ResMed Tango CPAP Machine

DP wrote: ... The problem is that there good caregivers are the minority and most have very poor or nonexisitant. This is the problem with the entire industry. I want to see that changed.

Now a CPAP machine needs to be designed for the patient. The caregiver is not going to be the one sleeping with it every night (well unless he/she too is a user). So a machine designed for a caregiver does not make any sense.

I acutally think we are all on the same page. The problem with messageboards is the lack of tone and emotion when reading a post so misunderstandings can result.

Yeah! NOW we are on the same page, DP!!!

rested gal wrote: ... resmed sure wasn't/isn't concerned about making their products available to the those people when they put their minimum prices that online stores had to charge in place ...

Amen. Amen, I say unto you, Amen.

rested gal wrote: ... BrianRT wrote ...
The rep said it would be low 200's with humdifier and around $195 without. I guess she meant the DME's prices, I don't know. Probably.

rested gal wrote ... I think your guess is probably right, too...that she was talking about the price the DME could buy them for, not the price the DME would set for the the end user. We shall see.

... I expect we'll all hear sooner or later what kind of price resmed makes their "approved dealers" set as a minimum for the Tango. My guess is they will make their dealers price it considerably higher than either of these machines ...

Unless they've miraculously come up w/a special HCPCS code for the Tango, the local DME suppliers are going to be selling them as E0601, THEIR cost will be lower, BUT the patient will not be saving a thing or getting ANY break. Nor will those who HAVE insurance. Their insurance will be paying the same, the patient getting even less of a machine and the DME supplier absorbing greater profit. The Tango may well be a real boon to the rest of the world but selling it in the US is just Resmed pandering to the DME suppliers with this machine.

Slinky wrote:This is NOT a machine needed except in small quantities for those w/low income who have no insurance.

And you seriously think that only a small number of CPAP suffers globally will fit into that category!

RG.....yes...the older generation teaches the younger and the more experienced teach the lesser experienced. I agree 100%. Now to be fair, a setup of mine earlier this week, a 66yo, had beena Googling and knew some things too. I was impressed. He asked me about Bipaps mostly.

Dreamstalker,
Let me clarify what I was referring to. Most every public library have computers that the public can use to get on the Internet for free. I wasn't really referencing checking out a book or anything

Willsucceed wrote:

I looked at the clinician brochure... this is a seriously vanilla machine. Does not even have leak adjustment.

DP replied:

Yep, should make for a very good backup machine. Will be cheap, probably the same cost as many people sell used machine for.

DP later wrote:

Every CPAP machine today compensates for leaks. It is standard.

The problem is that there good caregivers are the minority and most have very poor or nonexisitant. This is the problem with the entire industry. I want to see that changed.

RG wrote:

Doesn't look like it to me, according to this fact sheet on resmed's own site... this link is to the clinician's brochure about the Tango:

C-Series Tango Fact Sheet

Doesn't look like automatic leak compensation is in the specs for any of these basic resmed machines:

C-series Tango
S8 Compact
S8 Escape

DP then wrote:

I'll call my rep tomorrow and see what he says. Thanks for pointing that out.

OK, DP. I just hope that when you are dealing with your patients, delivering service that is "caring," you do a better job of paying attention. The very first response to your initial post pointed out that the clinician brochure about this machine said that it does not have leak compensation. I'm not sure why you are thanking RG for pointing this out to you as you had already been told about it 24 postings earlier in this thread. And, the clinician brochure to which I referred was found through the link that you provided in your initial post!

This is not "venom" DP, just an honest observation. If you are going to make matter of fact statements like "every machine today compensates for leaks. It is standard" then you might want to make sure you have done your homework first. This homework is as simple as actually reading the data on the link that you provide and, paying attention when someone else (like a patient) gives you some information.

For me, this is a big part of what scares me about equipment providers... for some reason, they often seem to think that they know EVERYTHING, don't check facts before they make statements, and do not want to be bothered listening to their patients, or anyone else for that matter, who might offer information.

DP wrote: "The problem is that there good caregivers are the minority and most have very poor or nonexisitant. This is the problem with the entire industry. I want to see that changed." This, DP is a great sentiment! I can offer a suggestion of where you might start.

Brian RT wrote:

But seriously, the Tango is a cool little deal. Even has a heated humidifier and a ramp. Sure it doesn't have auto-leak adjustment or whatever else it was that someone was pissed about, but you have to skip over the Compact and Escape to get that feature in the Elite or Vantage, so it's far from a damning feature in and of itself, considering other ones are without it too.

That some of the other ResMed machines don't have leak compensation does not excuse this machine for not having it. I'd damn ALL the machines that don't have it. And, contrary to your comment, I'm not "pissed" about it, I just pointed out that the Tango lacks the feature and that I think auto leak adjustment is very important.

I agree with you regarding options like data collection and automatic altitude adjustment -these are not necessary for many, many users and, for those who don't have insurance or $$ to buy anything but a very basic machine, there should be a low-cost, no-frill alternative. But, a feature like leak adjustment should not be thought of as a "frill," it should be a standard feature.

The manufacturers should be ashamed of themselves for not putting this in every machine and I'm surprised that an RT is advocating for a machine that does not have it.

Having been responsible for ordering hardware and software at a teachers colleger, I have long ago learned never to trust anything a sales rep says. Only what they agree to put in writing.

DP, I sugges you try getting all your sales reps to write down anything and everything they tell you about machines. You'll be surprised how different that will be from what they say.

I am also impressed by what WillSucceed pointed out, as I am by the fact that you apparently ordered 20 machines with no leak compensation, without realing knowing that is the case.

This is not cynical question - I mean it seriously:
Will you cancel the order if it turns out they have no leak compensation?

O.

Will,
A cursory examination of all of the CPAPs offered by Cpap.com reveals that out of 28 different models available, only 12 have auto leak compensation. Less than 50%. It makes one wonder just how important it really is then.

A nice feature to fully optimize therapy...sure
Absolutely essential for Xpap use.....not really


What I'm saying about the Tango is that.....
It is what it is.
And for that, the features offered aren't that bad.
But bemoaning the fact it doesn't have this or doesn't have that....well, you're missing the forest for the trees. It's a cheap PAP with decent features for what you pay for (which is TBD anyway)

To me, it's like going to a car lot, looking at an economy 4-cyl car, and being upset it doesn't have a GPS or Onstar or heated seats.

I love car analogies.....Dreamstalker, to ever so humbly offer to correct your analogy a bit more accurately (ummm....how about the uboquitious and obligatory "IMHO") I wouldn't think it's like a car without a steering wheel, that's obviously undrivable, but more like a car without any gauges. No speedometer, gas gauge or what have ya.

BrianRT wrote:To me, it's like going to a car lot, looking at an economy 4-cyl car, and being upset it doesn't have a GPS or Onstar or heated seats.

I love car analogies.....Dreamstalker, to ever so humbly offer to correct your analogy a bit more accurately (ummm....how about the uboquitious and obligatory "IMHO") I wouldn't think it's like a car without a steering wheel, that's obviously undrivable, but more like a car without any gauges. No speedometer, gas gauge or what have ya.

Sure ... fair enough.

But I still don't think it is right for car dealers to be selling cars without any gauges ... a rip-off is still a rip-off ("IMHO").

I mean if economy has a higher priority for patients than data capabilities, then maybe they should be looking for one of

these.

At $29 it has the same basic functionality and also has a way cooler name than Tango too.

DreamStalker wrote:

BrianRT wrote:To me, it's like going to a car lot, looking at an economy 4-cyl car, and being upset it doesn't have a GPS or Onstar or heated seats.

I love car analogies.....Dreamstalker, to ever so humbly offer to correct your analogy a bit more accurately (ummm....how about the uboquitious and obligatory "IMHO") I wouldn't think it's like a car without a steering wheel, that's obviously undrivable, but more like a car without any gauges. No speedometer, gas gauge or what have ya.

Sure ... fair enough.

But I still don't think it is right for car dealers to be selling cars without any gauges ... a rip-off is still a rip-off ("IMHO").

In MY (not so) Humble Opinion, the "rip-off" is on the end-user and the insurance carrier that's more than likely paying for it. They're getting a less-than optimal machine and their insurance provider is going to be billed the same amount.
And, I don't think this is even close to a vehicle analogy.....unless the majority of the car buyers just walked into a dealership and said "I need a car.....I'll have to take whatever you're going to give me.....because my insurance is paying for it." You drive off in a YUGO and the insurance gets billed for a Corvette.

Den

well, you're missing the forest for the trees.

I think that I'm seeing the forest just fine, thanks. Having a bunch of non leak-compensating machines on the market does not, in any way, suggest that they are good machines. A lot of crap is still just crap.

BrianRT wrote:

A cursory examination of all of the CPAPs offered by Cpap.com reveals that out of 28 different models available, only 12 have auto leak compensation. Less than 50%. It makes one wonder just how important it really is then.

This statement, in and of itself, means squat! I'm surprised that you would think that this observation mattters.

More interesting would be to look at which machines sell and which don't and, the demographics of the purchasers. Further, how many people buy a vanilla machine, do some learning ("funny thing, why didn't the RT or equipment supplier tell me about these other features that are available when I was in here buying my first machine?") and then upgrade to a machine with features (the clever machine supplier scores twice!) later on?

Are you serious, Brian, in drawing an analogy between leak compensation in a CPAP and a GPS in a car? Give me a break. Leak compensation is clearly a feature that should be on all CPAP's, it is not, in any way, an unnecessary option.

BrianRT wrote:

It's a cheap PAP with decent features for what you pay for (which is TBD anyway)

It's a cheap PAP alright -with essentially zero features (it has a ramp, manual altitude adjustment, OPTIONAL humidification, and a carry bag -big flippin' deal!) no matter what they charge for it.

Keep an eye out for those trees in the forest, Brian... I'd hate to hear that you have bumped your head on a few branches while you were out walking!

And yes, lest I be bashed, the above statements are my humble opinion. OK, I lied, they are not humble.

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, CPAP, auto

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, CPAP, Ramp, Altitude, auto

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, CPAP, Ramp, Altitude, auto

Whoa whoa whoa...time out!!

You know....Emerson also said that to be great, is to be misunderstood. I guess that makes me practically a deity.

OK...umm....let's see here.......

Dreamstalker,
Yeah...Scorpion is a cool name....but...kinda makes you not want to strap a scorpion to your head every night though. I suppose with a name like Tango, they hope you have dreams of dancing with a latin beauty every night (though I like Den's Tango and Cash better)

I'm running a little low on time, but let me recap a few things here. I in no way, shape or form advocate DME's screwing people over this stuff or taking the bottom end model, IF THEY DON'T WANT IT. Does it happen...sure. Should it not?.....sure. There's probably a special place in hell for these DME people that do it.

Basically. what it all comes down to is looking out for number 1. To further the car analogy. Most people don't go to dealerships without doing research so why does it happen with medical equipment? It's certainly more important. I guess that some people think that, since it's medical equipment and someone's health is involved, that the provider will take the moral high road and look out for their best interest. We all know this never happens.

If you don't want a machine that doesn't leak compensate, fine. Don't take it. You don't want an automatic transmission in your Vette, fine. It's all about choice and educating yourself so the dealer won't screw you....and without any KY at that.

Willsucceed....honest question here bro, OK. Tell me how you understand automatic leak compensation and it's limitations, fully. Seriously, I'm being honest, no barbs or saber rattling here. I know we all come to the table with different knowledge bases, so I'm trying to find some common ground here.

BrianRT - not signed in wrote:There's probably a special place in hell for these DME people that do it.

NO.....that place is reserved for the manufacturers that make them and then entice the DMEs to sell them. Then the DMEs can say "The Devil made me do it!".

I'll be curious to hear WHERE these new "YUGO" flow generators are being made.....(if anybody manages to get inside one if it isn't stamped on the bottom)......maybe....China?....Mexico?....Malaysia?

Den

I still don't get it! Where is this a cheap machine in the US? MOST CPAPS are PAID FOR by insurance companies. Which means our expensive insurance is going to be paying as much for an even cheaper machine than they are now the majority of the time.

And, my understanding is, IF a DME supplier accepts Medicare they can't sell equipment at less than Medicare allowed amounts. So even those w/o insurance are going to be paying the inflated E0601 price for an even more inferior machine if they purchase from a local DME supplier.

And given the "practice" of quite a few local DME suppliers to charge uninsured (and even insured) patients the difference between the billable amount and the allowed amount .....

I just don't see where many Americans, if any, are going to benefit from this cheap CPAP.

Let me ask what may be a question (or few) that may have an obvious answer that I have somehow overlooked:
If you take cost to insurer and/or patient, and profit/loss to manufacturer and distributer out of the equation altogether, is there some reason why a caregiver who is concerned first and foremost with the welfare of the patient would want the patient to have a machine that provides only compliance feedback to patient or caregiver alike if something goes wrong?
While compliance and lack of support are perhaps the most significant obstacles to xPAP success, wouldn't it help the dedicated patient AND the dedicated caregiver to make sure the patient has a machine that will assist as much as possible in helping identify and address problems that may arise in the course of the patient's xPAP therapy?
I might agree that an informed, dedicated and conscientious caregiver might be a bigger asset to a patient than the machine the patient uses, but how many serious patients are able to count on quality assistance from a caregiver or the best possible assistance from their machine if things go wrong?

Bill

BrianRT... honest answer here, Bro.

My understanding of leak compensation is that the machine somehow measures difference between prescribed pressure and what the patient is actually getting. It somehow decides that there is a leak which is greater than the normal leak (exhalation) of the mask and increases pressure so that despite leak, the patient still gets the prescribed pressure. Or, it signals, waking the patient, so that the mask can be adjusted so as to reduce the leak. To me (yes, my humble opinion) this is a good thing -keep treatment at the prescribed pressure; it just seems logical.

I'm not an RT, and certainly no expert in treatment for OSA. I do, however, work with lots of RT's and respiratory medicine doctors and I ask them questions about this stuff when there is something that I don't understand. When I asked about leak compensation, they all said the same thing: properly functioning leak compensation helps keep treatment at the prescribed pressure. If the prescribed pressure is correct, then the patient is getting the best treatment that the machine, given it's other features/flaws, can give. This, of course, is dependent on the accuracy of the titration study upon which the prescription is based.

If you want to give me some explanation of why leak compensation is not important, go for it. If what you offer makes better sense to me than my own thinking and the comments that I've heard from the experts at work, I'll happily change my tune. Until then, I'll be singing the same old tune, even though you think I'm "pissed" and "bemoaning" the issue.

Whoa whoa whoa...time out!

Back at ya'.