A letter to the editor that Edward Eckenhoff, president and chief executive officer of the National Rehabilitation Hospital in Washington, wrote to this magazine recently (Oct. 6, p. 20) should give us all pause.
In his letter, Ed was eloquent, direct and to the point, so much so that rather than paraphrasing what he wrote, I will quote from it:
"Forty years after being paralyzed, the odds say I should not be where I am today, the founding president and chief executive officer of a healthcare system employing nearly 1,000 people. More than 68% of Americans with disabilities are unemployed. Acute-care hospitals are working miracles by saving lives today that just five years ago would have been lost. But there is a difference between merely living and life. Are we condemning those patients to live the rest of their lives in an 8-by-10 room or will they be enjoying an active, productive life in their communities with family and friends?"
During the past 18 months I've had two hip replacement surgeries, the result of years of competitive running and ice hockey. The truth is, I received so much enjoyment from those sports that the price was worth paying, even if I wish I didn't have to pay it.
The tough thing about hip surgery is that afterward there is a period when it's hard to get around, and it's painful. You have to go through a pretty intensive period of rehabilitation to get back on your feet. All kinds of things go through your head during rehabilitation, and you begin to understand to some extent what it must be like for those who are permanently impaired. It's not much of a stretch: The surgery I had didn't exist even a few decades ago. It makes me realize how lucky I am.
What I went through has made me keenly aware of those who have to use wheelchairs to get around. I see them every day in airports, at sporting events, in work environments and just about anyplace you can think of. It always impresses me that those who are disabled can enjoy the freedom to travel, work and marry.
Ed had called me about his concerns about some rules the CMS was considering changing in order to ease access to vital rehabilitation care. He believes the changes would hurt rather than help. "The current '75% rule,' " Ed wrote in his letter, "will be changed to require that 65% of admissions to inpatient rehabilitation facilities fall into one of 12 diagnostic categories (the current rules mandate that 75% of patients must be in one of 10 diagnosis groups).
"That sounds like progress, but the problem is that the new categories do not reflect the reality of modern medicine. And they certainly do not reflect the needs of our patients. Cardiac rehabilitation is excluded. Services for transplant patients are limited. The list goes on, but the bottom line is the CMS must amend the proposed changes and allow us to make a difference in people's lives. The quiet heroism displayed by individuals in the aftermath of a disabling injury or illness must not go unheeded. Every American with a disability deserves the same opportunity for success that was afforded to me by way of skilled medical rehabilitation."
Eckenhoff, despite being a paraplegic, plays golf and plays it well. He routinely scores in the 80s and has hit two holes in one. It shows you how far rehabilitation has come, and I don't believe any of us would want to turn the clock back on that progress.
Eckenoff understands that the CMS wants to ease the burden on inpatient rehabilitation facilities, but he also makes clear that he and his colleagues in rehabilitation care are worried about the unintended consequences of the proposed rule changes.
Ed tells me that 50% of rehabilitation hospitals may have to close under the proposed new rules. As he wrote, "This is a classic example of one step forward, two steps back. Hopefully the CMS will revise the rule. But should we entrust our patients' recovery to hopes or actions? On Sept. 25, I was proud to join the American Hospital Association, Sen. Ben Nelson (D-Neb.) and Rep. Frank LoBiondo (R-N.J.) on Capitol Hill to raise awareness of this critical issue. Now we need (healthcare executives) to join us."
In his book, Leadership is an Art, Max DePree, former chairman of furniture manufacturer Herman Miller, tells the story of his giving a talk to the company's sales force and reading a letter from a grateful mother who talked about her son, a Herman Miller employee, who was handicapped.
The mother wrote that if the company had not given her son a job he probably wouldn't have regained his confidence and joy in life. As Max DePree read the letter he broke down in tears and the sales manager had to adjourn the meeting for a few minutes so the boss could recover.
DePree had been a pioneer in hiring the handicapped, and the letter must have made him feel that the program was worthwhile.
Let's hope the CMS can find the same feeling in reconsidering its rule changes before those who need rehabilitation most are doomed to lives of despair and isolation.
All lives are precious,
360 N. Michigan Ave.
Chicago, Ill. 60601-3806
E-mail: [email protected]
Lauer is the author of two books, Reach for the Stars and Soar with the Eagles, and is an experienced guest lecturer available for public speaking engagements. For more information, visit www.chucklauer.com