DCwom, I'm not sure what you're saying but you seem to be saying that "capitalism" is to blame for the corruption and twisted priorities of our "medical system"...
If you think we have real "capitalism" in the U.S. medical markets today, I think you need to re-evaluate this position. What we have is a socialistic and heavily regulated and governmentally-controlled medical system. Hardly capitalism
at all - and definitely not a "free market". (and next year when Obamacare begins, it will be even more socialized).
Too many people want to "blame capitalism" for all the ills of this medical "system", when that's not at all what we have. You need to blame "socialized medicine" or at least "government-controlled medicine", I think, because that is basically what we currently have in the U.S.
The health care insurance industry is already a mess of hard-to-understand (and sometimes conflicting) rules, regulations, procedures, etc. governed by numerous laws created and enforced by numerous governmental agencies.
The DME industry is also.
The hospitals, labs, sleep centers, doctors, etc. are also.
or a free market
Quote:When something becomes a commodity profits drop, innovation wanes, and investment drys up
Where did this come from?
Everything that is sold and bought is a "good" or a "commodity", including all goods and services offered by the medical companies and service providers. It is the ability for companies to freely market and sell their goods and services which allows for competition in the market, price stability for consumers, etc. The competitive market (if we had a true capitalistic market here) would incentivize companies to innovate and invest in new ways to deliver a better machine or service so that they can gain greater market share.
It is not
a free, capitalistic market that is causing DMEs to distribute low-end, non-data capable CPAP machines to patients - it is the socialistic government's reimbursement regulations for Medicare and Medicaid Services (http://www.cms.gov
) and the Dept of Health & Human Services and their numerous sub-agencies and divisions that is causing this. DMEs get reimbursed the same amount for CPAP by Medicare, Medicaid and insurance companies (who follow CMS rules & regs). This stupid government-supported reimbursement schedule is what makes it profitable for a DME to give a patient a low-end CPAP rather than an APAP. This is direct governmental interference into the free market pricing structure.
We've talked about this before on Apnea Board. As a general rule, DMEs get reimbursed roughly $1500 for a CPAP, whether or not it's a non-data-capable low-end piece of junk or a nice fully data-capable APAP. So, given this lousy governmentally-ruled "system", the DME would rather give the patient a low-end machine that cost them $500 (they make $1000 profit that way [$1500 - 500 = $1000 profit])... rather than giving them a nice data-capable APAP that cost them $1000 (they only make $500 profit that way [$1500 - $1000 = $500 profit]). Both CPAPs and APAPs have the exact same billing code and reimbursement schedule.
In a true capitalistic system, a supplier would make a mark-up percentage on the item sold. So a DME would make more money by pushing APAPs into the market - because in a true free market, they would make more money as a percentage of the purchase price (generally APAPs cost more than CPAPs). So if the stupid government would get out of the way and let the free market decide the price of CPAP machines - the DMEs would have an incentive to push APAPs, rather than low-cost, non-data-capable CPAPs.
For instance, in a truly free market where a DME would have a price markup of 20% on CPAP and APAP machines, they would rather sell a higher-end APAP, because they'd make more money. (20% of a $1000 APAP is a lot better than 20% of a $500 CPAP)
But no, we can't have that in the U.S. - instead, we have a myriad of confusing laws and regs enforced by numerous agencies, departments and divisions of government to "protect us from ourselves". The disappointing result of this over-regulation is that the patient gets poorly served with machines of lesser quality, all at a higher overall cost.
But, it doesn't matter. The whole stinking world is moving more and more towards socialism and these systems are all going to crash and burn eventually. Soon, countries won't be able to support these programs. Just keep your eye on the wonderful "socialistic utopias" of Europe over the next few months and see how it all turns out when government decides it knows better than the free market.
As Margaret Thatcher said, "The problem with socialism is that eventually you run out of other people's money to spend