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[Equipment] Black Friday APAP purchase?
#11
RE: Black Friday APAP purchase?
(11-27-2017, 10:04 AM)Phill Wrote: Clearly I am missing something here, but are you unhappy with the supply of equipment from "Your NHS". Dielaughing

And of course the never to be forgotten "NHS Choices".

Phill

Guys Hospital clearly notes on their web-site that they only dispense CPAP. I do not know whether they would have prescribed BIPAP or ASV as I did not/do not have any other complications which might have required it having 'simple' OSA.

I got a Resmed Airsense 10 Elite with humidifier, climate line heated tube, and filters as well as a FFM all FREE from the NHS. When it was clear to them that the FFM did not suit me, I was told to get a fitting for the P10 after which it would be on order for me to collect FREE. So I actually was dispensed for me, life saving equipment at a cost of about £1000.00 free. However the fitting at the Resmed shop was going to cost £25 but this £25 fitting charge would be rolled into final cost of £80 if I bought it there and then with a 10% discount immediately on becoming a member.

As I wanted to get resolving therapy ASAP with wanted the CPAP to work, I therefore paid for the P10 myself. There is no stopping anyone from paying out of pocket for their own healthcare here, as you know. Feel free to do so at any point, Phil, if that makes you happier rather than knocking the NHS.

I would have tried to make a case for changing the CPAP to an APAP had my therapy not worked. Many here in the forum helped me to 'settle' and settle I did with no 'formal' need for an APAP from the NHS. The Resmed Black Friday offer was so good but I have missed it now as I tried to buy it after investigating alternatives from Jason and Reznik earlier on. This is despite it being earlier than midnight deadline here.

Thanks guys, I arrived home about 2 hours ago and got going after dinner. I suppose there is no real time limit on Jason's suggestion. Thanks guys but I shall continue to look to get a 'For Her' model. I am intrigued to self titrate with the P10 and cervical collar.
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
#12
RE: Black Friday APAP purchase?
Check the vendor as there is a phone number there and maybe an international call will get you a for her model. Rather than the black model.
#13
RE: Black Friday APAP purchase?
Check your PM
#14
RE: Black Friday APAP purchase?
(11-27-2017, 05:10 PM)Apn ea Infant Wrote: I would have tried to make a case for changing the CPAP to an APAP had my therapy not worked. Many here in the forum helped me to 'settle' and settle I did with no 'formal' need for an APAP from the NHS. The Resmed Black Friday offer was so good but I have missed it now as I tried to buy it after investigating alternatives from Jason and Reznik earlier on. This is despite it being earlier than midnight deadline here.

Thanks guys, I arrived home about 2 hours ago and got going after dinner. I suppose there is no real time limit on Jason's suggestion. Thanks guys but I shall continue to look to get a 'For Her' model. I am intrigued to self titrate with the P10 and cervical collar.

Here in the U.S., there was a time when APAP machines were considerably more expensive than CPAP machines. That doesn't seem to be the case any more. Either that still is the case in the UK, or the policies in the UK are still driven by the belief that it is the case.

I paid $14,000 for my healthcare this year, including $7,200 in premiums for my family and about $6,800 reaching my out of pocket maximum.

I would be delighted to live in a place where those costs were rolled into my tax burden, and the hospital had a cashier that gave out money for travel expenses.
#15
RE: Black Friday APAP purchase?
(11-27-2017, 05:51 PM)Reznik Wrote:
(11-27-2017, 05:10 PM)Apn ea Infant Wrote: I would have tried to make a case for changing the CPAP to an APAP had my therapy not worked. Many here in the forum helped me to 'settle' and settle I did with no 'formal' need for an APAP from the NHS. The Resmed Black Friday offer was so good but I have missed it now as I tried to buy it after investigating alternatives from Jason and Reznik earlier on. This is despite it being earlier than midnight deadline here.

Thanks guys, I arrived home about 2 hours ago and got going after dinner. I suppose there is no real time limit on Jason's suggestion. Thanks guys but I shall continue to look to get a 'For Her' model. I am intrigued to self titrate with the P10 and cervical collar.

Here in the U.S., there was a time when APAP machines were considerably more expensive than CPAP machines.  That doesn't seem to be the case any more.  Either that still is the case in the UK, or the policies in the UK are still driven by the belief that it is the case.

I paid $14,000 for my healthcare this year, including $7,200 in premiums for my family and about $6,800 reaching my out of pocket maximum.  

I would be delighted to live in a place where those costs were rolled into my tax burden, and the hospital had a cashier that gave out money for travel expenses.
Reznik

Firstly, thanks very much for your PMs re the links to get the For Her model. Same to Jason too.

The NHS here is very precious and most of us treasure it and would want it to continue. Our taxes are high but not extortionate. The Scandinavian countries pay much more. Prior to recent apnea issues, I have not 'used' the NHS resource excessively apart from some visits to the GP and getting prescriptions cheaper than over the counter. I have 2 lovely children delivered under the auspices of the NHS and cannot fault the care from the first gynaecological visit to the 10 visits by the Health Visitor after each were born. My daughter had urinary reflux which the Health Visitor discovered, as despite looking like a Sumo Wrestler at birth, her weight dropped slightly which started many years of visits to the Paediatrician till at age 12 when she was 'discharged'. Reflux can lead to kidney infections and high blood pressure etc. Both mine have a series of other little illnesses not worth noting here. But the point is, the care and support is second to none.

I would be decimated financially if I had to pay for all that myself. I am happy to financially support the social system here through my taxes for all to benefit. Apparently the NHS healthcare provision is very cost effective per capita. Definitely it has ever increasing costs due to a variety of reasons.
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
#16
RE: Black Friday APAP purchase?
To cut through the flannel, nothing is "FREE" as you mention frequently, many do not consider the NHS to be a treasure but believe it to be a state run monopoly that will never improve all the time treatment options are more or less restricted to the one provider, something like the old Soviet Union.

Of course I have used private healthcare, this being no panacea as you will most likely be dealing with the same medics as you would be under the NHS, though in more pleasant surroundings and jumping the waiting list, avoiding the proles in the NHS waiting rooms is a big plus.

Despite you protestations clearly "Your NHS" did not work for you as you had to purchase your own machine, out of taxed income, not a system to shout about I would have thought.

Now this sounds a little more like it!

After reading posts about the condition of hospitals in the UK , both good and bad and emails from my brother on service for my sister-in-law, plus two cousins complaining of both doctors and hospitals,I thought I would write a post about my visit accompanying a patient yesterday to the Medical University of South Carolina, Ashley River Tower Hospital, while it is fresh in my mind.



At 6:15am we parked the car on the third floor of a nine story parking garage and walked a short distance to what is called a skywalk a glass enclosed pedestrian walkway connecting to Ashley River Towers Hospital which is one of five hospitals grouped together that form the Medical University of South Carolina in Charleston.

We left the skyway and entered another glass enclosed corridor then automatic doors opened and we entered the hospital proper.* The first thing we noted was a concierge station and two receptionists to direct you to were you should go.* Next nearby was a baby grand* piano, silent now, but from noon to 4:00 p.m. volunteer musicians and music teachers etc. play show tunes or light classical music.,* It's a nice soothing way to enter a hospital environment.* next you would be instantly aware you were in a massive* atrium, five stories high and half a city block wide, a glass enclosed open space that rose five floors above and the glass ceiling way up that flooded the place with natural light.* Central were three flights of stairs going down to ground level. Naturally there were side elevators for use as well.

We walked down the staircase and entered the registration area.* Insurance etc. was verified and we were given instructions where to go for our appointment, smoothly and efficiently, and asked if we parked and for our ticket it was stamped and we were told it would be for a maximum three dollar charge for each twenty-four hours of a patients stay or day visit..

As instructed we took an elevator to the third floor.* On board were other patients, doctors, nurses etc. everyone said good morning to us as we entered, the closest to the door asked our floor and punched it onto the elevator keyboard.* Charleston, S.C. has won the title "The most friendliest city in the USA" for years and new arrivals soon get into the urge to retain that title, and friendly greetings are the norm.

We left the elevator on floor three. A receptionist asked if she could help us and directed us to our area.* Again the perimeter was all glass and I could see the small boat mariner and harbor area* of Charleston harbor.* We checked-in and a comfortable waiting area set-up in small groupings, armchairs, couches around coffee tables with current magazines available plus there was a complimentary twenty-four hour individual regular and decaffeinated coffee brewing station, very welcome at 6:45am.

At seven a.m. my patient's name was called and followed an attendant who led the way into the surgical area.* At around 7:30 a.m. I was called and escorted to the room were the patient was prepped ready for the surgical procedure.*

A screen was displaying vital signs, and the nurse was typing away on a computer.* All allergies were double checked and identified by bracelets.* Medical history was verbally gone over.

Next a senior resident came in and the procedure to be used was explained, plus how a recover would follow and that the surgeon would stop by and discuss the completed surgical procedure and* follow-up etc.

A resident anesthesiologist* was next and using the in-room computer station verified name date of birth and the patients knowledge of what was to be done.* She reviewed the patients medical chart, triple checking meds, allergies and past medical history.* This additionally had been handwritten on a large white board, visible to all who came in the room.

She explained the type of anesthesia that would be used and the name of the head anesthesiologist in charge.

7:50am and the patient was rolled away a little sleepy already.

The room was comparable to a very good hotel standard, modern furnishings and spotless.* The walls were decorated with photo scenes of the* Charleston area.

The nurses wore colored tops and pants as did the nursing assistants each with there own color, I assume for easy recognition.* The orderlies that* pushed the gurney wore a modern track suite of yet another color.

An attendant brought me a cup of coffee while I waited in the room.

The procedure completed, we had a three hour wait for a couple of x rays to be taken to confirm all was in order, which it was.* In between the surgeon came in and briefly explained what he had done and how the procedure went from his p.o.v..* No problems.

The last x ray was taken and the doctor okayed that the patient could resume eating and drinking.* The nurse brought in a menu, anything could be ordered off the cafeteria/dining restaurant menu.* She said the time would be anytime up to three quarters of an hour or they had pre-made picnic boxes, Juice, milk or coffee.* A picnic box was agreeable, as the patient had not eaten since the previous dinner and was starving.* The box meal consisted or a cheese and turkey sandwich on whole wheat bread. A packet of graham cracker cookies, a bag of baked chips (crisps) and a container of apple sauce and a small can of coke.

The patient was discharged with follow up instructions.

I left to get my car, vacated the garage and paid three dollars parking drove around the hospital and up a large circular ramp and the patient was waiting seated in a wheelchair with an attendant to see to the car door and give assistants.

Thus ended a trip to the hospital.* Both the patient and I are senior citizens, U.S. Medicare is our primary coverage for which a senior pays one hundred dollars a month out of a monthly pension for 80% coverage, the remaining 20% is covered by a supplemental insurance policy @ $420.00 a month, the patients was roughly the same.

Out-of-pocket for the day was gas for the car and $3 parking.

Results are coming in daily on one's computer on what is called "My Chart" which is the patients complete medical history which can be seen only by the individual patient and his/her doctors and other doctors (who must I.D. themselves before access).

Currently all the results from tests taken during this visit are being posted.

I know it's a bit lengthy and I've tried to give all details no matter how mundane to give you an awareness of the medical system I am exposed too.

I have limited experience of UK hospitals.* My one visit was to visit my grandmother in Whips Cross General Hospital in 1993.* She was stuck in a ward for about sixteen, with a tatty screen in want of being turned into polishing rags for privacy.* And while I, my wife and my Canadian first cousin visited, a nurse brought her a cup* of tea, with milk, six sugar cubes, and two chocolate covered digestive biscuits....My grandmother was a diabetic, which my pished off cousin quickly pointed out and was sharply told one cup of tea wouldn't harm her!* That and the general ancient age of equipment and facility did not impress us.* Still that was a long time ago and my only introduction to the NHS.

My only other exposure to Europe's system was my car was broken into in Seville, Spain and a bag stolen which contained my medication.* I went to the Seville University Hospital to get a replacement prescription.* We did, but it was scruffy and dirty, as were the hospital employees and most patients and staff were smoking.* And this was a medical university hospital who's existence is to train their nations future medical staff.

I guess the answer is if we are all happy with our medical system regardless it's the right one for each of us.* I just thought my report on a hospital visit in the USA may be of interest.

A link to Ashley River Tower:

https://www.bing.com/search?q=ashley...=en-US&PC=DCTE

If you click on to the links you will see the ground floor concierge station, if you look behind them you will see the stairway I mentioned and at the top is the piano station.*
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#17
RE: Black Friday APAP purchase?
And for all of that, you incurred expenses that are 10x what the services would have cost in Canada or the U.K.  If you have insurance, you'll end up paying for it in premiums.

I went to the ER in New York City over the summer and was stuck in the hall the in a dingy ER the entire time.  There were blood droplets on the floor, and nobody ever came to clean them up.  I waited three hours to be seen while I suffered from severe abdominal pain.  I was offered no medication for pain, and was discharged without any relief.  And for that, I also paid 10x what it would have cost in the U.K. or Canada.
#18
RE: Black Friday APAP purchase?
Thanks to Reznik I am now the proud owner of the Resmed Autoset for Her. Cant use it yet-have to get an adapter and will use it this weekend.

To Phil, just to clarify your apparent misunderstanding - I have been using Resmed Elite successfully for the last 7 months with a climate line heated tube obtained FREE at collection from the Sleep Clinic. Of course we all pay for the NHS through our taxes which I have done for the last 30 years. As I personally wanted to have a spare I decided the legendary For Her model would be worth the investment and have decided to buy it myself.

I watched a programme, again on telly, about how Americans who did not have private medical insurance queued round the block on occasion when free doctor's consultation was available. And this was only to diagnose any condition they might have. Most of them would not have been able to afford treatment as this was not free. Perhaps the Americans on this forum would confirm or deny this. Do all who cannot afford private medical insurance qualify for Medicare and thus medical consultations/treatments? I have family in America who inform me they only have access to medical care as the insurances are available as a perks of employment.

I have paid for medical operations in parts of the world in hospitals which are like 7 star hotels. I have stayed privately in luxurious medical rooms by myself but boy did I have to pay for it. So that is right, nothing is free but there is economy of scale in the NHS and consultations/treatment is free at the point of need. The measure of a civilised society is one which cares for those who can't care for themselves. The UK is far from Utopia but it is better than a few places on this earth.

This thread has served its purpose in buying online and would be grateful if the mods can close the thread for me.
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
#19
RE: Black Friday APAP purchase?
Yes, the NHS may not be perfect, but most here would pay twice as much for it rather then loose it.
Same goes for pensions, most would pay twice as much.
Ok, some areas the NHS may not be perfect and they do some treatments maybe they shouldn't (Such as giving people a family they might not otherwise have) but it is the envy of most of the world.  Yes, out hospitals are a bit run down and there are waiting lists.  It is a bit of a postcode lottery where you stay and the care you get.  But I would gladly pay twice as much to keep it.  It also suffers form people coming from abroad to have operations and visitors fall ill and get free care (though they should have medical insurance like everyone has to have to visit other countries) and people that come to this country and get instant care and handouts (which is wrong) but private care has risks as well and a recent report showed that you were even more at risk of an infection at a private hospital.
However, that said, this forum is not about the NHS or the UK in general.

It is for the use of CPAP users that would like a little help and not for people to slag off others and the Uk!
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
#20
RE: Black Friday APAP purchase?
(11-30-2017, 04:18 PM)Apnea Infant Wrote: Thanks to Reznik I am now the proud owner of the Resmed Autoset for Her. Cant use it yet-have to get an adapter and will use it this weekend.

You're welcome.  I'm glad that I could help!

(11-30-2017, 04:18 PM)Apnea Infant Wrote: To Phil, just to clarify your apparent misunderstanding - I have been using Resmed Elite successfully for the last 7 months with a climate line heated tube obtained FREE at collection from the Sleep Clinic. Of course we all pay for the NHS through our taxes which I have done for the last 30 years. As I personally wanted to have a spare I decided the legendary For Her model would be worth the investment and have decided to buy it myself.

FYI- Here in the U.S., insurance covers one machine every five years.  If we want a backup, we also have to pay for it out of pocket.

(11-30-2017, 04:18 PM)Apnea Infant Wrote: I watched a programme, again on telly, about how Americans who did not have private medical insurance queued round the block on occasion when free doctor's consultation was available. And this was only to diagnose any condition they might have. Most of them would not have been able to afford treatment as this was not free. Perhaps the Americans on this forum would confirm or deny this. Do all who cannot afford private medical insurance qualify for Medicare and thus medical consultations/treatments? I have family in America who inform me they only have access to medical care as the insurances are available as a perks of employment.

What you've seen is absolutely true.  There are nonprofit organizations that travel to various parts of the country providing medical care in tents as if the U.S. were a third world country.  There are also a pair of women who drive through some of the poorest parts of the U.S. in a motorhome providing care that were featured on 60 Minutes a few years back.  In many large cities, there are also "free clinics" that provide very basic care to the poor, but their resources are very limited.

The ironic thing about it is that the places where this is most common are the places that voted for Trump, and he's doing everything he can to dismantle these programs by cutting the government funding that they get, or, in the latest tax bill, taking away the income tax deduction for the private charitable contributions that make up the rest of their budget.

Medicare is only available to senior citizens.  Ironically, they get the most care and the most expensive care and insurance companies won't cover them.  So, the U.S. taxpayers all split the cost of the oldest and sickest, while the younger and healthier people must buy private insurance from companies that keep the profit.  So, by taking the old and sick out of the pool, the U.S. taxpayers are essentially subsidizing the insurance companies.  It'd be more efficient to let everyone join Medicare and then use the profits from the young and healthy to subsidize the old and sick, but that'd be too sensible and so it has never happened.

There is another program called Medicaid, but it only covers the truly destitute, and the coverage is so bad that many doctors refuse to accept it.

Obama's Affordable Care Act actually helped quite a bit.  Previously, you were only guaranteed the ability to buy insurance if you had a job and were part of an employer group.  Typically, the employer covered part of the cost and you had to pay the rest.  If you didn't have a job, or were self-employed, you could try to buy coverage on the individual market, but the insurance companies would refuse to accept your application if you had a "pre-existing condition," which meant anything that they thought might cost them money.  

This was especially a problem for people whose medical conditions made it impossible to keep their job.  So, a cancer diagnosis might mean that you lose your job, lose your insurance, and be unable to buy it on the individual market because you have a pre-existing condition.  Then because you didn't have insurance, you didn't get the care, and so you died.  Now, any American has the right to buy insurance even if he doesn't have a job.

Also, it used to be that if you had individual insurance and your insurance company removed your doctor from the plan, you might not be able to switch to another plan and keep your doctor.  The most important time to keep your doctor is when you get an expensive medical condition, and so if tried to change plans, they'd deny your application to change based upon your pre-existing condition.  Now, you can switch, even if you've developed a pre-existing condition in the interim.   Also, since insurers only operate on a State level, if you wanted to move from one state to another, you couldn't do so because you'd lose your insurance policy and might not be able to get another one if you had a pre-existing condition.

And if you did get insurance and then you got sick within a few years thereafter, they'd send an investigator out to investigate your medical history, and then use the most paltry of excuses to rescind (cancel) your policy claiming that you lied on your insurance application.  They refund all the money you paid for premiums, stop paying for your needed treatment, and then sue you to get back what they have paid for the treatment.  Typically, the person would die, and the insurance company would take their house, cars, etc.  This happened so frequently, especially if you contracted an expensive disease, that it got its own name:  It's called "post claims underwriting."  Several states made it illegal, but the insurance companies did it anyway.  

The ACA also currently provides tax credits that will reduce the cost of insurance for most Americans.  However, many conservatives, including the two-person 50-something husband--and-wife team that cleans my house, refused to sign up for it because they've been told that "Obamacare" is bad.  They both have developed medical conditions and are not seeking treatment for them.  I've tried to explain to them that with the subsidies, they could get a really good policy (better than mine) for about $50 a month, but they won't hear of it.

I'm very fortunate to earn so much that I don't qualify for the tax credits.  Last year, I spent US$7,500 in insurance premiums for a three person family.  Those premiums didn't cover any care, other than an annual physical exam by my primary doctor.  My plan is a high deductible plan.  I don't get any coverage until I spend another US$6,000 in out-of-pocket expenses for myself or US$12,000 total for my family.  Next year, the premiums are going up even higher, and the insurance company has taken away all travelling coverage except for emergency visits.  That means that if I go out of my local area, I see a doctor at my expense unless it is an emergency.

I have a friend who is an allergist.  He runs 5 offices in Southern California.  He employs SIX administrative personnel whose SOLE job is to process claims with insurance companies.  That's SIX people who receive full-time salaries and benefits, but who provide zero care to patients.  They spend all day phoning insurance companies that have refused or failed to pay for services that he rendered or have failed to respond to requests for pre-authorization, usually claiming that they never received paperwork that his staff have sent over multiple times. The insurance companies presumably employ another six to answer all of their inquiries.  All of these costs end up getting factored in to the cost of the insurance I buy and the care that I receive.  It's an enormous waste of time and money.

Insurance companies also use the "pre-authorization" process to delay care.  It took me three-weeks AFTER my OSA diagnosis to MAKE AN APPOINTMENT TO GET A CPAP, because that's how long my insurance company took to issue the authorization.  It then took another two weeks to get into the medical equipment provider to get the unit.  Then I found out that my insurance company was only RENTING the unit until I meet compliance.  Once I meet compliance, it's $1,700 for a ResMed AirSense 10 AutoSet.  Once I found this out, I just bought one myself online for $550.00 (though I got the "For Her" version since it was cheaper).

(11-30-2017, 04:18 PM)Apnea Infant Wrote: The measure of a civilised society is one which cares for those who can't care for themselves. The UK is far from Utopia but it is better than a few places on this earth.

Amen to that.  Canada's pretty nice as well.


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