I just wanted to toss this idea out for comment. It's based on only my first experience with the Medicare/DME system but years of experience as general purpose engineer, builder, DIY, and all around cheapskate.
Our first power chair chair was bought through Medicare about 18 months ago. I wanted the power elevation option so the copay was $5800, but it probably would still have been $3000 - $4000 without it. Since then, my wife's condition changed significantly and I wanted to switch leg rest styles. The original DME was not responsive and I knew by the list price of the components that the copay might still be several hundred dollars. So, I started watching craigslist and ebay for parts. Never saw what I wanted, but I found that prices on complete used chairs are shamefully low - especially those with expensive rehab seating. I ended up buying a complete Q600 with the full TRU-Balance seating system (included the leg rests I wanted) for only $1000. It has literally only 1 mile on it. It also included a Roho Quadtro in virtually new condition.
So my question is why doesn't Medicare allow the purchase of used chairs. The savings to Medicare would be huge and the incentive for the patient is simple. NO COPAY for a used chair. To increase the supply and discourage dumping at fire sale prices they could also institute a buyback program. If you bought a new chair and you turn it in, you could get percentage of your original copay back based on the age and condition. DMEs would probably even make more by charging an inspection/reburb fee for changing batteries and customizing it for a new patient than they would on a new chair.
So what do you all think? The reason used DME has no value is that Medicare will not cover it. I'm talking about emulating the lame program where you pay overpriced rent on used items like mattresses but still have a copay and own it in 13 months. This is no copay on used equipment, no lucrative rental program for suppliers, and a reasonable one-time fee to DME to refurb/refit. Would you forgo new to get the same equipment for no cost?