The Future Of American's Health Care?

[akcpapguy]

I can see why Johnny would be opposed (I don't know for certain that he is) to Universal Health Care, especially if it covered CPAP at 100% cost. This would drastically cut into his customer base both present and future. Regardless of his personal views, from a business stand point these are scary times for him I'm sure. However B&M DME's are partying in the streets if this passes. I don't blame Johnny for bringing this up in the slightest.

[So Well]

If big insurance is the capitalist alternative to government run healthcare, we are screwed.

The "big insurance" that we have today, is not a capitalist alternative. This system came about due a morass of federal and state regulations and tax policies. These regulations have killed the free market and much of capitalism in the health insurance field. You can easily find on the internet state-by-state tables of insurance companies and market shares. You will find that in at least 21 states, one carrier controls more than half the market. More than half of the market is controlled by two carriers in at least 39 states.

Look at the data and you will see that a nonprofit controls the market in most of the states. Federal regulations and regulations in most states favor the nonprofits and keep competition out.

This morass of regulations has left us consumers with little choice and little to no recourse when we are exasperated by our carriers. We at the very least need health insurance reform. Regulations need to be cut back and changed so the smaller companies can begin to compete with the entrenched "big insurance". Unfortunately the current bill only makes matters worse.

My copay was $890 for a dumb ResMed Escape -- what a rip off.

This is a good example of what can happen to the consumer in a heavily regulated market. We would not tolerate this at the grocery store, the camera shop or the car dealer. But with insurance companies protected by regulations and no competition, recourse is very difficult if not impossible.

[roster]

I wonder what type of CPAP machine he needs that costs £700 (US $1120) ?

Oh, never mind. I know: One that is purchased by a government bureaucrat with other people's money.

If the co-pay of $890 I have quoted below is the smaller portion of total machine price, the $1120 U.K. price comes in very low compared to some of the current U.S. healthcare nonsense...

My copay was $890 for a dumb ResMed Escape -- what a rip off. viewtopic.php?f=1&t=46325&p=415953&hilit=copay#p415850

Absolutely no bells and whistles on the above U.S. offering at a bargain price of only $890 co-pay plu$ typical behind-the-$cene$ U.S. healthcare corporate greed co$t$...

I think Mowgli's post explains that well. If you look behind the words, "corporate greed", you will find a regulatory structure that results in much less choice for the consumer.

I find nothing wrong with enlightened businesses (Best Buy, WalMart, Honda Automotive, actually anything Honda makes) who charge the "highest price the customer will pay in the longrun" and try to optimize profits. These are great companies to buy from when they are in a competitive market. But when they are protected by regulations that restrict competition, then the injustices occur. The evil is coming from the government.

[leejgbt]

As a "brick and mortar" DME manager I want to weigh in on this issue. My perspective is different from CPAP.com and most of the people here in that most people who visit this site purchase from on-line companies. While I applaud companies like CPAP.com as I am also a capitalist (and proud of this) and totally understand niche markets it must be stated: CPAP.com is a niche market. This makes it the exception to the rule, not the rule.

It is easy sometimes to make the wrong assumption that you are part of the majority when associating with like minded individuals as this site is. But be clear about one thing, you represent a miniscule minority of the CPAP business. The real players in this industry are the insurance companies, Medicare/Medicaid and the national chains. Recently, the "mom and pops" have gained a voice (even though they represent the majority of all providers) by forming their own organization to lobby Congress on their behalf.

While the Medicare model is mentioned as a model for national healthcare I am here to tell you this would be a BIG mistake. Someone used the stat that 30% of insurance premiums are used for administrative costs and by going with a government plan this would save this cost. Not even close, as now with Medicare Part B DME the cost to process a claim is now OVER 50% of the cost of providing the equipment! For those who advocate paying for CPAP out of pocket versus insurance think of the vast majority who choose not to do this. DME companies now take on this burden to stay competitive. Medicare estimates that the amount of time it takes to learn their rules for billing is now over one year. Yet I can teach someone to bill insurances in 60 days. The manual we are forced to use was so thick (almost 12 inches) that Medicare made it electronic only as the expense of printing and updating was onerous. Is this REALLY the system you want?

Someone advocated that the best system is where the patient writes the check and can shop for the best buy. That is what this industry had in the 1980's and the prevailing rate for oxygen was $385.00 per month for a concentrator and almost $800.00 for liquid oxygen. One of the few things Medicare did that had a positive effect for the patient was developing an allowable. The reason this worked out well was because now competition was based on service. The "mom and pops" could compete with the nationals very well in this department as in general they could offer more personalized service. The recent onslaught of complicated rules is an attempt by the nationals to drive the little guy out of the market as they were competed against too well in the service arena. Now with the learning curve so steep the nationals can spend the money to train while the little guys are at a disadvantage.

One of the most common threads here is why people dumped the DMEs due to poor service and excessive costs. A lot of the perceived poor service equates to lack of training. The excessive costs involve the costs imposed on the industry by excessive regulation.

So I applaud ANY alternatives that come from competition. Unfortunately the legislation introduced does not foster competition but curtails it. "Competitive bidding" (Medicare's neat term) is really an attempt to eliminate the competition.

It took us 50 years to reach this point in our healthcare industry. How can Congress believe it can be fixed in a summer? This scares the crap out of me. I do believe healthcare should be provided for all and paid for equitably. But who truly believes this current legislation is the answer? NOT ME

[WNJ]

Johnny,

You are certainly free to post what you want. It’s your site. But perhaps you would do well to consider whether you want a CPAP support site or a political site. The latter will ruin the former. I’ve seen it happen with much better web sites than this. Your choice.

BTW, I fail to see the connection between your business and the proposed regulation of the health insurance industry. Last I checked, CPAP.COM does not accept payment from insurance companies.

Timba,

“Free market enterprise has always provided better service and lower prices.”

Baloney! Unregulated free markets have brought us monopoly, poor service, and abusive prices. Look back at our history before the anti-trust laws and regulations on business were put in place 100 years ago. Look what has happened over the last 30 years with all the deregulation.

LSAT,

If you find Medicare so bad, I think it important that you know that you are not required to participate. No one is forced to claim or even accept any government benefit. There are dozens/hundreds of insurance companies. Go buy a policy on the free market and get back to us.

Mowgli,

“The "big insurance" that we have today, is not a capitalist alternative. This system came about due a morass of federal and state regulations and tax policies.”

Insurance is not subject to federal regulation. It is regulated by each of the 50 states. Regulation by the states is very weak for the most part. Insurance companies are exempt from federal anti-trust law. What we have now is substantially the result of lack of regulation.

---------------

Perhaps everyone should consider that the story from the UK may be newsworthy because it is unusual in the UK. In the USA, over 44,000 persons die each year because they have no health insurance. Untold thousands also die because of denial of medical care by insurance companies. Denial of medical coverage is not newsworthy in the USA. It took my wife years to get a sleep study pre-approved by her insurance company and her apnea is far worse than the fellow in the UK article.

We spend far more than any other country on health insurance and health care, yet we have about 47 million uninsured, millions denied coverage by greedy insurance companies, and infant mortality rates of a third-world country. Gotta love it!

Wayne

[So Well]

We spend far more than any other country on health insurance and health care, yet we have about 47 million uninsured, millions denied coverage by greedy insurance companies, and infant mortality rates of a third-world country. Gotta love it!

Wayne

So have you investigated the bill that is likely to pass tomorrow morning? Can you tell us how it will help with the problems you mention?

[WearyOne]

1. I don’t have health insurance; I do have health care
2. I run a small business; competition is good.
3. Standing in line at the post office today for almost an hour with one person working and three windows closed, again shows me the efficiency of government-run agencies. (This is not unusual.)
4. Johnny, thanks for voicing your thoughts and opinions.
5. Government, stay away from my healthcare.
6. Bill passing tomorrow = The Nightmare Before Christmas
7. If you want to use the word zealot, go right ahead, but I prefer passionate, intelligent, caring, sensible…all things conservative and good!


Thanks, Johnny, for all you do and all you provide both in this forum and cpap.com.

[Autopapdude]

]7. If you want to use the word zealot, go right ahead, but I prefer passionate, intelligent, caring, sensible…all things conservative and good!

I'd go for misleading, deceptive, selfish, and self-preoccupied--all things conservative and mean spirited. Bah Humbug! Figures, as you are from a red state, so no great surprise.

1. I don’t have health insurance; I do have health care
2. I run a small business; competition is good.
3. Standing in line at the post office today for almost an hour with one person working and three windows closed, again shows me the efficiency of government-run agencies. (This is not unusual.)
4. Johnny, thanks for voicing your thoughts and opinions.
5. Government, stay away from my healthcare.
6. Bill passing tomorrow = The Nightmare Before Christmas
7. If you want to use the word zealot, go right ahead, but I prefer passionate, intelligent, caring, sensible…all things conservative and good!

1. You have health care. Do you care if anyone else does? I doubt it.
2. Imagine how it has been with insurance companies running medical care--438% profit in 9 years. Better odds than Las Vegas.
3. Competition is good- how about letting the consumer an opportunity to compete, as opposed to the doctors, medical lobbies, insurance companies, and drug companies regulating things.
4. Johnny, the politics before Christmas was tasteless.
5. Government, save us from the privatization of everything, so we might be able to afford decent health care. Who gives the chief executive of a drug company the right to a 20 million dollar salary a year, when people don't have health care?
6. The bill passing tomorrow= shuts up a few conservatives for a while.
7. Already answered above.

[WearyOne]

7. If you want to use the word zealot, go right ahead, but I prefer passionate, intelligent, caring, sensible…all things conservative and good!

I'd go for misleading, deceptive, selfish, and self-preoccupied--all things conservative and mean spirited. Bah Humbug! Figures, as you are from a red state, so no great surprise.

Funny, didn't think I was being mean-spirited. In fact, I wasn't. And let's see, self-preoccupied? Nah. Not a deceptive bone in my body. Nope, don't mislead people either. Not selfish. Um, nope, you're wrong about me; sorry. But I'm honestly and good-naturedly not surprised at your response; it's typical. I like red. Like purple best, though.

[Autopapdude]

Funny, didn't think I was being mean-spirited. In fact, I wasn't. And let's see, self-preoccupied? Nah. Not a deceptive bone in my body. Nope, don't mislead people either. Not selfish. Um, nope, you're wrong about me; sorry. But I'm honestly and good-naturedly not surprised at your response; it's typical. I like red. Like purple best, though.

Not at all surprised at your response either. You don't care about anyone else's heath care but your own. That isn't mean-spirited? Scrooge would have a field day with conservatives! lol

[WearyOne]

Funny, didn't think I was being mean-spirited. In fact, I wasn't. And let's see, self-preoccupied? Nah. Not a deceptive bone in my body. Nope, don't mislead people either. Not selfish. Um, nope, you're wrong about me; sorry. But I'm honestly and good-naturedly not surprised at your response; it's typical. I like red. Like purple best, though.

Not at all surprised at your response either. You don't care about anyone else's heath care but your own. That isn't mean-spirited? Scrooge would have a field day with conservatives! lol

You're the one that said I didn't care about anyone else's health care but my own, and since that's wrong, I'm not being mean-spirited. It may be your opinion of me, but factually it's incorrect. Just because I believe this bill is the wrong answer doesn't mean I don't believe there's a problem.

I'd go for misleading, deceptive, selfish, and self-preoccupied--all things conservative and mean spirited.

I've always been curious, though, why you can't seem to carry on a debate without name-calling or remarks that are degrading a person or group of people (i.e. conservatives.) Others can. Not asking for an answer, just an observation formed over several months.

Well, I've contributed to getting way off the OT, so I'm done with this little tennis match. You may have the last word...or last volley...if you so choose!

Oh, I almost forgot---Merry Christmas! And I'm not being sarcastic; I really mean it.

Pam

[timbalionguy]

Timba,

“Free market enterprise has always provided better service and lower prices.”

Baloney! Unregulated free markets have brought us monopoly, poor service, and abusive prices. Look back at our history before the anti-trust laws and regulations on business were put in place 100 years ago. Look what has happened over the last 30 years with all the deregulation.

LSAT,

If you find Medicare so bad, I think it important that you know that you are not required to participate. No one is forced to claim or even accept any government benefit. There are dozens/hundreds of insurance companies. Go buy a policy on the free market and get back to us.

Wayne

Wayne,
First of all, I never said 'completely unregulated free market'. A few regulations need to exist to prevent greedy people from taking over everything, and punishing those who do, anyway. But some stifling regulations like the Prescription Drug Act, have created much of the problem we have today by creating a closed system. Granted, having a prescription for a drug or machine can act to protect someone from just obtaining and using said drug or machine improperly. But it also severely limits treatment options, and gives those 'blessed' to provide this option the ability to charge whatever they want, because you cannot get around it. Consider Mexico. You can purchase many drugs there you would need a prescription for here, over the counter. It is up to you to use the drug properly (and I strongly believe that everyone should be responsible for their own actions. Most people would go to their doctor, anyway before obtaining a given drug, because most people do not know much about drugs.). But because the system is open to competition, the drug is much less expensive. And you don't see people dying in the streets for misuse of most of these drugs. (I believe that drugs that have a significant potential for abuse are regulated, but I am nos sure about that.)

Autopapdude, the passage of the health care bill isn't silencing conservatives. It is making them more angry than ever, as they can see what a sprawling mess this law will create.

I see the passage of this bill in the Senate tomorrow as a curse before Christmas. It is like giving every person in America a lump of coal (or maybe uranium) for Christmas.

[Jay K]

Whatever point Johnny was trying to make by posting an example from Wales, yes WALES!!, would seem to be defeated by the fact the best he could apparently come up with to illustrate that point was an article from Wales, a country of a mere 3 million people which administers its health care system separate from the rest of Great Britain from what I understand. What does Wales have in common with the United States? Uhhhhhh . . . . virtually nothing??

It was a rather desperate attempt to disparage the prospect of a greater government role in health care in the U.S.

And I'll tell you, when someone earlier tried to use the post office as an example of why there should be no government involvement in health care, I must mention I have had a hell of a lot better experience with the post office (it delivers my mail reliably and at relatively low cost) than our capitalist health care system. In fact, I am amazed at how well the postal service performs its massive responsibilities. And the last time I went to a post office (in Manhattan) I waited approximately 60 seconds to be served.

I have nothing against capitalism when it works. When it fails, as it largely has in the health care area, bring on the government.

[mars]

Hi All

Its almost like old times reading this thread, only this time I am not involved.

And I will remain that way.

For all sides of the arguement I leave you with -

http://www.pbs.org/newshour/bb/white_ho ... _12-23.htm

and just to tease -SWS for Christmas -

http://www.google.com.au/search?q=i+wil ... =firefox-a

Happy Christmas Eve

Mars

PS It appears the PBS link is not available, dont know why.

You might find the interview at http://www.pbs.org/, just click the link to the Obama interview with Jim Lehrer

[LinkC]

I've always been curious, though, why you can't seem to carry on a debate without name-calling or remarks that are degrading a person or group of people (i.e. conservatives.)

Cause that's all he's got. This is someone who thinks there is a "First Amendment provision" allowing him to post on a privately-owned forum.

Did you really expect thoughtful, reasoned debate? It ain't happened yet!

Blue is the color of fog...and sadness.