Let's clear up some misinformation

[SleepingUgly]

Everyone is pissed at the OP, who they think isn't listening,

To the contrary, I am not pissed at the OP and I do think she is listening.

Don't tell me we agree on something! I've had a crappy enough day without this!

But I don't know what she is doing here and why she would spend such time and effort.

My guess is that she feels DMEs are getting the shaft, she feels we unfairly blame the DMEs who are in fact just victims, and is trying to get us to see the light, as well as spur us to action against our common foe: the insurance companies. But that's just a guess.

[RocketGirl]

♫♩This... is... the..

...thread that doesn't end
It just goes on and on, my friend!

Some people started posting it not knowing what it was,
And we'll continue posting it forever just because

This is the thread that doesn't end...♪♬

[mstevens]

I have to say my own experience suggests that DME's are, in fact, actually expecting reimbursement far in excess of actual cost on flow generators.

For my previous machine I spent ages dealing with my insurance company and DME trying to get the machine I wanted. Extracting the information from them was painful - nobody wanted to specify what they would or would not pay for until after I got a machine. Both insurer and DME refused to give me information either as a patient/subscriber because "that information is only available to doctors" or as a doctor "because the answer is dependent on the specific patient". And no, they would not let me as a doctor use my own information as a patient to learn those answers.

I finally ended up getting the machine I wanted for an upcharge. The upcharge was more than the total price for which I could have purchased the machine outright. I did this because my insurer wouldn't have covered anything else (masks, filters, etc.) for a machine that I'd bought outright. They still paid the DME whatever they would have paid the DME anyway.

For my most recent machine I just bought it from CPAP.com and submitted a claim to my new plan, which had previously told me in writing that I could use whatever supplier I wanted, what their reimbursement limits were, etc. I'm two weeks away from a year after that purchase and have not recouped a dime from my insurer. I can't say I deal with insurance companies for a living - I practice medicine for a living and deal with insurance companies as a necessary but very ugly part of that. I am better-equipped to succeed at that game than most, though.

I'll also point out that every "brick and mortar" DME I've ever dealt with has utterly failed to provide me with any usable information about anything. I had to give them the product number for my first Breeze since they'd never heard of one. None has ever even attempted to monitor my usage, even when I offered to send them my card. None has allowed me to come to their office for maintenance, insisting I wait at home for their tech to show up. (No, I can't let my wife hand them my machine - I have to cancel a day's patients to wait).

I can afford this nonsense. Most of my patients cannot. I am absolutely convinced from personal observation that my patients who get autotitrating flow generators and monitor their own data (and I have roughly a dozen such patients) end up considerably more satisfied with treatment based on subjective improvement. Yes, those are also typically better-educated patients (who have higher-paying jobs that enable them to spend the money on CPAP without having to starve their children), more motivated (to navigate through this ridiculous system), and often more able to do problem-solving on-the-fly.

The OP is factually correct that no insurer gives a damn about any of this. Where I disagree, and strongly at that, is that there is any significant value added by most DME's for most patients.

The problem is not DME's, pharmacies, hospitals, or most clinics or doctors. It's insurance companies. Our healthcare system is irretrievably broken. Market forces are incapable of fixing it. We already have an example of a system in this country that offers high-quality, low-cost healthcare. I grew up using it. It's used by our Presidents and Congress. Unfortunately, it's only available to them and to military personnel. Such a system will likely never be available to most Americans because in every respect this system is a fantastic example of everything that's right with socialized medicine. We're barely willing to chip in together to pay for roads or water systems. There's probably no way that the average American will ever be willing to risk spending his own money to save the life of someone else's child, especially if that child has the wrong shade of skin or speaks with the wrong accent.

[SleepingUgly]

OK, ltts, better late than never... How about acknowledging some of the content posted in this thread and all over the board about the ways in which the DMEs suck the life out of us? How about a nice long paragraph detailing the ways in which many DMEs not only don't help, but actually harm the patients with their incompetence and the many obstacles they put in our way that likely contribute to the high rate of noncompliance among the average CPAP user (which we are not)? Even if you end that delicious paragraph with "...and it's all the insurance companies fault!", it would be great if you could acknowledge this.

[Gerald?]

Another thing. When was the last time a hotel or restaurant asked you to pay a 2% upcharge when you paid your bill with an American Express card? Never of course. The contract they sign to be in the Amex system, or any card system, prohibits them from charging a fee for a customer to use a card. If the retailer doesn't like the fact that it cost them 2% more to process an Amex charge than a Visa one, they simply don't accept the Amex card. I've run into that many times. With every set of contractual relationships comes benefits and restrictions. If you don't like the restrictions, then don't enter the contract.

Again, like our insurance, this is also not the case in Australia. The law was changed to prohibit clauses in contracts from Amex, Visa etc that prohibted a surcharge. It is quite common now to see an additional surcharge for using a creidt, card, usually with a higher surcharge for Amex. Gives visability to the customer as to the cost of the credit card system rather than forcing it on the merchant.

[jnk]

...thread that doesn't end...♪♬

Older threads here never end
They lie in wait to dance again
Another page, another screen
They echo even when not seen

[retrodave15]

This needs to be posted.



That being said:
There are good DME's and rotten to the core DME's. There is nothing wrong with purchasing equipment on the internet. You have a choice to decide where you spend your money! You have to decide where you will spend your hard earned dollars.

If you want to go outside your insurance and DME; people forget about flexible spending accounts. I just started mine and I am going to use this to buy supplies this year and between the tax savings and the lower prices from an online vendor - I will come out ahead this year!

[Therapist]

Hello,

Here is the answer for the people enslaved by DMEs who are actively trying to harm them, as some people have said.

1) Get off your ass.
2) Get a fucking job.
3) Buy your own machine.
4) Deal with it.

Finally something I can relate to.

Yes quit spending half the day whining in a forum.

You would think DMEs and insurance companies are breaking into their houses and sitting on their faces.

Thank you for saying it gvz!

[McSleepy]

[...]
Our healthcare system is irretrievably broken. Market forces are incapable of fixing it. We already have an example of a system in this country that offers high-quality, low-cost healthcare. I grew up using it. It's used by our Presidents and Congress. Unfortunately, it's only available to them and to military personnel. Such a system will likely never be available to most Americans because in every respect this system is a fantastic example of everything that's right with socialized medicine. We're barely willing to chip in together to pay for roads or water systems. There's probably no way that the average American will ever be willing to risk spending his own money to save the life of someone else's child, especially if that child has the wrong shade of skin or speaks with the wrong accent.

Thank you, doctor! I am so glad to see some people in the medical profession also think that way. I just wish more people would realize this, before it's gotten out of hand.
McSleepy

[mstevens]

before it's gotten out of hand.

You don't think it already is?

[BlackSpinner]

Hello,

Here is the answer for the people enslaved by DMEs who are actively trying to harm them, as some people have said.

1) Get off your ass.
2) Get a fucking job.
3) Buy your own machine.
4) Deal with it.

I have plenty of acquaintances in the US who have been searching for jobs for over a year. The real jobless rate is like 1 out of every 6 americans are without a job. Many companies automatically reject applicants who are not working. For each job advertised they have HUNDREDS of applicants. Many of the people over 50 cannot find any job at all because they are considered "over qualified".

And then of course you come to seniors who are retired. Do you want to add them to this jobless pool too?

Your industry leader have sent all jobs overseas, including the technical ones. I suppose all unemployed amercans could try to move to China as illegal aliens.

[McSleepy]

before it's gotten out of hand.

You don't think it already is?

I guess I am an optimist - I still think the trend can be reversed. Although, one of my major worries is that this time it may not be just another "turn in the spiral": yes, the economy goes up and down, but one thing that hasn't been going up-and-down that is going down nowadays is education. And that could be a big problem to overcome. I am having hard times convincing my kids that education is necessary - all they see around them is: who is making millions without even having college education. Sad.
McSleepy

[rocklin]

♫♩This... is... the..

...thread that doesn't end
It just goes on and on, my friend!

I remember when I was a very little girl, our house caught on fire.
I'll never forget the look on my father's face as he gathered me up
in his arms and raced through the burning building out to the pavement.
I stood there shivering in my pajamas and watched the whole world go up in flames.
And when it was all over I said to myself, "Is that all there is to a fire?"

Is that all there is, is that all there is
If that's all there is my friends, then let's keep dancing
Let's break out the booze and have a ball
If that's all there is

And when I was 12 years old, my father took me to the circus, the greatest show on earth.
There were clowns and elephants and dancing bears
And a beautiful lady in pink tights flew high above our heads.
And as I sat there watching the marvelous spectacle
I had the feeling that something was missing.
I don't know what, but when it was over,
I said to myself, "Is that all there is to a circus?"

Is that all there is, is that all there is
If that's all there is my friends, then let's keep dancing
Let's break out the booze and have a ball
If that's all there is

Then I fell in love, with the most wonderful boy in the world.
We would take long walks by the river or just sit for hours gazing into each other's eyes.
We were so very much in love.
Then one day, he went away. And I thought I'd die -- but I didn't.
And when I didn't I said to myself, "Is that all there is to love?"

Is that all there is, is that all there is
If that's all there is my friends, then let's keep dancing

I know what you must be saying to yourselves.
If that's the way she feels about it why doesn't she just end it all?
Oh, no. Not me. I'm in no hurry for that final disappointment.
For I know just as well as I'm standing here talking to you,
when that final moment comes and I'm breathing my lst breath, I'll be saying to myself,

Is that all there is, is that all there is
If that's all there is my friends, then let's keep dancing
Let's break out the booze and have a ball
If that's all there is

[teknomom]

I'm so glad this forum has a "Foes" list! No more advice from certain people!

[kempo]

We're barely willing to chip in together to pay for roads or water systems. There's probably no way that the average American will ever be willing to risk spending his own money to save the life of someone else's child, especially if that child has the wrong shade of skin or speaks with the wrong accent.

This is how the left portrays the average American, "RACISTS". If you don't like Obama Care you are a racist. Just saying the phrase "Obama Care" you are considered a racist by some.

Many of you here are on medicare. Obama Care, by law, is taking $500,000,000,000.00, thats half a Trillion, out of medicare and putting it in medicaid over the next 10 years. That means the cost of your visits to the Doctor, your meds, and cpap devices are going to cost you more and more.

The availability of competitively priced insurance is the problem. Do you have trouble buying car insurance at a competitive price? Home insurance? Life insurance? NO because you can buy it from anyone in the U.S. But you can only buy health insurance from someone inside your State. In my State there is just a hand full of companies you can buy from. Thats the law. Talk to your congress critter about it.

If we were allowed to buy health insurance from any company in the U.S. people could buy insurance in larger groups. The health insurance companies would be beating each other up trying to get your business. Look at all of the Vehicle, Home, and Life insurance companies advertising all day and night on TV and radio.

Just my 2 cents.