Wheelchair reimbursement reform makes disabled people fear the worst

Anita Bonutti et Cyril Lefaut, conseiller maintien à domicile de Bastide médical, inquiets pour l'avenir. Midi Libre – K. H.

Il y a un an, le Président Macron annonçait un remboursement intégral. Mais dans le détail, le nouveau barème pourrait exclure de nombreuses personnes. Une fausse bonne idée ?

"Having a wheelchair is not a lifestyle choice. It's just my autonomy as a disabled person! Having a high-performance and comfortable chair is not a whim, it's vital!" With a smile and a concise sentence, Geneviève, immobilized since years after an accident, sums up the feeling of all those who are forced to live in a wheelchair. "One million people in France", specifies Lisette Labourayre, 70 years old, in a wheelchair for 24 years, and APF France Handicap representative in Gard .

So, when Emmanuel Macron announced last April at the National Disability Conference that "manual and electric wheelchairs will be fully reimbursed", everyone believed in it, delighted, before becoming disillusioned. "We be wary of smoke and mirrors ads!",say the Allègre couple, parents of Guillem, 39 years old and quadriplegic since birth. And this one seems to be one of them.

Lisette Labourayre, from APF France Handicap in Gard: “Many chairs could no longer be reimbursed”. Midi Libre – K.H.

"Obstacle course"

The Social Security reimbursement scale has not changed for thirty years: 600€ for a manual chair, 3900€ for an electric one. But the cost of a personalized chair with various options, "essential for safety, comfort and autonomy", insists Liliana Allègre, can quickly flare up. Mutual societies, MDPH, CCAS and associations then intervene to complete the financing. A real administrative headache that takes months, "an obstacle course", grumbles Lisette Labourayre.

The new nomenclature would propose 2600€ for a manual chair and 18,000€ for an electric one. The announcement is beautiful… but the devil is in the details: "It's a  ceiling. Beyond that, there will be no Social Security reimbursement. So neither mutual nor MDPH", laments Anita Bonutti, 71 years old, APF France Handicap relay in Arles.

"Many will no longer be supported!"

Result: "Very many chairs, beyond the ceiling, will no longer be reimbursed at all!", worries Lisette Labourayre who cites the example of a man suffering from multiple sclerosis "his chair is worth 50,000' euro;. How will he do ?" "Should we be reduced to making online jackpots to equip ourselves properly ?, questions Anita Bonnutti. In 2024, it's unworthy !" Like many disabled people, his chair is custom-made, adapted to his pathology and his lifestyle "I am very active in associations, I do more than ten kilometers every day with my wheelchair, I need suitable options, she explains.

What impact on suppliers ?

"You realize! 20000€ an electric wheelchair is the price of a car, is offended by Lisette Labourayre who realizes that the new reimbursement scale will impact the suppliers who will have to cut margins, the number of models, and the quality of the chairs no doubt. "Currently, we have 180 different models, there will be fewer , explains Cyril Lefaut, home care advisor at Bastide Médical. This cleaning up of the nomenclature was necessary. But this is a vision that is more accounting than human." The risk: cheaper equipment, therefore less ergonomic for users, "that risks slowing down innovation too". 

"Our chair supplier tells us that he risks working at a loss with this new scale or supplying low-end equipment and that the small businesses like him will face competition from the big guys in the sector!", testifies Liliana Allègre whose quadriplegic son needs a custom-made armchair .

In a press release, the Union of Home Health Providers (Upsadi) sounds the alarm: "In view of the proposed guidelines, the presidential promise will not be kept, worse the situation of people with disabilities is condemned to deteriorate significantly (…) And the survival of hundreds of businesses is threatened". Upsadi also points to cumbersome routes, extended access times, "dramatically reducing the autonomy and ' integration into society of people with disabilities. 

A petition with 60,000 signatures

"The only advantage of this reform,  This means that we will only have one contact, Social Security, note Liliana and Jean- Paul Allègre.But we will have an offer of discounted equipment, less choice, low-end chairs to fit the price. And if we sacrifice options, we will also sacrifice comfort. This reform standardizes disability and aims to actually save money".

With collateral risks: "A bad seat and I will have bedsores, for example. So I need a jack to modify the seat on my electric chair", explains Listte Labourayre. An armchair that is too heavy and unwieldy and it's your back that takes the brunt…

Associations and people with disabilities are up in arms against this reform, which was to come into force this spring, but has finally been postponed until the summer. A petition on the APF France handicap website, carried by MP Sébastien Peytavie, himself in a wheelchair, has already received more than 60,000 signatures. Their request: "Full coverage by Social Security,  therefore with no out-of-pocket costs,  all models of  wheelchairs&quot ;.

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