Manufacturer Pricing Policies

[johnnygoodman]

http://www.chron.com/disp/story.mpl/hea ... 40813.html

[mindy]

That's a fascinating article, Johnny! It highlights one small corner of the whole health care mess.... and also, IMHO, the huge problem of corporate greed and appeasing shareholders. There doesn't seem to me to be much of a check on what corporations do these days and that ends up hurting the consumer.

I feel that we live in a big brother society where we don't have much of a voice in what happens to us. The fact that this forum is so successful is due to a number of factors but one is certainly the feeling of empowerment we have in connecting with others to feel we are in control of our own therapy.

Thanks for your part in helping us do that!
Mindy

[NiceDMEDude]

Johnny and mindy, I agree that Medicare does pay too much for some aspects of caring for their beneficiaries.

However, especially in the case of home oxygen, many of these customers/patients require a great deal of assistance. For every oxygen customer who never has a problem requiring a home visit (except for routine 1 or 2-month equipment checks), there will be at least one or two more clients who need multiple deliveries of supplies and replacement oxygen tanks or liquid oxygen refills. Some clients need several deliveries per week, if they are extremely active (which is a good thing).

Medicare needs to pay for certain services, like home oxygen, on a tiered level, paying more for the higher-tech equipment and less for a basic oxygen setup. There is actually a strong movement towards this, and a highly respected retired pulmonologist, Dr. Petty, is a supporter of this plan.

It would be nice if insurers would also recognize the difference between a basic CPAP and a high-end device like the A-Flex. Probably will never happen though!

[Wulfman]

http://www.chron.com/disp/story.mpl/hea ... 40813.html

Thanks for that article, Johnny.

"These industries rely on a basic threat: If you mess with us, we can turn the seniors against you," said former Sen. Alan K. Simpson, R-Wyo., who tried to cut Medicare reimbursements in Congress. "Angering seniors is the quickest route to political suicide."

How approptiate that HE should be quoted in that article......Mr. Spineless, fence-sitter with his finger in the air wondering which way the wind is blowing.....
Something tells me he didn't "try" very hard.

A perfect example of WHY or WHY NOT.....as per his quote!
(He left out angering the entities that make political contributions and that he comes from a family of lawyers)


Den

[Wulfman]

Johnny and mindy, I agree that Medicare does pay too much for some aspects of caring for their beneficiaries.

However, especially in the case of home oxygen, many of these customers/patients require a great deal of assistance. For every oxygen customer who never has a problem requiring a home visit (except for routine 1 or 2-month equipment checks), there will be at least one or two more clients who need multiple deliveries of supplies and replacement oxygen tanks or liquid oxygen refills. Some clients need several deliveries per week, if they are extremely active (which is a good thing).

Medicare needs to pay for certain services, like home oxygen, on a tiered level, paying more for the higher-tech equipment and less for a basic oxygen setup. There is actually a strong movement towards this, and a highly respected retired pulmonologist, Dr. Petty, is a supporter of this plan.

It would be nice if insurers would also recognize the difference between a basic CPAP and a high-end device like the A-Flex. Probably will never happen though!

It would be even better if the manufacturers would QUIT making "basic" CPAPs. For one thing, by streamlining their product line, they SHOULD be able to make MORE money.

Den

[mindy]

Hi,

Here's another link to a much more in-depth article and includes the whole DME industry

Code: Select all

[url]http://www.nytimes.com/2007/11/30/business/30golden.html?hp[/url]

Mindy

[NiceDMEDude]

Great article mindy!

That sums up much of what is embroiling the manufacturer/DME/Internet dealer issues that we have been discussing.

Competitive bidding has the industry in an uproar, trying to figure out how to stay alive if reimbursement is cut dramatically. The "sky is falling" mentality has gripped many DMEs, and who knows how it will eventually play out. If history is any indication, I bet all it will do is create a huge new government bureaucracy to oversee the bidding, and end up actually costing more to administrate than the savings will be.

But what the heck do I know

One more thought: I am embarrassed to be associated with an industry that uses false information to seniors to further their cause. But I guess that happens in politics

[mindy]

Hey NiceDMEDude,

There aren't enough of you!

I don't think the problems are limited to DMEs! It seems like there is a cacaophony of voices all saying "me", "me", "me". And that becomes a downward spiral very quickly.

As consumers, I think we sometimes expect too much (and sometimes not enough!) and it's the same elsewhere. I certainly don't know of any good solutions. Best I can do is navigate the waters for myself and this group certainly makes substantive contributions to our collective lives.

Maybe that's the answer for the new millenium and the internet... groups banding together for mutual assistance and spreading the word.

I'm certainly much more conscious about with whom I do business.

To me, a workable model is where everyone feels reasonably satisfied. It seems to me that our host does a creditable job of doing that. He needs to make a profit .... but his business model seems innovative in a positive way IMHO.

Mindy

[FreeLancer74]

I'm new to CPAP as well, and have heard severl DME stories lately. This appears to be another mark against them. My question is "Why is this the norm instead of the exception"? That is rediculous.

Thank you for sharing this so more people can witness how DMEs treat their customers.

DMEs appear to be the new carlot of the world.

[DreamStalker]

Johnny and mindy, I agree that Medicare does pay too much for some aspects of caring for their beneficiaries.

However, especially in the case of home oxygen, many of these customers/patients require a great deal of assistance. For every oxygen customer who never has a problem requiring a home visit (except for routine 1 or 2-month equipment checks), there will be at least one or two more clients who need multiple deliveries of supplies and replacement oxygen tanks or liquid oxygen refills. Some clients need several deliveries per week, if they are extremely active (which is a good thing).

Medicare needs to pay for certain services, like home oxygen, on a tiered level, paying more for the higher-tech equipment and less for a basic oxygen setup. There is actually a strong movement towards this, and a highly respected retired pulmonologist, Dr. Petty, is a supporter of this plan.

It would be nice if insurers would also recognize the difference between a basic CPAP and a high-end device like the A-Flex. Probably will never happen though!

It would be even better if the manufacturers would QUIT making "basic" CPAPs. For one thing, by streamlining their product line, they SHOULD be able to make MORE money.

Den

Exactly ... why is it that PC manufacturers are not making 286 desktops anymore? ... cuz it would be stupid and ineffcient to do so. The PAP blower manufacturers have not figured that strategy out yet.

[WNJ]

NiceDMEDude,

Thanks for the thoughtful well-written post.

You asked, “If the Big Three (R,R, F&P) all implement MAPs, will you seek out blowers and interfaces from others (AeioMed, PB, ProBasics, etc.) who do not have MAPs? Or would you be inclined to use the most effective therapy, whether from one of the Big Three or any other manufacturer?”

With insurance, I pay only about 30% of the cost of my equipment. I am financially comfortable to the point that I could pay the entire tab without much worry. My decisions are only slightly impacted by price. I would never have found this web site if I hadn’t gotten such terrible service from my local DME, American HomePatient. After I got what I characterized at the time as “the bum’s rush” from American HomePatient, I started looking hard for an alternative because I did not want to patronize such a worthless outfit. It’s a matter of principle.

I am pleased to save myself and my insurance company money by buying on-line. Saving money is not my top priority. I am pleased to support (and recommend) cpap.com because of the good service.

Give me good service at a fair price (not necessarily the cheapest price) and I will be a loyal customer.

On principle, I avoid where possible companies which engage in obvious non-competitive practices, legal or not. I avoid companies which have given me poor service/products in the past. (I haven’t bought anything by GE in over 40 years because of a number of crappy products I bought long ago.)

I will enthusiastically seek out products from companies which do not engage in anti-competitive practices. OTOH, if the only effective therapy available to me is from ResMed, I will (grudgingly) buy ResMed.

[begin rant]

There is no free market in XPAP. The market is dominated by a handful of manufacturers. Competition is extremely limited. The movement to implement minimum pricing policies is ample evidence of lack of full competition. Such vertical control of the market would be impossible (or suicidal!) if there were enough manufacturers.

MAP (and a number of other equally anti-competitive practices) should be illegal. (Write your Congressman!) As for the manufacturers fearing suit for anti-trust violations: FUGEDABOUTIT! With the current (Bu$h) administration, the last thing a monopoly needs to worry about is the US Justice Department enforcing the anti-trust laws. Remember what happened with the Microsoft anti-trust case when they took office? (Throw the bums out!)

[end rant]

Wayne

[Gerald]

The answer to the "puzzle" might be a "private branded" machine with most of the same features of a similar machine sold to DME's....but still different....and with a different part number.

I seem to remember having read that one or more of the large DME's were furnishing blower units (without normally standard features) to their customers in order to increase their profit margins.

Why can't cpap.com have a private label machine built and sell it to the internet crowd?

Adam Smith's Invisible Hand is a powerful mechanism......the market always moves in the direction of the best value.

Gerald

[Suz-E-Q]

Rested Gal & NiceDMEDude....I actually like the term Client best.....better than Customer....Client means that what they do is all about me!!!!

[BobF4]

I have been reading the posts about the MAP policies of the major CPAP suppliers. To me, this definitely sounds like collusion, in order to drive up prices.

5 years ago, I got my CPAP from a local DME (Apria). I was given no choice who I would be going with, and, looking at all this going on, I sure wish I had that choice. I was given very little setup training for my machine, but I figured it out quickly, and on my own.

Right now, I am considering asking about getting a replacement machine, since mine is so old, not to mention it's logged over 11,000 hours of use. I am not sure if I will go back to Apria, go to an internet provider, or go to a local brick-and-mortar store that just opened (CPAP Xpress) for my needs. I will definitely have to consider and compare prices before I make my decision.

If anyone has any suggestions, please let me know.

[rested gal]

If anyone has any suggestions, please let me know.

Well, my suggestion would be if you're going to be price comparing and are pretty sure you're going to buy yourself another machine, I'd do it before March 31 goes by.

Speaking of "comparing"...take a look at how much the Minimum Advertised Prices for Respironics equipment will be going up:

MAP -- Respironics "Minimum Advertised Prices" after March 31, 2008

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