Your points are well taken, Arch. I'd like to point out that nearly all the points you mention (quoted below) are due to an ever-intrusive government increasing the cost of bringing new technologies to the market, for the most part.
(12-14-2012 04:09 PM)archangle Wrote: Given that we're going to be stuck with:
[*]A broken patent system that makes it impossible for anyone other than the big boys to make devices anymore.
Absolutely correct. This is due to over-reaching regulation that makes it next to impossible for small-time CPAP manufacturers to compete, due to excessive cost of compliance with government regulation. The economies of scale is the only thing that is allowing even the big boys make devices at a profit today. No chance for innovative little guys to enter into the market due to the high cost of governmental compliance that is forced upon manufacturers.
Quote:[*]An oligopoly of device manufacturers. Be realistic. There are only two major manufacturers of CPAP machines today.
Completely correct again-- due to all the reasons I stated above. Too expensive for small companies to enter into the market and comply with all the massive regulation.
Quote:[*]A broken insurance/medical system that goes for the lowest cost choice no matter the consequences to the patient.
Again, this is due to an over-reaching desire to lower cost by legislation and regulation (government) rather than letting the free market dictate prices, where patients and doctors can make decisions. Today, we're willing to hand over the decision-making process to a nameless, faceless insurance/Medicare/Medicaid "decider", who is far-removed from the patient and doctor.
Quote:[*]Companies that will cut corners to save pennies, even though it costs lives.
Again, due to the fact that massive government regulation and taxes forces companies to use all excess funds to comply with regulations, leaving the profit margins so slim that they are forced to cut corners in order to stay competitive. Like any large business, CPAP manufacturers must attract investors, and they compete for investment dollars in the capital stock and bond markets just like any other corporation. If they don't produce a decent profit, investment money will go to where it's treated better - into other non-CPAP industries. In other words, if I had $100,000 to invest, why would I invest in a CPAP company making a return of 5% when I could invest in another industry and make a return of 7%? Profit margins matter.
Quote:[*]A broken legal system that doesn't properly punish the big guys when they do something wrong and hurt someone. And then punishes the innocent.
Completely agree. The U.S. legal system is a huge mess.
Quote:[*] A vast army of sheep consumers who wouldn't know a good, safe, machine from a bad one. The sheep outweigh us smart consumers and we'd simply be ignored.
We do need regulations to protect the interests of the consumer.
Granted, many folks don't know a bad CPAP from a good CPAP, but that is slowly changing. I think we can't completely discount patient intelligence on these issues. If given a chance, an independent and fair non-governmental system could be developed whereby CPAP machines can be rated by both patients and health care professionals - and folks can purchase them based upon those ratings and comments. To some degree that's being done with online DMEs and these forums. Heck that's done on Amazon and millions of products are sold every day based upon those ratings and comments with pretty good success. Produce a lousy product and sell it on Amazon and you'll be out of business within months. If CPAPs were sold that way, rotten products would be forced out of the market quickly.
But currently, we have a governmental Medicare and insurance reimbursement system that is responsible for DMEs actively pushing low-end brick CPAPs over data-capable CPAPs, simply because the insurance/Medicare regulations have made it more profitable for DMEs to do exactly that. In any normal unregulated market, these DMEs would try to sell you a higher-end data-capable machine, because the slightly higher cost would give them a higher profit margin. In our topsy-turvy regulatory world, we have a crazy system that motivates DMEs to sell you a piece of junk over a quality data-capable machine. That's just nuts.
Quote:I'll say it again, though. The cost to comply with these regulations will be very minimal per machine and will be well worth the cost to the patient. This stuff is just not that difficult to do.
There is only one reason why the large CPAP manufacturers will resist making these improvements: it increases cost of production
. It's a simple business decision on their part. Take away the taxes and costs involved with intrusive, massive and ridiculously complicated regulatory health care laws, and it will free up all sorts of funds for companies to make a better product in response to consumer wants and needs.
But, that's probably not going to happen, given our socialistic tendencies as of late. The public will undoubtedly clamour and shout that we need our BIG BROTHER 'savior' government to come protect us from every little risk in life
, and they will continue to increase taxes on both corporations and individuals, expand regulations and federally micro-manage of all these businesses; and THAT will be the death of our economy and the end of any type of sensible health care system, eventually. Heck, that process is already well under way now. I don't have high hopes that it can be reversed without first coming to a complete crash of the current unsustainable system.