Amputee victims from Boston bombing get promise of help

A HISTORY OF PROSTHETIC DEVICES

Prostheses have been around for centuries. Ancient Egyptians made artificial legs from fiber; a Roman general fighting in the Second Punic War (218-201 B.C.) had an iron hand fashioned to hold a shield. Little attention was paid to individual fit, comfort or function. Today, prostheses are light years ahead. A look at the evolution:

Source: Sources: Troy A. Turner, Amputee Coalition, Science and Medical Advisory Committee Frank Pompa and Joan Murphy, USA TODAY

G. Jeffrey MacDonald, S pecial for US A TODAY

10:22 p.m. EDT April 30, 2013

At least 15 victims of the Boston Marathon bombings needed amputations after wounds from shrapnel and debris made limbs unsalvageable.
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Costs will be less of a problem for Boston bombing victims who lost limbs in the April 15 attacks and now hope to return to active lifestyles with help from sophisticated prostheses, an industry group announced Tuesday. With the launch of the Coalition to Walk and Run Again, the American Orthotic & Prosthetic Association
(Photo: Darren McCollester, Getty Images)

(AOPA) pledged to supply prostheses for amputees who were injured in the bombings yet lack adequate insurance to cover the costs.

A prosthetic limb can cost anywhere from $8,000 to $60,000, depending on what's needed, according to AOPA members. But insurance policies routinely cap payouts at $2,500 or $5,000, according to the Amputee Coalition, a Manassas, Va.-based advocacy group. Further, prostheses generally need replacing every five to seven years. Total amputation costs over a person's lifetime are estimated to exceed $500,000. "We want to ensure that, in the midst of this horrific tragedy, these individuals are not further traumatized by the harsh and unreasonable limits that are present in all too many health insurance policies," said AOPA Executive Director Tom Fise during a telephone press conference from Washington, D.C. The coalition will cover the initial prostheses as well as any repairs or adjustments to the initial protheses, but wasn't able to extend coverage for the victims' lifetime needs. At least 15 victims of the Boston Marathon bombings needed amputations after wounds from shrapnel and debris made limbs unsalvageable. Hospitals did procedures without regard to costs or patients' resources, but the question of who would pay for prosthetic limbs had been unanswered until now. Amputees include a 10-year-old boy, a 29-year-old preschool teacher and a 34-year-old father. Two of Boston's amputees lost all or part of both legs. By and large, all were active people in good shape, according to Boston prosthetist Greig Martino, and will be outfitted with prostheses that let them return to their favorite vigorous activities. "Being a serious runner requires a specialized prosthesis," said Charles Dankmeyer, founder of Dankmeyer Inc., an orthotics and prostheses company in Linthicum, Md. "Most insurers are going to cover a prosthesis for one person for daily use, but not for any specialized uses We're looking to be able to help with that." Some of the bombing's amputees might find their policies cover all their prosthetic needs. The rest can depend on in-kind donations for their prosthetic equipment, though not for physical therapy since AOPA members are not physical therapists. By strapping on the initial prostheses with no out-of-pocket costs, Boston's bombing victims will be rare among the nation's 2 million amputees, advocates say.

The Amputee Coalition has successfully lobbied in 20 states to make artificial limbs affordable, in most cases by prohibiting caps on how much insurers will pay toward a new arm or leg. The group has introduced similar federal legislation in each of the last three congressional sessions and also has efforts underway in more than 20 state legislatures. Health insurers have generally not supported initiatives to require coverage for specific services or devices, including prosthetic limbs, according to Susan Pisano, spokeswoman for America's Health Insurance Plans, an industry group representing health insurers. "Those laws have driven up the cost of coverage, making it more difficult for employers to afford," Pisano said. "They have hundreds of requirements already."
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