How to become a cyborg in Russia

And how much does it cost

Blog of the company "Motorika", Geektimes

It's no secret that bionic prosthetics are sooo expensive. Both in Russia and abroad, a minimum number of potential users manage to get a high-tech prosthesis. 

So how do you still get a cool prosthesis for an ordinary person? While our team is developing an affordable bionic prosthetic arm, I will tell you how today Russian disabled people can become cyborgs.

How much does it cost to become a cyborg

At the end of last year, a forearm prosthesis with a bioelectric Bebionic 3 brush cost about 1.8 – 2 million rubles in Russia. The shoulder prosthesis will cost more – the elbow joint adds about 200-300 thousand rubles to the total amount. It should be understood that the cost of the prosthesis depends on the level of amputation, the region of installation of the prosthesis and accessories (an electric wrist rotator, for example, costs several hundred thousand rubles).

More advanced brushes (for example, Michelangelo hand and I-limb Quantum) cost one and a half to two times more expensive. 

Michelangelo hand and I-limb Quantum

There are simpler options. In 2014, the Myofacil brush from Otto Bock cost about 750 thousand rubles. Considering that Otto Bock raises prices annually, I assume that now such a forearm prosthesis costs about 1 million rubles. 

Myofacil

The cost of the prosthesis usually includes the work of a prosthetist (i.e., the manufacture of a stump sleeve), a charger, a spare battery, a cosmetic glove (at the rate of one glove for six months), as well as warranty repairs for a period of 2 years. The prosthesis from Otto Bock also comes with a prosthetic care product, and the Bebionic 3 comes with a Bluetooth adapter and a CD with software for adjusting the brush. 

Currently, there are three ways to purchase a high-tech prosthesis:

1. Receive at the expense of the state.
2. Buy at your own expense.
3. Through charitable foundations and crowdfunding.

I will not consider the last two options now. Because even if you have a couple of free millions of rubles, or if some foundation or philanthropist suddenly buys you a prosthesis, this will not solve the problem in the future. After 2 years, the warranty on the prosthesis will end, and with active use, the prosthesis will necessarily break.

By the way, that is why we have launched the repair of prosthetic hands in Motor Science and are ready to extend the service life of artificial limbs as much as possible. But after a few years, the prosthesis will still have to be changed. Therefore, if you do not have a multimillion-dollar salary, you should seriously consider only prosthetics at the expense of the Social Insurance Fund. 

An important point. Unfortunately, I have personally encountered people who received bionic prostheses and did not use them. Bebionic3, received from the state for 2 million rubles, can lie on a dusty shelf. Why? Because many disabled people get used to do without a prosthesis and it hinders them more than it helps. Or, for example, a person received a prosthetic hand, but he was too lazy to study or the management of the prosthesis seemed too complicated. Please don't do that. The budget of the Social Insurance Fund is not infinite, and the prosthesis that you received for free and eventually did not use could really improve someone's life.

Cyborgization at the expense of the state

According to the legislation, all citizens of the Russian Federation with disabilities have the right to receive a technical means of rehabilitation (TSR) at the expense of the state. It is for such things that we all pay taxes and contributions, bear collective responsibility and can receive collective support if necessary. A prosthesis for budget money can be obtained in two ways:

1. Purchase TSR yourself and then receive compensation for the prosthesis from the state. 
The main problem with this option is that in some regions, disabled people are not compensated for the entire amount spent on a prosthesis. The amount of compensation depends on the amount of the last realized competition. And in such contests, the prosthesis that costs the least wins. Often the winners are some kind of prosthesis developed in the 70s, which the user eventually does not even wear. Because of this, for example, in the Voronezh region, compensation for the purchased bionic prosthetic hand is about 150 thousand rubles.

2. Get a prosthesis through public procurement
The procedure for obtaining a good prosthesis for a state account is, as a rule, a long and complicated procedure and not all disabled people get exactly the TSR they want. The success of this event strongly depends on the well–being of the region - it is much easier to get bionics in Moscow and St. Petersburg than in the provinces.

The main stages (using the example of obtaining a bionic hand):

1. First, a person who has lost an arm must undergo a medical and social examination (ITU).

ITU is a kind of consultation of doctors that establishes a disability group and determines which rehabilitation measures are necessary for a disabled person to restore lost functions (both from a medical and social point of view). 

It is the ITU that determines whether a bionic prosthesis is put on a person or he will manage with hooks or even a cosmetic prosthesis:

traction shoulder prosthesis

cosmetic prosthetic forearm

What is the ITU guided by when prescribing a particular prosthesis? Diagnosis and "perspective" of a disabled person. That is, if you are young and ambitious, and a bionic prosthesis will allow you to lead an active social life (for example, get a job) – your chances of getting bionics will be higher than that of an old recluse. In addition, there is a list of contraindications for prosthetics, for example, mental disorders in the acute stage, etc. A direct contraindication for obtaining bionics is the weak activity of the muscles responsible for controlling the prosthesis. 

Let's say everything went well, a disabled person went to a meeting at the ITU and he received an individual rehabilitation program marked "Forearm prosthesis with an external energy source". Now the state is obliged to provide him with a bioelectric prosthesis. 

2. A disabled person writes an application to the local Social Insurance Fund, where he is given a referral for prosthetics within two weeks (according to the law). In theory, the FSS places an application for prosthetics at an auction in which various prosthetic enterprises participate and the disabled person will be prostheticized in the company that will offer the minimum price for the manufacture of the desired prosthesis.

3. PROFIT. A satisfied disabled person gets a cool prosthesis and lives happily ever after. After 3 years, the bionic prosthesis can be changed, again at the expense of the FSS.

But back to reality. Getting a prosthesis can take years or not be successful at all. At each of these stages, you can get stuck for a long time.

The fact is that in Russia there is a system in which the effectiveness of the Social Insurance Fund is assessed by the number of TSR issued. And what is more profitable: to give one disabled person a bionic brush for a million, or for the same money to give prosthetic hooks to 30 disabled people? That's it. Therefore, the state strives to issue as many cheap TSR as possible to as many disabled people as possible. And this is to some extent justified, because according to statistics, only a third of all those in need are provided with prosthetic hands in Russia. 

That is why one of the main areas of work of "Motorika" is cooperation with government agencies and prosthetic enterprises. We are actively traveling around the country and in many regions we find the support of caring officials and prosthetists who really want to change the outdated system. We managed to certify and start mass-producing traction prostheses of Kibi hands in a short period of time. In some regions, for example, in Arkhangelsk, Novosibirsk and Novokuznetsk, our prostheses can already be obtained directly from local prosthetic enterprises. 

Of course, you can't change the system and the people in it overnight. In some provincial city, the conditional Antonina Ivanovna from the ITU has never seen the prostheses assigned by her herself. She is used to always prescribe cosmetic prostheses, not realizing that such a prosthesis is practically useless in everyday life. Or her colleague, the conditional Valentin Petrovich, who does not really understand anything about prostheses and himself asks the disabled person which prosthesis to fit him, and grumbles at the noisy mother with the child and in general – he has lunch.

To illustrate the hell that Russian disabled people sometimes have to go through, the story is well suited Svetlana Churakova from Arkhangelsk. It took her two years to get one of the top bionic hands. One year was spent on the proceedings with the ITU – they refused to appoint bionics for a long time. It even got to the point that she was summoned to a federal examination in Moscow, where she was forced to wash dishes demonstratively to find out how well she copes with an old traction prosthesis. Like, maybe she doesn't need a new one at all? It took about another year to correspond with the FSS and actively defend their rights. But, largely thanks to the active support of the Arkhangelsk prosthetic Enterprise, everything worked out for her and now Sveta has turned into a real bionic princess:

I repeat that in some regions of our country the system is more favorable to people with disabilities and it is quite possible to get a high-quality prosthesis there. I would like to take this opportunity to thank all the industry workers who welcome changes (there are many such people) and help disabled people get really useful, modern means of rehabilitation. 

Ok. Is it better abroad?

No, not better. Getting a bionic prosthesis for free is not at all easy both in Europe and in the USA. 

According to Jason Barnes, an American cyborg drummer and Bebionic3 user, it is "unrealistically difficult" to get a bionic prosthesis in the USA, and the final cost of a prosthesis with insurance can reach $100,000

Jason Barnes

And here's what the Englishman Nigel Ekland told me, whom you may know from the official Bebionic videos:

• The cost of Bebionic 3 in England is about £15,000. Another £6,000 – £10,000 is the manufacture of a stump sleeve. 

• Getting Bebionic in England is a difficult task. The National Health Service provides bionics for 10-15 people a year. Almost everyone I know is trying to raise money for a prosthesis on their own, besides they have to raise money for warranty service or insurance against breakdowns.

• I have high hopes for 3D printing - this is the only way to "rein in" greedy corporations. Printing prostheses on 3D printers will allow many people to have good prostheses. I think it's wrong when large companies benefit from people's failures.

Nigel Ackland

On this optimistic note, I will once again remind you that the future is coming and our team is already doing everything today for the appearance of affordable high-tech prostheses in Russia. The bioelectric Stradivarius brush is already on the way. Follow the news!

If you are legally entitled to a prosthesis, but you cannot get it due to bureaucratic delays, write to us and we will do our best to help you.

Portal "Eternal youth" http://vechnayamolodost.ru  18.04.2017