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What the Manufacturers REALLY Think About the Patients
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PsychoMike Offline

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Post: #21
RE: What the Manufacturers REALLY Think About the Patients
Yup, I sometimes hate to admit it, but I have to agree with the "medical mafia" moniker, at least as far as DMEs are generally concerned. Especially those in the US who are on some insurance lists (names withheld to protect the guilty).

When I started xPAP therapy, I got lucky and got a data capable machine. My first couple visits to my DME were less about getting me comfortable and optimizing treatment and more about whether my AHI was less than 5 and I was compliant. Concerns about the mask fit were more or less met with the "you're just not used to it yet" response.

When, thanks to some knowledge gained here, I started actually looking at my treatment numbers and working to optimize it myself NOT ONE of the DME's respiratory therapists even registered that the settings had changed significantly between each visit. They were all just shocked at how good my AHI was and were of the attitude of patting themselves on the back for how good of a job they must be doing. When the constant billing errors got old, I found a new DME.

I told my new RT that I would either be his best patient or his worst, depending on what was going on. I then floored him with how actively I was involved in my treatment and how well optimized I had gotten it (with the full blessing of my regular doctor). Now, he's content to ask if I have had any problems while giving the download a glance...he can actually spend time with me as a patient and find out what might make my therapy better / more comfortable (like trying a new mask design, getting feedback on the current mask, helping with actually fine-tuning my mask fit). TBH, it's great...I think he enjoys me as a patient and knows that if something isn't working, he'll hear about it.

If the ResMeds, F&Ps, PR's and other "biggies" in the industry cannot figure it out that, although they market to DME's, the patient is the overall customer...well, then they may just find a patient revolt on their hands. It only takes one to have a shift to dealing with the patient to make all the others into dinosaurs. Sure, not everyone wants to be actively involved in their therapy...but monetizing, incentivizing and dealing only with the DMEs doesn't help the DME see the patient as anything other than a paycheque. We're a monetary asset to most DMEs, not people / patients with a medical condition.
12-07-2015 05:17 PM
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eseedhouse Offline

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Post: #22
RE: What the Manufacturers REALLY Think About the Patients
(12-05-2015 11:08 PM)Mark Douglas Wrote:  Root cause analysis tells us gvt interference in market place is why medical care cost so much in the US of A.
Rant off Rolleyes

Rants should at least be based on some facts. For instance in Canada where we have a whole lot more "government interference" in the market place, medical costs are in fact much less as a percentage of GDP, and with equal or better performance. And this is true everywhere where single payer government health insurance has been introduced. I don't know what "Root Cause Analysis" shows (or even means, come to that) but I know that a counterexample disproves a theory and that there are a whole lot of counterexamples to your particular theory.

And the reason for this is something called the law of large numbers which was discovered over a century ago and made, among other things, the Life insurance industry possible. The law of large numbers isn't opinion, it's mathematical fact.

Ed Seedhouse
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I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
(This post was last modified: 12-07-2015 05:54 PM by eseedhouse.)
12-07-2015 05:49 PM
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Ghost1958 Offline

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Post: #23
RE: What the Manufacturers REALLY Think About the Patients
(12-07-2015 05:49 PM)eseedhouse Wrote:  
(12-05-2015 11:08 PM)Mark Douglas Wrote:  Root cause analysis tells us gvt interference in market place is why medical care cost so much in the US of A.
Rant off Rolleyes

Rants should at least be based on some facts. For instance in Canada where we have a whole lot more "government interference" in the market place, medical costs are in fact much less as a percentage of GDP, and with equal or better performance. And this is true everywhere where single payer government health insurance has been introduced. I don't know what "Root Cause Analysis" shows (or even means, come to that) but I know that a counterexample disproves a theory and that there are a whole lot of counterexamples to your particular theory.

And the reason for this is something called the law of large numbers which was discovered over a century ago and made, among other things, the Life insurance industry possible. The law of large numbers isn't opinion, it's mathematical fact.
Cant go aling with better performance.
Socialsed medicine means
Gotta hve a cpap before you might get apap or better.
Huge waiting times.
No choices.
Sub stamdard care in many areas.

Obama care has taught us here the folly of government run health care.
Tbe faster its abolushed the happier we will be.
But glaf your happy with the system you have.
12-08-2015 12:55 AM
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DeepBreathing Offline
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Post: #24
RE: What the Manufacturers REALLY Think About the Patients
(12-08-2015 12:55 AM)Ghost1958 Wrote:  Cant go aling with better performance.
Socialsed medicine means
Gotta hve a cpap before you might get apap or better.
Huge waiting times.
No choices.
Sub stamdard care in many areas.

Obama care has taught us here the folly of government run health care.
Tbe faster its abolushed the happier we will be.
But glaf your happy with the system you have.

There was a thread floating around some time back (pre-Obama care) with statistics that showed the USA system had higher costs for worse outcomes than comparable countries, most of which have a higher level of government involvement in the health system.

I've worked most of my life in the private sector, where profits are our primary motivation. So I'm by no means a socialist. However, I'm not convinced that profits should be the only motivation in the health care sector, which would happen in an entirely privatised system. The inevitable outcome is that you will have a population of wealthy individuals who can afford excellent care, and those who get virtually nothing. Hence society needs to step in to provide a safety net in some form or another. There are many such models, some of which work better than others.

Here are some articles which may illustrate the situation and the fact that you can't just run a simplistic argument...

http://www.forbes.com/sites/danmunro/201...countries/

https://theconversation.com/what-can-we-...tems-30885
https://theconversation.com/creating-a-b...ands-30270
https://theconversation.com/creating-a-b...land-30144
https://theconversation.com/creating-a-b...pore-30607
https://theconversation.com/creating-a-b...eden-30366
https://theconversation.com/creating-a-b...ates-30266
https://theconversation.com/infographic-...tems-30784
https://theconversation.com/australian-h...ally-30886

I haven't read all those article, but I have read enough to show that it's very complex with no simple answer.

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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.
12-08-2015 01:50 AM
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Sleeprider Online
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Post: #25
RE: What the Manufacturers REALLY Think About the Patients
I think the conversation is wandering off-topic discussing centralized government health care vs private insurance. The question was what do the manufacturers think about the patients. That has little to do with the insurance framework, and everything to do with the regulatory framework in which machines are sold. At this point, manufacturers develop their machines in accordance with FDA or other international health regulations to demonstrate efficacy in the treatment of Sleep Apnea. The R&D aspect is done pretty much free of the pressures of direct marketing since the intended consumers are legally the DMEs and medical practitioners regardless of whether the government runs the health care system or insurers. Remember, the manufacturer's attitudes and behavior towards patients existed in the U.S. before the ACA was even dreamed up.

If you perceive the manufacturers as disconnected from patients being a problem, that problem is unrelated to what type of insurance pays the bills. The only way manufacturers change their culture is if CPAP and related equipment becomes dis-coupled from the prescription and DME environment, and that is unlikely at this point. The "system" requires manufacturers to comply with medical standards for equipment development, distribution and servicing. The decision whether or not to provide clinician manuals and more diagnostic software is not entirely made at the manufacturer level, and I'm not aware of a regulatory mandate that prevents the distribution of clinical and technical information to patients, although this seems to be policy. So where is the problem? Why can't manufacturers make their clinical information more public?

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(This post was last modified: 12-08-2015 09:27 AM by Sleeprider.)
12-08-2015 09:20 AM
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SuperSleeper Offline

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Post: #26
RE: What the Manufacturers REALLY Think About the Patients
(12-08-2015 09:20 AM)Sleeprider Wrote:  Remember, the manufacturer's attitudes and behavior towards patients existed in the U.S. before the ACA was even dreamed up.

Good point. I admit I'm extremely frustrated that I (as a taxpayer) am forced to pay for the healthcare of others. Now under the ACA, I can't even afford to pay for my own health care insurance. And yet I'm forced to not only pay for the healthcare of other people through the income tax system, but I also have to pay a penalty fee for not having my own insurance on top of that, and I still have to pay for my own health care 100% out of my own pocket. It's theft of my money, plain and simple, and I'd vote in a heartbeat to go back to the system we had prior to ACA. I was spending less on taxes and was able to afford a somewhat reasonable health care insurance policy back then.

But what do I know? I'm just a middle-class schmuck who exists to provide funds to the state. Too-funny

I sat down once and figured out that when I consider all the taxes I pay, it's something close to $4 of every $10 I make goes to some form of tax. I have to work nearly 5 months out of every year just to pay all the various taxes! Income tax is just a small part of the whole we pay to governments each year.

The list of taxes Americans now pay is amazing. Here's just a partial list: Air Transportation Taxes, Building Permit Taxes, Business Registration Fees, Capital Gains Taxes, Disposal Fees, Dog License Taxes, Drivers License Fees, Automobile Registration Fees, Employer Health Insurance Mandate Tax, Employer Medicare Taxes, Employer Social Security Taxes, Environmental Fees, Estate Taxes, Excise Taxes On Comprehensive Health Insurance Plans, Federal Corporate Taxes, Federal Income Taxes, Federal Unemployment Taxes, Fishing License Taxes, Food And Beverage License Fees, Gasoline Taxes, Gift Taxes, Gun Ownership Permits, Hazardous Material Disposal Fees, Highway Access Fees, Hotel Taxes, Hunting License Taxes, Import Taxes, Individual Health Insurance Mandate Taxes, Inheritance Taxes, Insect Control Hazardous Materials Licenses, Inspection Fees, Insurance Premium Taxes, Interstate User Diesel Fuel Taxes, Inventory Taxes, IRA Early Withdrawal Taxes, IRS Interest Charges, IRS Penalties, Library Taxes, License Plate Fees, Local Corporate Taxes, Local Income Taxes, Local School Taxes, Local Unemployment Taxes, Luxury Taxes, Marriage License Taxes, Medicare Taxes, Medicare Tax Surcharge, ACA Individual Mandate Excise Tax, ACA Surtax On Investment Income (3.8%), Passport Fees, Professional Licenses And Fees, Property Taxes, Real Estate Taxes, Recreational Vehicle Taxes, Registration Fees For New Businesses, Sales Taxes, Self-Employment Taxes, Septic Permit Taxes, Service Charge Taxes, Social Security Taxes, Sports Stadium Taxes, State Corporate Taxes, State Income Taxes, State Unemployment Taxes, Telephone 911 Service Taxes, Telephone Federal Excise Taxes, Telephone Federal Universal Service Fee Taxes, Telephone Minimum Usage Surcharge Taxes, Telephone State And Local Taxes, Telephone Universal Access Taxes, The Alternative Minimum Tax, Tire Recycling Fees, Tire Taxes, Tolls, Use Taxes (Out of state purchases, etc.), Utility Taxes, Vehicle Registration Taxes, Waste Management Taxes, Water Rights Fees, Watercraft Registration & Licensing Fees, Well Permit Fees, Workers Compensation Taxes, Zoning Permit Fees, etc, etc..

So, I think we Americans are taxed enough already. If they can't even pay for legitimate government with all those taxes, then, my friends, something is severely wrong. I believe the current system is unsustainable and will implode in time.

That said, you're correct that the disregard that CPAP manufacturers have towards patients existed long before ACA. That part of the system which caused such attitudes has been the same prior to and after the implementation of the ACA. But I will say that the shear volume of additional laws & regulations (including the 900+ pages of the original ACA) that have been put on the books has done nothing but confuse everyone, drive up overall costs and make it so that CPAP manufacturers must charge even more to pay their fiscal and legal staff to interpret and ensure that they don't violate any of the regulations, of which the ACA is only a small part. So it's no wonder they don't want to deal with patients' issues - they don't have the time nor the money to do it - so they simplify their lives by making the DMEs their "customer"... much easier for them, that way.

Sorry for venting... All this is just my opinion, of course.

Thinking-about

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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.

12-08-2015 12:17 PM
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justMongo Offline

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Post: #27
RE: What the Manufacturers REALLY Think About the Patients
Did you omit the Medical Device Tax tacked on by the ACA?

To add my Rant: [Image: rant.gif]

I pay $0.25 per insulin syringe that should cost $0.10. In fact, an addict can buy them for $0.20 each under the state's clean needle program. Now, if that wasn't enough, starting in 2007, disposal of home "sharps" in the trash became illegal. It costs me $0.50 to dispose of a needle in accord with the law.

At 5 sticks per day, that would be 5 x ($0.25+$0.50) = $3.75 per day.
Over a year, that's $1368.

So, I reuse one syringe 5X -- it hurts be the 3rd stick because it's dull.

I guess I Threadjacked this thread: [Image: threadjacked.gif]

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.
(This post was last modified: 12-08-2015 02:32 PM by justMongo.)
12-08-2015 02:22 PM
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Sleeprider Online
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Post: #28
RE: What the Manufacturers REALLY Think About the Patients
I left CA in 2012. Here are sharps disposal guidelines in PA where I live now:
Quote:Pennsylvania Household Sharps Disposal

You can help prevent injury, illness and pollution by following some simple steps when disposing of sharps in your household trash.

1. Place all sharps in a puncture-resistant, hard plastic or metal container. An empty detergent bottle with a screw-on cap or an empty coffee can will do.

RECOMMENDED TREATMENT:
Prior to disposal, disinfect your sharps with a solution of 1 teaspoon of bleach in 1/2 gallon of water.
2. Close the container with its original lid and secure with heavy duty tape.
3. Place the tightly sealed container in a paper bag and discard it with your household trash. DO NOT PLACE IT WITH YOUR RECYCLABLES.

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12-08-2015 03:00 PM
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SuperSleeper Offline

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Post: #29
RE: What the Manufacturers REALLY Think About the Patients
There you go, Mongo... move from CA to PA and save yourself $1368 per year. (minus the cost of a bottle of bleach and some duct tape).

Bigwink

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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.

12-08-2015 03:07 PM
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justMongo Offline

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Post: #30
RE: What the Manufacturers REALLY Think About the Patients
(12-08-2015 03:00 PM)Sleeprider Wrote:  I left CA in 2012. Here are sharps disposal guidelines in PA where I live now:
Quote:Pennsylvania Household Sharps Disposal

You can help prevent injury, illness and pollution by following some simple steps when disposing of sharps in your household trash.

1. Place all sharps in a puncture-resistant, hard plastic or metal container. An empty detergent bottle with a screw-on cap or an empty coffee can will do.

RECOMMENDED TREATMENT:
Prior to disposal, disinfect your sharps with a solution of 1 teaspoon of bleach in 1/2 gallon of water.
2. Close the container with its original lid and secure with heavy duty tape.
3. Place the tightly sealed container in a paper bag and discard it with your household trash. DO NOT PLACE IT WITH YOUR RECYCLABLES.

Now I could live with that. But, it's not good enough for CA.
Have to use the 1 quart, red, sharps containers. They can be purchased with a mail back program; or some sheriff's stations have disposal bins for the containers.

Prior to 2007, I used a device called a Needle Disintegrator that shorted a battery across the needle. There is surprisingly little metal in a 31 gauge by 1/2" needle. The needle would be reduced to a flake of ash. The device was FDA approved (whatever that means.) The device is no longer made.

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.
12-08-2015 03:13 PM
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