Are You Being Served?

ser·vice [ súrvəss ]

1. work done for somebody else: work done by somebody for somebody else as a job, duty, punishment, or favor
2. helpful action: an action done to help somebody or as a favor to somebody
3. work for customers: work done for the customers of a store, restaurant, hotel, or similar establishment, often with regard to whether it pleases them or not

My last blog seems to have touched a nerve. Industry organizations and trade associations are all about service. They produce no tangible goods. The worth of an industry organization can be measured in the quality of service it gives to its members.

Controversy is only dreaded by the advocates of error. (Benjamin Rush)

A lot of what I say about the DME industry, its individual advocates, and its service organizations is controversial. I don't fear controversy, because I see it as a productive tool of change. I despise political correctness, because I view that as verbal tyranny. I've had people tell me that though they agree with something I've said, they're not going to do so publicly, lest they hurt or offend someone.

What's wrong with that? A lot. These people, instead of speaking their minds, are cowed into silently maintaining the status quo, even though they disagree with it.

Even if their silence hurts them in the long run.

Freedom of expression was granted to each American citizen by the founders of this country. That our society has become one where only a few have the guts to express themselves, often at great cost to others, is one of the saddest statements I can make.

Things won't change, readers, if you don't make them change. I've said it before and I'll say it again: You can say what's on your mind and be polite about it (if the situation warrants that kind of thoughtfulness). But you should never, ever, be afraid to say what you think because you fear being talked about or unpopular or because you fear reprisal.

Both pass quickly. Ask the Dixie Chicks, or anyone else who's been through a scandal. If they survived it, so will you. If things are a bit unpleasant for a while, hold your head up and be proud that you took steps toward effecting change. And don't for a minute allow anyone to make you think that you're in the wrong if you're a lone dissenting voice. If "they" are so right, why are things so wrong?

The first duty of a wise advocate is to convince his opponents that he understands their arguments, and sympathizes with their just feelings. (Samuel Taylor Coleridge)

The DME industry is packed with advocates. The problem is that some of them serve everyone badly (AAHomecare), and some of them clearly seem serve only their own interests (AMEPA, FAHCS and TAHCS).

No man should advocate a course in private that he's ashamed to admit in public. (George McGovern)

I got mail about my last blog, and in it a reader told me that AAHomecare's plan to seek an administrative delay to "adjust" competitive bidding was formulated and sprung on the state/regional associations with no consultation and no warning. I'm told that the plan was a "board action," and the states were asked to either agree with it or not agree with it (and if they didn't agree, they were asked for an alternative "practical" solution).

I've done some digging, and I've found that several of the state associations disagreed with AAHomecare; I'm told that at least one of them called for new staff at AAHomecare.

We need to find the courage to say NO to the things and people that are not serving us if we want to rediscover ourselves and live our lives with authenticity. (Barbara De Angelis)

AAHomecare's membership has been in steady decline for a decade. Though they claim to have a membership of 3,000 locations in all 50 states, I'm wondering how many actual members they have, and whether or not AAHomecare has many small, independent providers.

A leader is one who knows the way, goes the way, and shows the way. (John C. Maxwell)

I'm not saying that AAHomecare is alone in the failure to prevent and then to repeal competitive bidding. But though the industry gets a lot (too much) of hot air and posturing from AMEPA and their FAHCS/TAHCS off-shoots, AAHomecare is the organization that tells the DMEs that it is their "voice in Washington." AAHomecare tells its members that it is seen in Washington as the "credible representative of HME."

If this is the case, and I doubt it is, this is bad news for the industry. Why? Because the association wants an "administrative" delay so the program can be tweaked (again) and brought into line with what some economists had to say, which will then result in the industry accepting the program.

It is a bad plan that admits of no modification. (Publilius Syrus)

The current AAHomecare plan isn't a modification, it's pretty much a re-run. Did the first delay do any good? No. During that time, there was at least an effort to repeal competitive bidding. Now the goal is to change it so it's more palatable.

That's not much of a goal.

He that will not apply new remedies must expect new evils; for time is the greatest innovator. (Francis Bacon)

A new remedy isn't a drastically watered-down goal that amounts to giving up.

In times of rapid change, experience could be your worst enemy. (J. Paul Getty)

Despite the anger and disagreement of so many in the industry, AAHomecare appears to be moving ahead with its plan. I can only conclude that the association's board and its staff think that they know better than anyone else. History has not proven them right.

The worst things in history have happened when people stop thinking for themselves, especially when they allow themselves to be influenced by negative people. That’s what gives rise to dictators. Avoid that at all costs. Stop it first on a personal level, and you will have contributed to world sanity as well as your own. (Donald Trump)

Though I'm not addressing world sanity, I do think that the most important part of that quote is the importance of thinking for ourselves. If our "experts" aren't doing the job we pay them to do, it might be time to ask ourselves if they really know what they're doing and if they really know more than we do.

Don't be buffaloed by experts and elites. Elites can become so inbred that they produce haemophiliacs who bleed to death as soon as they are nicked by the real world. (Colin Powell)

Experts often possess more data than judgment. (Colin Powell)

If you disagree with AAHomecare's intentions, and are not willing to accept an adjusted competitive bidding program, now is the time for you to make it clear to CMS and to legislators that AAHomecare does not represent and does not speak for you.

The sad truth here is that it's extremely unlikely that round one can be stopped. That's another battle lost. But the war isn't over. It's time to regroup and to come up with plans (viable plans!) that don't include giving up the fight. Somewhere out there is someone who can step up and lead (not you, Rob Brant).

The vision must be followed by the venture. It is not enough to stare up the steps - we must step up the stairs. (Vance Havner)

Don't follow a bad plan blindly. Make sure you're being served.