Anyone else heard about ResMed stopping Internet sales?

[drj130]

I've read all the post on this topic and I thought that I'd throw in my thoughts on this issue over all. As most of you know, I'm a Soldier who is stationed in Germany and fall under the TriCare insurance plans for receiving my supplies, unless I pay for them out of my own pocket. I'll try to make everything that I mention make sense if I can. Here is what they've told me for getting new stuff.

1: New Mask(s) once a year.
2: Supplies (hoses, filters, etc) Once a year.
3: While deployed, buy from online.

I have the fun of being able to visit many different places. 99.9% of those places are not conductive to the 'normal' life of a XPAP machine or related equipment (sand, dust, rain, and other adverse or extreme conditions that normal machines and masks have to deal with).

I will be deploying next year to Afghanistan next year unless my doctor, whom I'll be seeing for the very first time on Friday, says other wise. Now according to Army regulations, I can deploy if the following things can be met:

1. A reliable source of power. (While deployed, all power is provided by generators. I'm not sure how that would affect a ResMed machine, hearing about special power needs)
2. Absence of environmental factors that would render electrical equipment inoperable or unreliable.
3. The availability of a reliable source of replacement supplies, such as masks, harnesses, and filters, etc.

It also states that if these supplies can not be met, or the absence of using a XPAP device would hinder the Soldier from performing his/her military duties.

Right now, all the supplies that I have are because I was able to buy them online. I've been stocking up to ensure that I have what I need while I'm there. Everything that I have extra has come out of my pocket. A second machine, humidifier, hoses, masks, filters, etc. The next thing that I'll have to stock up on is distilled water for use while I'm there. I'm guessing that I currently go through about 5 liters (a gallon?) a month, which may increase while I'm there. I'll be looking at taking with me, at the least 24 gallons of water with me.

If it wasn't for https://www.cpap.com or other places online where I'm able to buy the items I need to ensure that I can perform my duties, then I'd be in a world of hurt. I don't think that it is possible, though I could be wrong, for me to go outside one of the bases there in Afghanistan and visit a Local DME to pick up needed items. To tell the truth, I don't even think that you could buy any of the stuff a normal user needs for their treatment there, and if you could it would be at least 10 times higher than an online seller. The only thing that I'd have to worry about is my stuff being blown up, and yes that does happen.

Guest wrote:What's going to happen when manufacturers get their act together and start charging online companies more - the online prices go up, and your best deal ends up being at the local DME that's been there for the last 20 years? (forget insurance - think cash only).

Myself, I think that the same thing will happen as did when another famous online seller came out, prices dropped on many things. I don't think that manufacturers will increase the prices like you're talking about, though I could be wrong.

I'm glad that people like Johnny have gone and are selling things online. Other wise, I wouldn't be able to stay in the military (18 years and 9 months) to take care of my fellow Soldiers. I'm not looking for special treatment, don't need or want it because I'm in the military. I just want what everyone wants, the best bang for my buck. For me, that is buying online.

My 2 cents, take it how you'd like.

Now I think that I'll climb back inside my tank and watch some more fireworks happen here on this topic.

David

[akcpapguy]

David,

You need to talk to the Tricare rep at Landstuhl, your Dr. is able to write you an order for supplies for an extended deployment. I did 2 tours in Iraq with my CPAP, and it survived just fine and is still pumping away. I got my Dr. to write me an order for 4 masks, 24 filters, 2 hoses and 2 extra water chambers, Tricare authorized the complete order, the Dr. stated that it was necessary for deployment. I used bottled water while I was over there and had no problems at all, never had a problem with power either, the generators on my first deployment nevver bothered my machine, on my second time we had power from the Iraq grid. Many times the magic words to get Tricare to pay for things are "medically necessary".

[drj130]

David,

You need to talk to the Tricare rep at Landstuhl, your Dr. is able to write you an order for supplies for an extended deployment. I did 2 tours in Iraq with my CPAP, and it survived just fine and is still pumping away. I got my Dr. to write me an order for 4 masks, 24 filters, 2 hoses and 2 extra water chambers, Tricare authorized the complete order, the Dr. stated that it was necessary for deployment. I used bottled water while I was over there and had no problems at all, never had a problem with power either, the generators on my first deployment nevver bothered my machine, on my second time we had power from the Iraq grid. Many times the magic words to get Tricare to pay for things are "medically necessary".

Thanks for the information. As noted above, I mentioned seeing the doc tomorrow, so we'll see how that goes.

I just thought that I'd throw in my two pennies into the frey seeing as how some of the unnamed people who are posting in here are calling some of the B&M DMEs the best thing to happen to us, and suppliers on the net aren't worth dealing with. Myself, I'd rather deal with Johnny and his group before a B&M DME.

David

[roster]

My message to the manufacturers is simple.

Delivering mask fitting, patient training, followup training and troubleshooting one-on-one by a RT is very expensive and it is ineffective.

Continuing to pursue this model will maintain the high noncompliance rate.

Maintaining a high noncompliance rate means word-of-mouth publicity that CPAP is horrible and cannot be tolerated.

This bad publicity means the undiagnosed (90%?) will continue to shy away from diagnosis in droves.

And you know what that does to the sales potential for machines.

Manufacturers need a different model to market their products.

[BlackSpinner]

So, let’s talk compliance, after all is said and done above, I still have a 49% failure rate for XPAP patients within the first 60 days. The largest reason “I just don’t want to be tied to a machine for the rest of my life”, many patients come in and say “I don’t like it” and when asked if they can state specifically what they don’t like, i.e. mask fit, pressure, noise, difficulty breathing, they often become defensive and angry and leave the office. I understand that a lot of the anger is not directed at me or even at anything, they are suffering from OSA after all and many of us can understand the OSA short fuse syndrome.

That is because you try to do a one on one "education" (which most DME's don't bother with) Besides just knowing how to hook up and control leaks, people need group therapy to deal with the emotional issues. Cpap is not just about using a machine, just like diabetes it is about a dramatic life change and coming to terms with it, coming to terms with loss and dealing with the grieving process off that loss. This is why you have a 49% compliance failure. Cpaptalk forum is providing this for many people - for free. It isn't the only forum on the internet, it is just to most unmoderated one. You can go to the yahoo forums and find the same issues except they don't get any answers due to the excessive moderation.
It says something that we and they have many members over 70 who were desperate enough to learn to go on the internet and hunt for this information and support.
The big problem is Western medical idea that a body part is a stand alone thing - not attached in anyway to the emotional or mental part of the human being, that you can treat body parts/issues as having less impact then a pair of shoes. And mentioning shoes, I get better help in fitting my shoes the I do my masks, the shoe salesperson doesn't sit across the desk and tell me that it looks good and it is just to bad that I want to try a smaller size because they don't carry it I have to make do with the size they give me - and my shoes cost a bout have what I pay for a mask in my DME ($300CDN).

[jnk]

It is my opinion that one does not improve compliance rates by making the product more expensive and more difficult to obtain. It is also my opinion that one does not increase sales of one's product by insulting the patients who use the product by putting them at the mercy of people who are not rewarded financially in any way for the amount of, or effectiveness of, the help they might provide once they already have the dough. The model of "Hey, I know, why don't we let a business make a huge profit selling a machine so that then maybe that business will be helpful to patients out of the goodness of its heart" has not been successful. Insurance has messed up the process beyond all recognition. You can't fund the treatment of a chronic condition as if it were an acute one. And a brick-and-mortar room full of crutch salesman who are required to have one semi-retired respiratory guy on staff does not a sleep-medicine-brain-trust make for any patient anywhere.

[roster]

......... The model of "Hey, I know, if we let a business make a profit selling a machine, maybe then they will be helpful to patients out of the goodness of their hearts" has not worked. Insurance has messed up the process beyond all recognition. ...........

You need to do a deeper analysis. What you see as "bad behavior" by insurance companies and DMEs is their response to heavy regulation. Dig a little deeper and you will find government is the root of most of the bad behavior.

That said, even with minimal regulation, a one-on-one approach using RTs would still be very expensive and inefficient.

I don't want an RT assigned to me. (Not even akcpapguy who seems to be one of the best.)

[jnk]

......... The model of "Hey, I know, if we let a business make a profit selling a machine, maybe then they will be helpful to patients out of the goodness of their hearts" has not worked. Insurance has messed up the process beyond all recognition. ...........

You need to do a deeper analysis. What you see as "bad behavior" by insurance companies and DMEs is their response to heavy regulation. Dig a little deeper and you will find government is the root of most of the bad behavior.

That said, even with minimal regulation, a one-on-one approach using RTs would still be very expensive and inefficient.

I don't want an RT assigned to me. (Not even akcpapguy who seems to be one of the best.)

I see the point. And I admit I am not a politically savvy guy. But, tell me, how exactly does one prove that insurance/big-business isn't, in fact, "the government"? Laws (regulations) are generally made by those best served by the laws (regulations) that end up being made. If one defines "government" as "those in control," I think in this context we may be making a distinction without a difference. I again fall back to, follow the money.

[Engransan]

Welcome aboard Gil. I am sure that you will gain some valuable insights from other members on this forum. Since my insurance approved DME is 100 miles away I find that managing my own treatment with help from members of this forum is invaluable.
Engransan

[BlackSpinner]

You need to do a deeper analysis. What you see as "bad behavior" by insurance companies and DMEs is their response to heavy regulation. Dig a little deeper and you will find government is the root of most of the bad behavior.

LOL Most regulation in the medical industry has come about because otherwise they kill people by sloppy performance, lack of training or other kinds of fraud in order to make big bucks. That - the desire for quick and easy money at your life's expense- is the root of the evil, regulation is the government's response to death by medical treatment. Do you want to see them selling those herbal supplements guarantied to cure OSA ?

[howkim]

Hello! Serious question please.

If you needed a new mask or tube, etc., and the cash price for this item at your local DME or other retail outlet was exactly the same as the price online, would you still buy online? This question has nothing to do with Map policies, etc. nor insurance or copays.

Thank you.

Yes. The closest locations to my home that my DME has are about 40 miles away. Not convenient at all.

[roster]

......... The model of "Hey, I know, if we let a business make a profit selling a machine, maybe then they will be helpful to patients out of the goodness of their hearts" has not worked. Insurance has messed up the process beyond all recognition. ...........

You need to do a deeper analysis. What you see as "bad behavior" by insurance companies and DMEs is their response to heavy regulation. Dig a little deeper and you will find government is the root of most of the bad behavior.

That said, even with minimal regulation, a one-on-one approach using RTs would still be very expensive and inefficient.

I don't want an RT assigned to me. (Not even akcpapguy who seems to be one of the best.)

I see the point. And I admit I am not a politically savvy guy. But, tell me, how exactly does one prove that insurance/big-business isn't, in fact, "the government"? Laws (regulations) are generally made by those best served by the laws (regulations) that end up being made. If one defines "government" as "those in control," I think in this context we may be making a distinction without a difference. I again fall back to, follow the money.

.......If one defines "government" as "those in control," I think in this context we may be making a distinction without a difference. ........

Maybe you thought deeper than I realized – savvy is not necessary. You are right that government/some companies are nearly unworthy of making distinctions about. They are like conjoined twins trading money and power between themselves at our great expense. The companies provide the money and the politicians dole out the power.

Going after the companies is a poor solution. The solution is to limit our government to the powers the Constitution allows them. If they cannot dole out favors, the companies will quit lobbying and “get back to business”.

Obama has some really bad premises ingrained in his brain. One of the more minor ones is that capitalists like free trade. But capitalists are not free traders. Capitalists want regulations that favor their companies and their industries. The government's job is to make sure this doesn't happen and protect our rights to trade freely.

Our founders were aware of this and wrote a constitution to severely limit the federal government’s power. It also puts severe limits on state governments and most states have state constitutions that limit their power. But “We the Sheep” have let governments exercise power that the constitutions forbid.

Interesting times. We need new brave leadership. The incumbent reelection rate is over 90%. We get the government we deserve.

[BlackSpinner]

Rooster - the problem with incompetent DME's is international - it has F-all to do with US presidential politics.

All governments regulate the medical industry for the same reason - practitioner greed and patient deaths. In many places there are many more regulations and the end results is the same.
The sleep industry is not regulated enough. It needs more standards, it needs more regulation as to minimum care and education, it needs a patient bill of rights.

[Muse-Inc]

...All governments regulate the medical industry for the same reason - practitioner greed and patient deaths. In many places there are many more regulations and the end results is the same. The sleep industry is not regulated enough. It needs more standards, it needs more regulation as to minimum care and education, it needs a patient bill of rights.

Hear, hear! I agree 100%. The function of govt IMHO is protection against the predations of big organizations (including govt) which invariably fall into the old power creates the desire for more power ad infinitum...substitute "profit" as desired...they both run amuck without watchdogs. I had to threaten to bring in OSHA at one company because they were exposing me to a carcinogen because it was cheaper than installing the chemical venting that was needed (nice OSHA guy worked with me anon to coach me thru the process..pre days of caller ID). Biz will always do the cheapest to make the most $ regardless of the consequences, long-term biz results are immaterial in our instant gratification, right now, this & next quarter quarter world. We, as individuals, are pretty much powerless against the influence, power, and $, that big entities bring to the table because they 'own' our legislators via campaign funding..what voice do we have against this? They will continue to do what they do for as long as they can until their profits are seriously affected or these 'rights' are curtailed by regulation/law.

[roster]

...........The sleep industry is not regulated enough. It needs more standards, it needs more regulation as to minimum care and education, it needs a patient bill of rights.

Yeah, like I want to go to my doctor and watch him going down a checklist created by a government regulator while he talks to and examines me.

No thank you!

I will continue to choose doctors who love helping patients in order to make a very good income. Those are the ones I trust (but verify).

You are an idealist who thinks just like Obama: "If we can just get the right policies written down everything will work great." History shows that does not work.

Democracy is messy. Freedom is scary. But that is what my country has been about and that is the way I want to continue to live.