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

Posted:
in iPhone edited January 2014
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."
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Comments

  • Reply 1 of 147
    Quote:

    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."
  • Reply 2 of 147
    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.
  • Reply 3 of 147
    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.
  • Reply 4 of 147
    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.
  • Reply 5 of 147
    enzosenzos Posts: 344member
    Quote:
    Originally Posted by crees! View Post


    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.
  • Reply 6 of 147
    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.
  • Reply 7 of 147
    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.
  • Reply 8 of 147
    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!
  • Reply 9 of 147
    Quote:
    Originally Posted by hillstones View Post


    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.
  • Reply 10 of 147
    dluxdlux Posts: 666member
    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
  • Reply 11 of 147
    irelandireland Posts: 17,475member
    Quote:
    Originally Posted by iphonedeveloperthailand View Post


    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.
  • Reply 12 of 147
    Quote:
    Originally Posted by JavaCowboy View Post


    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.
  • Reply 13 of 147
    lilgto64lilgto64 Posts: 1,147member
    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.
  • Reply 14 of 147
    teckstudteckstud Posts: 6,476member
    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.
  • Reply 15 of 147
    Quote:
    Originally Posted by teckstud View Post


    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.



    Quote:

    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.
  • Reply 16 of 147
    teckstudteckstud Posts: 6,476member
    Quote:
    Originally Posted by Neruda View Post


    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?
  • Reply 17 of 147
    teckstudteckstud Posts: 6,476member
    Quote:
    Originally Posted by enzos View Post


    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.
  • Reply 18 of 147
    bertpbertp Posts: 274member
    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.
  • Reply 19 of 147
    bwikbwik Posts: 552member
    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
  • Reply 20 of 147
    Quote:
    Originally Posted by Neruda View Post


    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.
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