Low-Income Patients with Obstructive Sleep Apnea are Less Likely to Begin Treatment with CPAP Therapy

According to this article, wealthier patients are more likely to be CPAP compliant than poorer ones. While I was always concerned about the poorest patients, I really didn't think that there would be an issue among those who are of relatively modest means, but not dirt poor. Apparently, this is an issue. Of course, the poorest ones are the worst situated.





Link ===> http://web.archive.org/web/201805222047 ... p-therapy/

That study was apparently done in Israel, where the cultural and economic climate and patient popuation are very different from N. America. I would not try to extrapolate equivalent results from it, especially being unfamiliar with their insurance set-ups etc. Or do you know something we don't?

Thank you DH for the interesting article. Julie - Thank you for your excellent caution on extrapolation. The article may encourage US researches to look for similar patterns domestically. I believe the US healthcare system particularly ignores the working poor. The medical needs of the well off and Medicaid beneficiaries seem to be fairly well taken care of.

I think that while Israel is different in may ways, it's probably not different in ways that are likely to make this conclusion significantly different.

Unless you understand the cultural or ethnic makeup of their population, the economy in general and other factors you're only guessing. Obviously cohorts with more money and education in general will be more likely to be on Cpap anywhere, but why, in that setting vs why in N. America may be very different.

Health care in Israel is universal and participation in a medical insurance plan is compulsory. All Israeli residents are entitled to basic health care as a fundamental right.

LSAT wrote: ↑

Tue May 22, 2018 4:03 pm

Health care in Israel is universal and participation in a medical insurance plan is compulsory. All Israeli residents are entitled to basic health care as a fundamental right.

The implication of this is that the U.S. would be even worse. Obamacare was never that comprehensive and has been gutted by having the penalties for non-participation removed. Thus, access to healthcare would be even worse in the U.S. than Israel. Israel is probably more similar to Canada in this regard.

LSAT wrote: ↑

Tue May 22, 2018 4:03 pm

Health care in Israel is universal and participation in a medical insurance plan is compulsory. All Israeli residents are entitled to basic health care as a fundamental right.

This is correct, but as the article points out, there is a 30% co-payment for the CPAP machine in Israel. It would be interesting to know how much that 30% co-payment is relative to the regular income of Israelis below the median income level. It's interesting to note from the little the article said it does not appear that there is any subsidy for low income people to be able to afford the machine.

In the US, I'd wager that many people with low income never even get a diagnosis, let alone start treatment. If you have Medicaid/Medi-Cal*, finding a lab that will accept Medicaid/Medi-Cal for testing can be challenging, and then finding a DME that will supply a machine for Medicaid/Medi-Cal reimbursement (usually far lower than Medicare and private insurance with additional billing complications and risks) is the next challenge.

Many people don't have insurance in the first place in this country and may not be able to afford testing or treatment. And for those who do, the deductibles and co-payment often make diagnosis and treatment prohibitive. So I'd bet the stats are even worse in the US.

*Medi-Cal is California's version of Medicaid. California's rules and regulations often differ from standard Medicaid.

As much as anything, I might have been thinking of certain groups of people, most of whom are relatively recent immigrants (1st gen) and whose ideas re medicine may not be as sophisticated as they are elsewhere in Israel, and therefore they might be less inclined to even see a doctor for some problems, and then not be as amenable to therapy. Please do NOT read into this any 'discrimination' etc... but these things are facts of life in the country whose population is very complex in ways even the most diverse neighbourhoods here may not be.

D.H. wrote: ↑

Tue May 22, 2018 4:28 pm

LSAT wrote: ↑

Tue May 22, 2018 4:03 pm

Health care in Israel is universal and participation in a medical insurance plan is compulsory. All Israeli residents are entitled to basic health care as a fundamental right.

The implication of this is that the U.S. would be even worse. Obamacare was never that comprehensive and has been gutted by having the penalties for non-participation removed. Thus, access to healthcare would be even worse in the U.S. than Israel. Israel is probably more similar to Canada in this regard.

Or quite possibly people in the U.S A are dumber, and can't get enough trash can liners and now have to troll the world to keep the can full. Jim

Hello Goof Proof. I do not understand your comment. I would appreciate additional clarification. Thank you.

Unfortunately, I do.
Jim's bias has reached a new low.
Don't be like Jim.

Thanks Chunkyfrog. I now understand the meaning of his post.

D.H. wrote: ↑

Tue May 22, 2018 4:28 pm

Obamacare was never that comprehensive and has been gutted by having the penalties for non-participation removed.

Having a penalty did not make it easier to participate. The costs were NOT practical or even possible for a lot of people. I almost lost my employer based insurance. I looked at the exchange, and even with subsidies, my premium would have been almost a week's paycheck. My deductible would have been $2000, so I would be in big debt before getting even a dollar of coverage. Total waste of money. Had I lost my insurance, I would have skipped insurance. At least now, the people who can't afford the premiums aren't being further punished by having to pay the penalty.

I am part of the working poor. I make too much to qualify for help, but not enough to live by myself. I drive a 20 year old vehicle, and right now the vehicle and my health needs are duking it out for who will have the highest expenses this year. Meanwhile, I have a coworker who has medicaid. She has totally free health care, while I am still paying off last year's medical bills.

Perhaps if politicians worked on getting costs down, we could make coverage affordable.

How come a monthly asthma inhaler can cost over $500 without insurance, but only $22 with insurance? HOw come I can afford to get medical care for my cat without insurance, but it costs extreme thousands of dollars for the same treatment on a human? I know some of it is to cover insurance, lawsuits, etc. But some of it is simply because they can.

Even in countries with universal coverage, you have to wait a long time for most things, and some things aren't covered. So, only the people who can afford to pay on their own can speed up their care. The others have to wait.

I never understood why people thought it was a good idea to force people to buy something, then make their finances worse if they can't afford to do that.

Selenium1% wrote: ↑

Tue May 22, 2018 5:15 pm

Hello Goof Proof. I do not understand your comment. I would appreciate additional clarification. Thank you.

Thousands of junk articles are written yearly and passed off as necessary and useful, most aren't either. but they all get paid for by someone. Think of them as Cannon Fodder for weak minds. They get passed around like smoke in the wind. Jim