

Originally Posted by crees!

What people fear is gov't running private insurers out of business.... To quote a wise man, "Everyday Congress meets we lose a little bit more of our liberty."

On the contrary, governments can and do run health programs effectively. In most of the *civilized* world, governments guarantee essential healthcare and do so for a small fraction of the per GDP cost that the for-profit private system in the USA can manage. Moreover, it's not just a matter of cost, it's also a matter of quality: people who live under universal healthcare systems live longer than Americans do (look up the WHO tables) and it is widely recognized that life expectancy is predicated by the quality and availability of health-care.


Getting back to Mr Ebert, I do hope he gets better... the world of public entertainment is diminished without him.

[iphonedeveloperthailand]

That's a great plus for those who need these type of tools. Apple should use this in one of their Get a Mac commercials.

[justbobf]

One more thought...

While Roger Ebert may be able to use an iPhone, I'll bet many people with speaking disorders also have other problems that would prevent them from using a tiny keyboard. I'm guessing that that $8,000 "device" has software that allow quicker access to common words and even sentences, so that those people can "speak" as well as hear. They may even come with something that allows for input with a stylus.

I remember Stephen (sp?) Hawking had some sort of contraption hooked up to his wheelchair.

[JavaCowboy]

Before making broad-reaching statements, could the Americans in the forums who have convinced themselves that "the government will run health care into the ground" research health care systems in other countries before commenting further?

Thanks!

[Dr Millmoss]

Originally Posted by hillstones

And you would think any insurance plan would be open to cost effective alternatives that provide the solution, rather than an $8,000 piece of junk computer. The company that offers such a computer should be shut down for ripping off the insurance companies with such an outrageous markup.

You would think, but you'd be wrong. Anyone who's had to deal with an insurance company knows that efficiency is not the name of the game.

[Dlux]

When Siskel and Ebert first aired I thought the two critics were a bit pompous and trite. But over time I grew to respect their depth of film knowledge and often agreed with the reviews' more subtle observations. It wasn't until much later that learned of Ebert's involvement with a crazy cult film that I had enjoyed for years, "Beyond the Valley of the Dolls". I then realized that his reviewer persona was only one facet of his complex life.

Whatever you may think of his film reviews, over-priced 'medical' hardware, the US Government, or DynaVox, you owe it to yourself to read more about Ebert himself, and all he's been through:

http://en.wikipedia.org/wiki/Roger_Ebert

[Ireland]

Originally Posted by iphonedeveloperthailand

That's a great plus for those who need these type of tools. Apple should use this in one of their Get a Mac commercials.

Stay classy.

[Neruda]

Originally Posted by JavaCowboy

Before making broad-reaching statements, could the Americans in the forums who have convinced themselves that "the government will run health care into the ground" research health care systems in other countries before commenting further?

Thanks!

You're welcome, BUT

Just because healthcare system X works in country A does not necessarily mean that system X will work in an entirely different country (B). Healthcare might be great in socialist countries, but if that is the price to pay for universal healthcare than I say no thanks.

The US already spends around 15% of GDP on healthcare. In my opinion, in the US the term government efficiency is an oxymoron (this article is a perfect example of that). Expect the percentage of GDP to increase if any type government run healthcare system is instituted in the US. Let's make the national deficit worse by paying for healthcare with money the government doesn't have.

[lilgto64]

As I read that I figured that the over priced figures that Medicare charges to the tax payers would have initially been because the company that provided the service had to spend a large amount of money on research and development of the tools - meaning that a lot of the $2000 is not for the actual gear but for the overhead - however, I strongly suspect that the overhead is long gone and the cost of parts is way less than it used to be - but since the government contract was already in place no one bothered to change it.

And that may be the biggest problem with our (the US) government - and its spending habits - is that once something is established it is rarely questioned or adjusted or modernized.

I saw a program about Navy ships which talked about using off the shelf type computer components rather than custom designs which would allow for less cost - easier and quicker replacement and even more frequent upgrades in capability - of course I also heard that the first war ship to be running entirely on windows os based gear was stranded at sea and had to be towed back to harbor when the windows network crashed - of course that may not have been the fault of the windows OS necessarily.

I saw another program on illegal immigration in which a public official said they were implementing a computer based paper work system to reduce the time and effort to produce 6 or 8 documents many of which shared much of the same information - and phase 2 of the project was going to be evaluating just what in the heck we need 8 documents for to begin with and to see if any of them can be eliminated.

[teckstud]

Why is AI bringing politics into the discussion here? You know there is no way to avoid it by posting this thread. I hate to see comments and arguments to come- pro and con.

[Neruda]

Originally Posted by teckstud

Why is AI bringing politics into the discussion here? You know there is no way to avoid it by posting this thread.

I don't think AI is bringing politics into the discussion, but our comments are.

I hate to see comments and arguments to come- pro and con.

Why? Being able to debate the pros and cons of any issue is a good thing.

[teckstud]

Originally Posted by Neruda

I don't think AI is bringing politics into the discussion, but our comments are.



Why? Being able to debate the pros and cons of any issue is a good thing.

OK- then, what do you think of those who believe in the march last weekend?

[teckstud]

Originally Posted by enzos

Getting back to Mr Ebert, I do hope he gets better... the world of public entertainment is diminished without him.

I agree- Roger Ebert is a true classy guy, who always added a refreshing insight to many films.
Thank you Roger for so many great film reviews.

[BertP]

Too bad about the quick diversion to the politics involved. I've had an interest in the subject since I was a kid, but this is not the right forum.

Believe it or not, even in the handicapped community, there is bickering and misinformation regarding the Macintosh and Windows platforms. I'll pass on that too.

Apple's emphasis on the UI has benefitted both the general user and the handicapped community. The portion of the visually impaired community that knows about VoiceOver are often ecstatic about VoiceOver being extended to the iPhone 3GS and the new iPod Touch.

Other components of Mac OS X utilize this alternative interface. For example, if you know how to do GUI scripting in AppleScript, you'll know about System Events. That component supports both VoiceOver and GUI scripting.

It really comes down to the power of object oriented programming and the Cocoa frameworks. Why not multiple user interfaces for different audiences? Also, note the commonality between Mac OS X and iPhone OS 3.1. Powerful stuff.

[bwik]

Apple products would be the perfect solution to slaughter the old people faster and with fewer errors. Don't forget, Snow Leopard has some exciting optimized features coming out

[aaarrrgggh]

Originally Posted by Neruda

The US already spends around 15% of GDP on healthcare. In my opinion, in the US the term government efficiency is an oxymoron (this article is a perfect example of that). Expect the percentage of GDP to increase if any type government run healthcare system is instituted in the US.

Are you fucking high or just stupid?

Myself and my three partners spend $27,840 per year on medical insurance premiums (excluding vision and dental), plus $34,000 ytd out of pocket. We spend over $450k on income taxes on our pay (exclusive of any spouses). There is no way the governmant could provide the same shitty insurance at a higher cost.

This money is parasitic; healthcare is ineffective in the US, but still far too expensive. My wife and I go to Thailand for some of our care and pay less than 10% for the same procedures. Very little with the US system is going right, yet for some reason you crazy neocon lunatics think it is great.

Get your head out of your ass.

[TBell]

Not sure what you mean by Medicare being in Bad shape. If you ask most people who are on Medicare they will tell you that they prefer it over private insurance. The reality, however, is many people don't understand the government runs Medicare. The above example of not using cheaper technology just because it has other benefits if true, however, is plain outrageous. I suspect this has more to do with a certain companies lobbying efforts then anything. If true, that really is the problem: private and political greed.

I also do not see how the government can ruin the heath care system much more then it already is. In the very least, all insurance companies should be required to be made non profit. It is outrageous that CEO are raking in billions, while many people are going without insurance.

Most people can't afford private insurance nowadays. It used to be employers would pay for it. That more an more is becoming not the case as employers look there first to cut costs.


A single payer system is the way to go. People shouldn't have to worry about health care. It should be a right. Society would be much better off.

Originally Posted by crees!

What people fear is gov't running private insurers out of business. And there's plenty of audio and video out there that vaildates those fears. Medicare is in such bad shape because Gov't can't run programs effectively, period. All the mandates and regulations are what brings down the system. To quote a wise man, "Everyday Congress meets we lose a little bit more of our liberty."

[TBell]

Yes, but you probably love all the public parks, schools, social security, medicare, roads, airports, and the list goes on of publicly subsidized programs and institutions.

You do understand that the word socialism is just a word thrown around to get zealots worked up in a knot so that programs that actually benefit the public don't get passed.

Originally Posted by Neruda

Healthcare might be great in socialist countries, but if that is the price to pay for universal healthcare than I say no thanks.

[LE Studios]

Originally Posted by hillstones

And you would think any insurance plan would be open to cost effective alternatives that provide the solution, rather than an $8,000 piece of junk computer. The company that offers such a computer should be shut down for ripping off the insurance companies with such an outrageous markup.

Yeah a iMac would have suffice. WTF?

[whodathunkit]

Originally Posted by crees!

What people fear is gov't running private insurers out of business. And there's plenty of audio and video out there that vaildates those fears. Medicare is in such bad shape because Gov't can't run programs effectively, period. All the mandates and regulations are what brings down the system. To quote a wise man, "Everyday Congress meets we lose a little bit more of our liberty."

Do you have any awareness of all that you're arguing against yourself? You say that people will abandon private insurance (run with an overhead of 30%) for a public option (Medicare operates with an overhead of 3%) and yet you state that the government can't run anything right. So, which is it? It can't be both. If the government can't run a public insurance option right, then the private insurers have nothing to fear, do they?

[isaidso]

Originally Posted by whodathunkit

Do you have any awareness of all that you're arguing against yourself? You say that people will abandon private insurance (run with an overhead of 30%) for a public option (Medicare operates with an overhead of 3%) and yet you state that the government can't run anything right. So, which is it? It can't be both. If the government can't run a public insurance option right, then the private insurers have nothing to fear, do they?

Don't try to talk logic to these people. You're just wasting your breath. (err, fingertips)

[charlituna]

Originally Posted by hillstones

And you would think any insurance plan would be open to cost effective alternatives that provide the solution, rather than an $8,000 piece of junk computer. The company that offers such a computer should be shut down for ripping off the insurance companies with such an outrageous markup.

yes you would. but previously the Gov't run program was all about only supporting medical solutions. Obama is trying to end that 'head up the butt' view and actually save money by being open to creative thinking. now it might mean that for something like the iphone they are only willing to pay half but that is still something (perhaps with the caveat they will pay all under particular financial conditions or only for the cost of the lowest model) but in this sitch, that's still an easy $7000 that can be used for other programs.

[anantksundaram]

Sure, the government might be stupid. But does that mean private insurers are smarter?


Is there any evidence that private insurers would allow the iPod rather than the $8000 device? If there isn't, the anti- government zealots should just move along.

[kpluck]

So, to sum up the story, it is a bad idea to have a bureaucratic government run agency managing our health care. It is far cheaper/better to leave the responsibility up to the individual.

-kpluck

[powqjfojqpof]

From the article: "Government rules require the PC be disabled from doing anything other than speech"

My question: SO, on what page of Obama's proposed plan does he specifically say he wants to change this rule?

[powqjfojqpof]

Originally Posted by TBell

Yes, but you probably love all the public parks, schools, social security, medicare, roads, airports, and the list goes on of publicly subsidized programs and institutions.

You do understand that the word socialism is just a word thrown around to get zealots worked up in a knot so that programs that actually benefit the public don't get passed.

The government did not invent roads, parks, etc. Don't give the government credit for these things. The government exists to run the military, pave highways, and guard free speech. Not to get between me and my doctor in the last moments of my life with a "consultation" where my doctor is given financial incentives to recommend me to "hospice care." Here's a link to the dangers of socialized medicine. This baby in England was mandated to die because of government rules:

http://www.dailymail.co.uk/news/arti...are-limit.html

Quote: "Doctors left a premature baby to die because he was born two days too early, his devastated mother claimed yesterday."

[souliisoul]

Originally Posted by aaarrrgggh

Are you fucking high or just stupid?

Myself and my three partners spend $27,840 per year on medical insurance premiums (excluding vision and dental), plus $34,000 ytd out of pocket. We spend over $450k on income taxes on our pay (exclusive of any spouses). There is no way the governmant could provide the same shitty insurance at a higher cost.

This money is parasitic; healthcare is ineffective in the US, but still far too expensive. My wife and I go to Thailand for some of our care and pay less than 10% for the same procedures. Very little with the US system is going right, yet for some reason you crazy neocon lunatics think it is great.

Get your head out of your ass.

Stop name calling and get your facts right with concern to comparing healthcare systems with US. Firstly not US citizen, but lived there for over 5 years. Secondly lived in Asia-Pacific for over 7 years off and on.
The cost of living, wages etc are completely different to US, so you going to Thailand earning a US wage and spending your US dollars, it would seem much cheaper. To average Thai person their cost of Healthcare is still high in their country.

I can say the same thing about India, with concern to healthcare, majority of physicians have been trained in USA or UK. The standard of care in private/big public hospitals is very good and the cost is much lower than western countries.

Now If I tell you that only 10-20% of the country can afford such level of healthcare that I have access to, then you understand that in population of 1,147,995,904.

So before you start comparing Thailand's healthcare with USA, just remember what you are comparing, since poor Thai people are NOT getting a good deal, but hey as long as you are happy thats great.

[rnp1]

Oh boy. A chance to speak here about what is really happening in the world!
1. The $8000 system is a part of why the USA dumps billions into wasted projects-lobbiests!
2. My Mac talked to me in 1984. Today, I follow along with it everyday, reading about how the economy is being ruined intentionally by Benny Da Bankster and his secret Bosses, Baron Rothschild and J.D. Rockefeller." It's great to have a computer that will speak to you!"
3. The Banksters are playing the left against the right, as usual. And everyone's fighting over Obama rather than Stopping The FED and truly moving forward.
4.We've got guys in $6000 suits telling us we have to makes sacrifices so that Goldman Sachs and JP Morgan don't have to! While we wear old jeans, T-shirts and eat corn laced fast food!
5. Healthcare is expensive because Doctors profit from "fee for services" and selfish bureaucrats keep jacking up insurance rates and removing people who need the coverage!
6. The quality of US healthcare is not a result of who is paying the bills! That makes no sense.
7. The last company to die a miserable death as a result of the coming deep and long depression-after the trillions in derivatives have hit the books and China demands the GOLD from the Banksters-will be Apple. Everyone needs a computer and a phone and an iPad and an iPod to be informed and entertained.
8. Microsoft will collapse way before APPLE due to incompetence in Ballmur's lack of street smarts and even a slight grasp of reality.
9. Bill and Melinda will be disgraced for selling mercury laden vaccines to Africans, who will suffer from huge outbreaks of autism, like the next generation of Americans who fall for the H1M1 manufactured panic, so Rumsfeld can expand his pharma based portfolio?
10. If a Mexican guy gets hit by a car in Arizona, will the paramedic let him die because he might be an alien? That guy Wilson yells, "You Die!"
11. If Obama and Biden are done away with, we are stuck with Nazi Pelosi!
12.√ Sorry for all you fools who think otherwise, but humans are all ONE RACE!

[souliisoul]

Originally Posted by aaarrrgggh

Are you fucking high or just stupid?

Myself and my three partners spend $27,840 per year on medical insurance premiums (excluding vision and dental), plus $34,000 ytd out of pocket. We spend over $450k on income taxes on our pay (exclusive of any spouses). There is no way the governmant could provide the same shitty insurance at a higher cost.

This money is parasitic; healthcare is ineffective in the US, but still far too expensive. My wife and I go to Thailand for some of our care and pay less than 10% for the same procedures. Very little with the US system is going right, yet for some reason you crazy neocon lunatics think it is great.

Get your head out of your ass.

Originally Posted by rnp1

Oh boy. A chance to speak here about what is really happening in the world!
1. The $8000 system is a part of why the USA dumps billions into wasted projects-lobbiests!
2. My Mac talked to me in 1984. Today, I follow along with it everyday, reading about how the economy is being ruined intentionally by Benny Da Bankster and his secret Bosses, Baron Rothschild and J.D. Rockefeller." It's great to have a computer that will speak to you!"
3. The Banksters are playing the left against the right, as usual. And everyone's fighting over Obama rather than Stopping The FED and truly moving forward.
4.We've got guys in $6000 suits telling us we have to makes sacrifices so that Goldman Sachs and JP Morgan don't have to! While we wear old jeans, T-shirts and eat corn laced fast food!
5. Healthcare is expensive because Doctors profit from "fee for services" and selfish bureaucrats keep jacking up insurance rates and removing people who need the coverage!
6. The quality of US healthcare is not a result of who is paying the bills! That makes no sense.
7. The last company to die a miserable death as a result of the coming deep and long depression-after the trillions in derivatives have hit the books and China demands the GOLD from the Banksters-will be Apple. Everyone needs a computer and a phone and an iPad and an iPod to be informed and entertained.
8. Microsoft will collapse way before APPLE due to incompetence in Ballmur's lack of street smarts and even a slight grasp of reality.
9. Bill and Melinda will be disgraced for selling mercury laden vaccines to Africans, who will suffer from huge outbreaks of autism, like the next generation of Americans who fall for the H1M1 manufactured panic, so Rumsfeld can expand his pharma based portfolio?
10. If a Mexican guy gets hit by a car in Arizona, will the paramedic let him die because he might be an alien? That guy Wilson yells, "You Die!"
11. If Obama and Biden are done away with, we are stuck with Nazi Pelosi!
12.√ Sorry for all you fools who think otherwise, but humans are all ONE RACE!

You start of by saying what is really happening in the world, but majority of your points are USA focused, am I missing something here

[rnp1]

Originally Posted by souliisoul

You start of by saying what is really happening in the world, but majority of your points are USA focused, am I missing something here

1. We are on the AppleInsider site, which is speaking about Apple products, which are, as it says on the Chinese boxes, "Designed in America"!
2. Most of the evil forces that are moving at this time are directed at destroying America.
3. I live and compute from America.
4. Most of the above discussion has been about America.
5. We use the most resources.
6. We are the World, we are the children!
7. Everything in the US is made in China!
8. SIskle & Ebert were an American TV show!
8. Im sorry....what were we talking about?

[Xian Zhu Xuande]

Uh-oh... Daniel Eran Dilger has found a way to bring politics to Apple Insider.

[mr_matalino]

Originally Posted by aaarrrgggh

Are you fucking high or just stupid?

Myself and my three partners spend $27,840 per year on medical insurance premiums (excluding vision and dental), plus $34,000 ytd out of pocket. We spend over $450k on income taxes on our pay (exclusive of any spouses). There is no way the governmant could provide the same shitty insurance at a higher cost.

This money is parasitic; healthcare is ineffective in the US, but still far too expensive. My wife and I go to Thailand for some of our care and pay less than 10% for the same procedures. Very little with the US system is going right, yet for some reason you crazy neocon lunatics think it is great.

Get your head out of your ass.

LOUD NOISES!!!!

"By agreeing to these rules, you warrant that you will not post any messages that are obscene, vulgar, sexually-oriented, hateful, threatening, or otherwise violative of any laws."

YOU FAIL

[rnp1]

Originally Posted by mr_matalino

loud noises!!!!

"by agreeing to these rules, you warrant that you will not post any messages that are obscene, vulgar, sexually-oriented, hateful, threatening, or otherwise violative of any laws."

you fail

guesss this means we can't post anything to do with microsoft at all!

[souliisoul]

Originally Posted by rnp1

1. We are on the AppleInsider site, which is speaking about Apple products, which are, as it says on the Chinese boxes, "Designed in America"!
2. Most of the evil forces that are moving at this time are directed at destroying America.
3. I live and compute from America.
4. Most of the above discussion has been about America.
5. We use the most resources.
6. We are the World, we are the children!
7. Everything in the US is made in China!
8. SIskle & Ebert were an American TV show!
8. Im sorry....what were we talking about?

Originally Posted by rnp1

guesss this means we can't post anything to do with microsoft at all!

try learning to count. btw we are taking about healthcare and apple products.

[souliisoul]

Originally Posted by rnp1

guesss this means we can't post anything to do with microsoft at all!

seems to me, just want to pick an argument because, the person is clearly focusing on the harsh obscene words used, which are not warranted.