One of the ways in which text to speech technology (TTS) has created an impact is by allowing the physically challenged to be immersed in the online environment. The advent of social connectivity and the diversity of new technologies that bring people together have reached the realm of healthcare. Among the technologies that have been adapted by the healthcare sector is TTS, which is viewed as an assistive device for speech-impairment. However, healthcare insurance companies are not always accommodating to assistive technologies proliferated in more widely popular platforms. Although TTS has become an integral part of any device with assistive functions, its availability in mobile devices is still yet to be recognized by the healthcare insurance companies as a medical device.

In an article by Ashlee Vance of the New York Times, it was reported that healthcare insurance companies are fighting TTS enabled mobile devices from being part of the covered devices in the insurance policy, “Medicare and private health insurers decline to cover cheap devices like iPhones and netbook PCs that can help the speech-impaired, despite their usefulness and lower cost” (Vance). The issue was described as a resistance by the healthcare sector to technological changes in favor of the companies that manufacture TTS-enabled speech-impairment devices labeled as medical devices. However, consumers perceive the said TTS-enabled medical devices as extremely expensive. As a result, consumers turn to mobile devices such as iPhone and Android smartphones that are more affordable.

DynaVox, a leading maker of devices for the speech-impaired, has computers that start at $8,000 and run Windows, just like 90 percent of all PCs. To meet insurance rules, DynaVox disables the general computing tools. After the insurer pays, customers can pay $50 to DynaVox to reactivate the full functions… But the prices may seem hard to justify based on components alone. One $5,000 DynaVox product is essentially the speech software bundled with a two-pound keyboard that has a six-inch screen. And the manufacturers mark up standard accessories by as much as 2,000 percent. Prentke Romich, for example, charges $250 for a Bluetooth wireless adapter similar to those that cost $20 in stores. – Vance

Vance also mentioned Kara Lynn who is suffering from amyotrophic lateral sclerosis (ALS) from San Francisco who spent $8,000 for a Medicare approved computer that turns typed words into speech that her family and friends could hear. In a statement, Vance recalls, “after being dismayed by the PC’s limitations and clunky design, Ms. Lynn turned to a $300 iPhone 3G from Apple running $150 text-to-speech software. Ms. Lynn, who is 48 and lives in Poughkeepsie, N.Y., said 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”.

There is a simple logic that clarifies the question of why medical insurance would not cover smartphones and regular PCs as medical device for speech impairment, simply because the said devices were not initially built for medical purposes and can be used for means other than medically prescribed.

In a statement from a health insurance executive, “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,” said Peter Ashkenaz, a spokesman for the federal Centers for Medicare and Medicaid Services. Private insurers tend to follow the government’s lead in matters of coverage. Two years ago, iPhones and netbooks barely existed, so it may not be surprising that the industry has yet to consider their role as medical devices”. – Vance

It is clear from the healthcare perspective that the use of TTS technology as an assistive remedy for speech impairment is specific only to devices manufactured and functions solely for the said purpose. In the meantime, people with speech disabilities have a choice: pay for a cheaper product from their own pockets, try to borrow one from a private assistance group or spend their insurer’s money on a specialty device from a company like DynaVox Mayer-Johnson or Prentke Romich.

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Read more at Insurers Shun Multitasking Speech Devices“. Vance, Ashlee.

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