How do health care providers get away with it?

[Kiralynx]

you morons have no idea what it takes to run a DME - get a life.

You're right. I don't have any idea what it takes to run a DME. I'm very grateful for the expertise of the RT at mine who helped me get the right machine for my complex apnea. But I'm not so grateful that I will now allow her to run over me and tell me I don't "need" something when I do...

I am a customer. I have worked in retail sales for 30+ years. I expect my DME to obtain the products I require for the treatment of my complex apnea in the same timely manner I would be expected to obtain books and research materials should you have need of them.

Unacceptable actions include ordering my goods from a producer. Sending them to a regional warehouse. Sending them to a local office. and THEN, finally, sending them to me. Instead of ordering my goods and having them sent direct to me. You're tacking on an extra two sets of shipping, and anywhere from 10-15 days to the time frame from when I place my order to when I receive my merchandise.

In most retail sales, if a customer is displeased with the service they receive from a retail establishment, they can take their business elsewhere. I, however, am only permitted to shop at one DME by my insurance. They know I can't take my business elsewhere, and they behave accordingly, like charging 3x as much for Smartcards as I could get them online.

Unacceptable.

Edited to add that I am getting a life -- thanks to the fact that I have taken control of my CPAP treatment! With the aid of the "morons" in this Forum whom you're castigating.

[Wulfman]

you morons have no idea what it takes to run a DME - get a life.

The other side of this coin is that (from my point of view) many of the online DME sellers (like CPAP.COM) DO know what it takes......yes, they would be considered a DME even though they're not "brick & mortar" in the traditional sense.
CPAP.COM is the first and only DME I've used.....and have had excellent service with them since April of 2005. I've never been over-billed, never had the wrong items sent or any other problems that I've seen reported in the posts by others on the forums.

Den

[turbosnore]

you morons have no idea what it takes to run a DME - get a life.

I guess its quite similar to arms sales.
[edit]
BTW, one of the arrested was the CEO.
(I hope my sense of humor didn't cross the line.)

[LinkC]

you morons have no idea what it takes to run a DME - get a life.

Lessee...One to put phone calls on hold and order equipment, one to deliver and semi- set it up. And 25 imaginitive souls in the billing dept!

That about sums up "what it takes"!

[mindy]

I suspect that for every layer you add, the price gets squared again. Interesting statistic: Medicare overhead is 3% while for insurance companies the average is about 29% .... and some would like to do away with Medicare and let the insurance companies run things!

The current system is so grossly unfair it's incredible. Those high prices that get negotiated down are the prices that the uninsured are charged. I'm very fortunate to have great insurance but also realize that many people don't.

Mindy

[Leatherneck]

you morons have no idea what it takes to run a DME - get a life.

....and you would rather call folks names and offer no useful discussion? We are all here to have a better life as a matter of fact. I may not know how to "run" a DME, but many of us including myself are in business. It doesn't take a Wizard to see how our health care system has become and absolute mess in many different ways. When I called about the crazy price of my CPAP equipment they got downright mean when I asked them why they would even charge 6 times what cpap.com charges. All I got was a crass "We don't compete with the internet". I completely understand that as there is much more that they do besides just provide me with equipment. They will service it, make sure it fits, works and functions properly, etc...but the fact remains that the amount they bill the insurance company is just crazy high! Health care costs are killing companies left & right and there has to be a way to make it work for both business and patient.

[Arizona-Willie]

I came to the conclusion some time ago that the medical providers such as DME's and the companies that make the equipment are bribing the people who work for Medicare and the other insurance companies who authorize the obscene payments.

It is totally against the insurance companies interest to be paying several times what an item can be bought for on the internet so why do they continue to pay so much for masks and machines? It's pretty obvious there is something crooked going on somewhere.

Insurance companies have floors of lawyers looking for ways to avoid paying claims and people who are supposedly looking for ways to cut costs ... so why do they overlook such flagrant overcharges?

Medicare is the most efficient insurance there is but even Medicare allows these incredible overcharges.

I suspect if the bank accounts of all insurance company employees were examined there would be some interesting questions to be asked.

[mindy]

But medicare and insurance companies really don't allow the large amounts charged - they all have amounts they actually pay which are often far less than charged. This is especially true for Medicare but also the other insurers. It's the uninsured patients who have to pay those obscene amounts.

Mindy

[Gerald]

It's apparent that the person who called us "morons" is a perfect example of what I was talking about.

Rather than help people understand, that person resorts to ad hominem attack....which is a standard tactic used by those who wish to confuse and dominate their victims.

With just a few words, "Guest" demonstrates his contempt for consumers of medical equipment and services. Lack of a free market (where people can choose) always creates adversarial relationships....instead of relationships built on integrity and cooperation.

Gerald

[plr66]

It's apparent that the person who called us "morons" is a perfect example of what I was talking about.

Rather than help people understand, that person resorts to ad hominem attack....which is a standard tactic used by those who wish to confuse and dominate their victims.

With just a few words, "Guest" demonstrates his contempt for consumers of medical equipment and services. Lack of a free market (where people can choose) always creates adversarial relationships....instead of relationships built on integrity and cooperation.

Gerald

Very succinctly and well-stated, Gerald.

[bucko]

The entire healthcare business and insurance companies have been quite successful at maximizing profits at the misfortune of others for years. Not many governments allow this behavior, and the US government should be ashamed for allowing this fleecing to continue.
Go rent "Sicko" and try to understand why we all put up with this crap. The US has one of the poorest records of healthcare systems in the world and should be embarrassed with it's treatment of it's own citizens. Meanwhile the US harps on and on about human rights. My feeling is put up.... or shut up. Fix things at home before passing judgment on the rest of the world.
Just another reason why I decided to to live elsewhere. I pay all my healthcare out of pocket in cash and I get better care than anywhere in the US for a whole lot less.

[georgepds]

...
Fine, but all that means is tax dollars (or more specifically, uncollected tax dollars) are being wasted too. Since the set of "taxpayers" overlaps pretty thoroughly with the set of "people who use the medical system," the net loser in this wacked out system is one and the same.

I do not disagree, but the original premise is that the insurance company decision to rent from a DME made no sense at all. It does make sense from a tax point of view.

Now if you would like to change the tax code along with inequities in US health care, my hat is off to you;)

--g

[DreamStalker]

I just talked to a friend of mine who suffered a heart attack about a month ago. In one month his medical bills have gone over $200,000 ... his annual deductible is $1,000 then his insurance is supposed to go from 80% coverage to 100% coverage ... but of course there are always certain types of DME costs that are not covered (like the $2,000 per month out-of-network heart monitor vest he had to wear for 2 weeks but still billed for entire month) so his out of pocket now stands at just over $4,000. Not all of his bills have come in yet either and he still has plenty more visits to the docs. He also was in extremely good physical fitness before the heart attack.

So even if one has good health and a decent insurance, one cannot always be prepared for the cost of a medical emergency in this country ... unless of course you are a member of congress

The solution of course is for everyone to become a member of congress.

[mindy]

... The US has one of the poorest records of healthcare systems in the world and should be embarrassed with it's treatment of it's own citizens.

Not one of the "poorest records of healthcare systems in the world" (emphasis mine), but the US does rank near or at the bottom of the industrialized countries, so you are right that it doesn't rate highly - just not quite as bad as the entire world!

Mindy

[MurphysLaw]

Welcome to Socialism.

This isn't even close to socialism. Socialism would be an improvement over what we have now, where everyone would be insured, regardless of our employer and pre-existing conditions. Even as things are now, we have to wait to see doctors---weeks, months in some areas and depending on the specialty.

FoxNews http://www.foxnews.com/story/0,2933,273875,00.html praised the movie Sicko . It's time to revive it while we have a chance of getting something done to help the citizens, not the big drug and insurance companies.