Walmart and personal control

[So Well]

Often WalMart partners with independent providers who locate in their store. I know of medical clinic, hearing aid service, and banks.

Even selling a few things helps keep specialist suppliers sharp. And WalMart employees often refer customers to specialty stores.

As for the debate of socio-economic politics herein, WalMart takes its chances in the free market protected by a justice system - people can avoid shopping there (as many did when it recently changed its product mix and pushed environmentalism). OTOH, socialism is based on central control. (Sure, advocates talk of spontaneous community processes, but reality is that it always becomes controlling. A big problem is failure to judge quality, which is rooted in a view of humans as incapable and untrustworthy, thus must be controlled by some magically omniscient collective.)

The problem many people herein are having with providers/suppliers comes from bureaucracy, be it government (as in the Canada-UK etc. system of direct government health care) or insurance companies and doctors who are operating under many government rules (such as gyrations of payment with Medicare patients). I find that doctor offices are staffed by bureaucrats who have not had a help-the-customer focus instilled in them as nurses and doctors have. And quality varies – some doctors don’t know how to measure blood pressure accurately, even a large hospital did not (they violate AMA/CMA guidelines). Ability to walk away is the best mechanism for quality improvement. (Those who are dishonest will find they are shunned by providers and customers – choice does not provide a free lunch.)

Amen bro'. Glad to see someone posting who has a clear view of reality.

[jnk]

I'm going to have to admit

How and where you buy your machine does not preclude getting medical advice on its use from doctors, just as doctors advise patients on the use of OTC drugs.

Aspirin is more dangerous than barely pressurized air, and Wal-Mart is allowed to sell it. And guns. And chainsaws. And matches. Etc. If the danger of misusing an item is the measure of what should and should not be sold in discount stores, air-blowers and masks would rate waaaaaaaaaaaaaaay down that list.

If we insist on CPAP being Rx, Glasses are an Rx item you can get at a discount at Wal-Mart, why not anti-snoring machines? CPAP is more like reading glasses, anyway, though, than Rx glasses.

The DME/insurance cartel holds us all hostage and needs to be broken.

Sleeping well is not something that generally involves doctors. It is every man's right to find how he can sleep best. To deny the man the right to try a CPAP to see if he sleeps better is criminal and will one day be considered barbaric and cruel.

The whole idea of letting discount chains sell the machines would be to get prices down to the point that they are cheaper than your average microwave oven. (Microwaves are dangerous, too. Someone could use a hammer on the door and leak microwaves all over his children. How can they be sold to just anyone like that?!!)

There is plenty of room for CPAP machines right next to the vaporizers. No study has been done to document the possible dangers of the misuse of vaporizers either. Why not? Because it is just water, much like CPAP is just air. I am sure some idiot could find a way to grow mold in his vaporizer and get sick, just like misuse of dishwashing detergent could result in sickness if someone never washed his dishes properly. That is no reason to make vaporizers Rx dispensed.

Forcing CPAP to be Rx dispensed is a way to make money off of the suffering of those who do not sleep well. We will all look back on these decades and be ashamed of ourselves for how hard we made it for Joe 6pack to get some decent sleep.

Shame on us. Shame on us all.

[kempo]

Good post jnk. It makes me so mad there are so many people who think they know what's better for you than you do.

[BlackSpinner]

There is plenty of room for CPAP machines right next to the vaporizers. No study has been done to document the possible dangers of the misuse of vaporizers either. Why not? Because it is just water, much like CPAP is just air. I am sure some idiot could find a way to grow mold in his vaporizer and get sick, just like misuse of dishwashing detergent could result in sickness if someone never washed his dishes properly. That is no reason to make vaporizers Rx dispensed.

t
Yes yes they are dangerous - Wallpaper falls off if you use them at too high a setting and might smother you - of course we also make wall paper illegal.

[jnk]

Yes yes they are dangerous - Wallpaper falls off if you use them at too high a setting and might smother you - of course we also make wall paper illegal.

Aw, shucky durn! Anybody wanna buy a vaporizer on the cheap?

I will only accept bids from those with painted walls and a note from their doctor saying they can be trusted with one, though.

[NightMonkey]

This is good enough that it deserves repeating:

How and where you buy your machine does not preclude getting medical advice on its use from doctors, just as doctors advise patients on the use of OTC drugs.

Aspirin is more dangerous than barely pressurized air, and Wal-Mart is allowed to sell it. And guns. And chainsaws. And matches. Etc. If the danger of misusing an item is the measure of what should and should not be sold in discount stores, air-blowers and masks would rate waaaaaaaaaaaaaaay down that list.

If we insist on CPAP being Rx, Glasses are an Rx item you can get at a discount at Wal-Mart, why not anti-snoring machines? CPAP is more like reading glasses, anyway, though, than Rx glasses.

The DME/insurance cartel holds us all hostage and needs to be broken.

Sleeping well is not something that generally involves doctors. It is every man's right to find how he can sleep best. To deny the man the right to try a CPAP to see if he sleeps better is criminal and will one day be considered barbaric and cruel.

The whole idea of letting discount chains sell the machines would be to get prices down to the point that they are cheaper than your average microwave oven. (Microwaves are dangerous, too. Someone could use a hammer on the door and leak microwaves all over his children. How can they be sold to just anyone like that?!!)

There is plenty of room for CPAP machines right next to the vaporizers. No study has been done to document the possible dangers of the misuse of vaporizers either. Why not? Because it is just water, much like CPAP is just air. I am sure some idiot could find a way to grow mold in his vaporizer and get sick, just like misuse of dishwashing detergent could result in sickness if someone never washed his dishes properly. That is no reason to make vaporizers Rx dispensed.

Forcing CPAP to be Rx dispensed is a way to make money off of the suffering of those who do not sleep well. We will all look back on these decades and be ashamed of ourselves for how hard we made it for Joe 6pack to get some decent sleep.

Shame on us. Shame on us all.

Excellent compilation of ideas that hopefully become obvious to the voters, which reminds me:

The DME/insurance cartel holds us all hostage and needs to be broken.

Don't forget how this so-called cartel is enabled. It is government regulation at the federal and state levels that is the enabler. When we solve problems, to be effective we should go to the root. Change the regulations and open up the market. A free market will change or crush the current suppliers who are making big bucks off of us.

To change the regulations you are going to have to go to the voting booth and change the regulators. Get over this nonsense of voting Democrat or Republican because of tradition. Look at some different candidates who believe in individual freedom.

[BlackSpinner]

Don't forget how this so-called cartel is enabled. It is government regulation at the federal and state levels that is the enabler. When we solve problems, to be effective we should go to the root. Change the regulations and open up the market. A free market will change or crush the current suppliers who are making big bucks off of us.

However one has to remember WHY this is so - the greed to make money ripping of sick people with untested and totally useless "cures"! Remember the term "snake oil"?
Just look at commercials for baldness, spam for cheap (and fake) viagra and all the history of aphrodisiacs! You may get cheaper xpaps but will they be reliable? Will you need a degree in medical engineering to chose amongst products?

[kempo]

Don't forget how this so-called cartel is enabled. It is government regulation at the federal and state levels that is the enabler. When we solve problems, to be effective we should go to the root. Change the regulations and open up the market. A free market will change or crush the current suppliers who are making big bucks off of us.

However one has to remember WHY this is so - the greed to make money ripping of sick people with untested and totally useless "cures"! Remember the term "snake oil"?
Just look at commercials for baldness, spam for cheap (and fake) viagra and all the history of aphrodisiacs! You may get cheaper xpaps but will they be reliable? Will you need a degree in medical engineering to chose amongst products?

No, you would go to websites like this one and find out which products are the best from people who have used them. People gravitate to the best automobiles and appliances by reading consumer reports and from people they know and trust. An xpap machine would be the same.

Even with all of the goverment regulations we have now, people with OSA are being ripped off by insurance companies and DMEs by selling them inferior machines because that person did not take the time to do some research. It's called personal responsiblity.

There is no reason we should have to jump through hoops and spend three prices on mask, chin straps, hose, or what ever, because we have to have a prescription to buy these products.

Write your congressmen people!

[jnk]

. . . how this so-called cartel is enabled. . . .

I am not a political person, but as a consumer, I actually would appreciate it if regulation would prevent Internet price controls, myself. Price controls hurt patients, despite ResMed's idiotic claims to the contrary. When it comes to that issue, I consider ResMed to be nothing less than public liars with their laughable spin on it:

http://www.resmed.com/us/dealers/intern ... nc=dealers

The theory that enabling B&M DME companies to overcharge for machines and supplies should somehow motivate the companies to be helpful to patients was ludicrous from the beginning and has been conclusively proved a total failure, in my opinion--as can be seen from the numerous posts to this site about the virtually universal underhanded practices of B&M DMEs in the United States.

Just my opinion. And we've all got 'em. Just like rear ends. Or ResMed executives.

[chunkyfrog]

Break the machine--you kill the cash cow.
Buckets of campaign money and lavish under the table benefits for lawmakers.
We do not stand a chance.

[NightMonkey]

However one has to remember WHY this is so - the greed to make money ripping of sick people with untested and totally useless "cures"! Remember the term "snake oil"?
Just look at commercials for baldness, spam for cheap (and fake) viagra and all the history of aphrodisiacs!

So you generally are not susceptible to being ripped off by marketers who are not controlled by legislation? What makes you think you would be ripped off in a CPAP market that is a free market?

You may get cheaper xpaps but will they be reliable? Will you need a degree in medical engineering to chose amongst products?

I have read enough of your posts to know you would do the research and select an excellent CPAP in a free market. Just like you would if you were buying a new TV, computer, DVR, mobile phone, or microwave oven.

What I don't understand is why a woman with your capabilities believes they need protection by government in an open market? Free markets are safer for the consumer and more dangerous for the suppliers. The suppliers quickly fail if they don't make the customers happy. On the other hand, in a heavily regulated market, the suppliers leverage the regulations to keep out competition and leave the consumer with less choice, less service, lower quality products, and higher prices.

[SRSDDS]

What we don't seem to be talking about is that all of this is the result of GOVERNMENT REGULATED INSURANCE COMPANIES. I had absolutely no problem getting a sleep study, rx, and the xPAP machine that I wanted. NOBODY (not even the doctor) told me what specific machine to get. I get all of the supplies I need at the price I feel is fair. I will have another sleep study when I deem it necessary.

Why have I been so successful with this? I DO NOT USE INSURANCE FOR OSA! The only reason I don't have to deal with overburdening government regulation is because their point of pressure is with the insurance companies, and I don't deal with the insurance companies.

Also, I would bet anything that my total costs are LESS THAN HALF of the total costs for services and equipment paid for by insurance companies.

So, is it the insurance companies? I don't think so. They are just doing what they are allowed to do by the government, in an attempt to make some money at it. The problem is GOVERNMENT! Get them the hell out of the way!

Stephen

[leejgbt]

The DME/insurance cartel holds us all hostage and needs to be broken.

Don't forget how this so-called cartel is enabled. It is government regulation at the federal and state levels that is the enabler. When we solve problems, to be effective we should go to the root. Change the regulations and open up the market. A free market will change or crush the current suppliers who are making big bucks off of us.

To change the regulations you are going to have to go to the voting booth and change the regulators. Get over this nonsense of voting Democrat or Republican because of tradition. Look at some different candidates who believe in individual freedom.[/quote]

I promise you that there is no DME/insurance cartel unless you are talking about the national chains like Lincare and Apria. As a member of my state DME association we are constantly trying to get Medicare and the insurance companies to see reason when it comes to the rules governing certain DME items like CPAP. There are hundreds of insurances with hundreds of different processes and reimbursement amounts. There are no hard and fast rules. Look at any thread about what people pay for co-pays as an example. I am a capitalist. I want to compete in two areas, price and service. The government and insurances only lets me compete in only one area at a time. Let me give you some examples. If I want a contract with an insurance nowhere in the contract does it allow me to compete with service, only price. And if you use the Medicare model where every company is paid the same then I can only compete with service not price. Doctors cannot make the choice of provider for a patient and usually gives them a list. Many rotate who they choose on this list of providers. If there are five providers on this list and one absolutely sucks and one is fabulous then the physician is sending 20% of their patients to a company that sucks.
We are constantly lobbying to change the system but every change that would benefit you, the patient, is usually rejected by the lobbying efforts of the nationals. It now costs as much to bill and document the medical necessity of a CPAP claim as it does to provide the service. I promise the DME industry did not ask for this system.

[jnk]

So, then, would someone please point me to the exact guv'ment regulation that has forced ResMed to choose on its own to enact Internet price controls? And could someone then please explain to me how it helps anyone but the whining, lying, overcharging DMEs?

It is a cartel. It is cruel. It is barbaric. It is killing people. It needs to end.

[So Well]

The DME/insurance cartel holds us all hostage and needs to be broken.

As a member of my state DME association we are constantly trying to get Medicare and the insurance companies to see reason when it comes to the rules governing certain DME items like CPAP.

You and the rest of your DME buddies would c*%# your pants if the regulation requiring a DME license to supply CPAP equipment and oxygen tanks was dropped.

I know you make the big bucks off those oxygen tanks. After the patient has used a tank or two he gets it down pat and could just as well get his reorder tanks from a low-cost internet supplier or WalMart. No need to have a licensed DME. You would be out of business and oxygen would be delivered at much lower costs and with less hassle for the patient. The doctors would also be happy about this.