| Breaking
the next wheelchair barrier Famed
inventor Dean Kamen's new iBOT wheelchair could make revolutionary improvements in the
lives of disabled people, today's writer says. But not unless they can afford the costly
device. And an ever-more-stingy Medicare is standing in their way.
Jan.
17, 2002
By Barbara J. McKee
The mystery of "Ginger" finally was revealed last month. Dean Kamen, the
inventor of this scooterlike device, had kept what he long had called only "It"
a secret, with the belief that Ginger would change the world.
I have a different opinion. Kamen has another incredible invention that isn't getting
as much attention as Ginger. He has invented the "iBOT," a wheelchair that gives
the disabled unsurpassed freedom and independence.
Back in June of this year, John Hockenberry did a segment on the NBC News program
"DateLine" on the iBOT. Kamen demonstrated how iBOT could go through deep sand
and gravel, climb stairs, raise the rider up to reach high shelves or give a loved one a
kiss.
Hockenberry could hardly contain his excitement. I could not contain my tears. A
wheelchair that makes a transformation by giving the user a working pair of legs!
Kamen's invention, backed by the pharmaceutical giant Johnson & Johnson, will give
thousands of paraplegics and quadriplegics their independence back. This invention, not a
scooter, is the "It" that will change the world.
Why isn't the iBOT on the front pages of every newspaper and magazine? Kamen wants to
know why. So do I.
Kamen should have kept the iBOT a secret longer than the now-famous Ginger scooter. The
scooter will be revolutionary to some, a plaything to many. But the iBOT is life-altering.
The wheelchair is designed with a combination of gyroscopes and computer chips that
sense the user's body weight, structure and center of gravity. Each wheelchair will be
built to the user's body specifications by the type of disability and its residual
effects, such as spastic limbs, spinal curvatures and level of movement. Previous
stair-climbing wheelchairs were not this specific. They were mere prototypes of Kamen's
invention.
Over the Internet, I chatted with a few disabled folks about the device, curious to see
what the disability community thought about the iBOT. I asked them why they weren't
excited and chatting up a storm about this device. I was a bit shocked at their responses:
"It is a lawsuit and injuries waiting to happen."
"Can you imagine this slipping or breaking on stairs? It would kill you."
"I saw one (like it) a number a years ago in a demonstration; it slipped down the
stairs once, and that was enough."
"No insurance company will ever pay for one at 25K to 30K."
I understand their fear. There will be risks with any invention that involves the
movement of a person from point A to point B. Remember the history of the first car? It
came with predictions of death, too.
But their fears are based on the old versions of stair-climbing and standing
wheelchairs that are quite dangerous and unpredictable.
I believe Kamen is onto something that is as big, if not bigger, than the first
automobile.
Johnson & Johnson wants the iBOT to be listed as a medical device, enabling
reimbursement by Medicare and other medical insurance. The U.S. Food and Drug
Administration is currently conducting clinical trials, testing the iBOT for safety,
reliability, ease of use and performance in various climates and adverse conditions.
Kamen states he's done all these tests, but rules are rules. The FDA will have its way
with the iBOT before any government funds are used to purchase this extraordinary
wheelchair.
The estimated cost is more than $20,000. That price is in the range of the electric
wheelchairs used today by quadriplegics who have little to no mobility. Medicare balks at
approving these. It could be two to three years before the disabled get a chance to live a
life they thought was gone forever. How will they approach the approval of the iBOT?
If the FDA approves the iBOT as a medical device, it will change the meaning of
"disability" in the lives of more then 200 million wheelchair users worldwide.
It will drastically reduce the need for long and sometimes steep ramps, lessen the lifting
and carrying chores of personal care assistants, and allow the disabled to enjoy their
homes without costly reconstruction of bedrooms and kitchens.
The iBOT will give independence back to those who have lost it for many years. No
longer will we have to ask for help to reach a box of cereal, wait for the rescue workers
to save us from the upper floors of a building or remain seated when the national anthem
is played.
The more I think about the iBOT, the more impatient I get.
Until the Hockenberry segment, I had no hope of ever having the chance of dancing at my
children's weddings. That possibility now exists. The very thought of raising myself to
kiss my husband chokes me up.
In my poetry book, "Trilogy of One and Other Poems," I have written about my
inability to stand up and give my husband a hug, describing my heartbreak as a dream never
to be realized. With the iBOT, my dream would come true.
If I sound like I'm babbling, well, I am. I'm giddy about the many freedoms this device
could give back to me.
But with every dream, reality comes crashing in. Because of my financial status, it
will be years before I can have my very own iBOT; Medicare will not cover this device.
Medicare is the insurance coverage for thousands of disabled Americans. The scope of
Medicare coverage has been dwindling during the past 10 years. Legislative butchering has
resulted in the denial of many items, including wheelchairs, that are essential for
lasting independence.
Ultra-lightweight wheelchairs, meaning the weight is less than 20 pounds, are the
preferred chairs of the younger, more active people of the disabled community. Medicare
doesn't agree that having a wheelchair that is light and easy to handle for daily living
and working is "medically necessary."
Guess what? It is medically necessary, if the user would like to keep his or her
shoulders from the rapid deterioration that eventually leads to joblessness, painful and
costly surgeries, and the inevitable move to an electric wheelchair.
But Medicare doesn't look at long-term effects. It is concerned only with keeping down
costs of the newly disabled. But its efforts to be more "frugal" are for naught.
The "approved" wheelchairs are heavy, cheap in cost and construction, and lead
to further health problems.
Besides the shoulder and back injuries, long-term use of these cheaper wheelchairs will
lead to reconstructive tendon surgeries and eventual institutionalization in nursing
homes, when the user can no longer use them without some form of assistance. Medicare's
lack of foresight will cost much more than the initial cost of the iBOT, but the
government is not too keen on being proactive on the issues of the disabled.
Unfortunately, the iBOT wheelchair will be financially out of reach for those who need
it most. The devices and treatment that allow vast and vital improvements in the quality
of life for disabled people will only be available to those who are free from the
constraints of government and private insurance companies.
Disability advocates are currently involved with Medicare in discussions about products
and services that are needed right now, such as prescription coverage.
With the introduction of the iBOT, I'm afraid the battle for high-quality health care
products has suddenly grown to a full-blown war.
TODAY'S BYLINE:
McKee, who gets around in a wheelchair, is an Albuquerque writer, poet, performer and
producer. She writes a column that runs in Insight & Opinion the first Saturday of
every month.
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