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billbolton wrote:

Slinky wrote:Resmed = Australia

Resmed has been legally been headquartered in the US, as a US Corporation, for quite a long time now. The Australian arm, which does design and manufacturing is a subsidiary of the US Resmed corporation.

Given the recent buyout of Respironics, Resmed may be the only US based company manufacturing CPAP equipment!

Cheers,

Bill

Hey Bill,

Do you suppose there were tax benefits for ResMed to headquarter in the U.S.? (Like Puritan Bennett being in Bermuda)

It seems like it's either tax advantages, labor costs or some other financial reason that these "global" companies choose to be where they are.

In my opinion, the U.S. is getting "payback" for 60 years of doing the same things around the world. In 1979, the oil company I was working for, moved into a new building and got a new IBM 370 computer. One night, I looked into the back of one of the big cabinet tape drives and it said "Made in France". HUH???

Den

Duh! So Resmed is headquartered in the USA now and the Australian branch is just that, a branch, a subsidiary?

Ha! Must have meant greater profits in the USA - until the dollar started falling so bad. Now it must be just the size of the USA market keeping the headquarters here. And when they price us out of their market as more and more of us are uninsured? And losing ground in wages? Resmed must be pretty confident that the USA is gonna adopt a universal health care coverage. *sigh*

Well, why not ask? It seems to fit this thread. Fisher & Paykel stock is down dramatically in spite of the Phillips Respironics buyout. What's with that?

fphcare.com/investor/shareprices.asp#TOP

billbolton wrote:

WNJ wrote:FWIW, the FDA has no role in regulating the pricing of medical devices. Their role is in approving them as to safety and efficacy.

The nature of any regulation in markets is that it definitely does impact price in a number of ways, even if the price per se is not specifically regulated.

Even if that were so, I think most us would gladly pay the premium for having drugs and medical devices that are both safe to use and actually stand a reasonable chance of doing what the advertising claims.

How many of you saw that video of “downer” cows being fork-lifted to the slaughter? Wouldn’t you like a little better inspection (regulation) of food products? (Medical products testing doesn’t make nearly as good theater as meat inspection video, but the effect is the same: Without regulation, the consumer is really on his/her own.)

billbolton wrote:For instance regulatory approval processes build cost into the price base, and caveats/restrictions how a product can be retailed also have potential price impacts etc.

This argument might have some sway in a competitive market. The CPAP market is not competitive. The big CPAP makers can pretty much charge whatever the market will bear (as now evidenced by ResMed, Respironics, and F&P) without fear of real price competition (or anti-trust enforcement.)

Besides, the “regulatory approval” costs pale by comparison to the advertising costs of drugs. I suspect the same is true in the CPAP market.

I note, too, that you did not further contest the proposition that DME markup is typically 300%. Since it is clear that you are an employee of ResMed, maybe you would share the wholesale/retail prices of a representative sample of ResMed products? Just to put these nasty rumors to rest.

Wayne

our prices are about double what the online prices are. Thank goodness. the medicare system pays for mine in the Great White North

granti55 wrote:our prices are about double what the online prices are. Thank goodness. the medicare system pays for mine in the Great White North

Where does your medicare system get it's money from? That's who's "paying".
The more THEY pay (medicare system), the more the contributors have to pay.


Den

WNJ wrote:Since it is clear that you are an employee of ResMed

So, just because I have some understanding how regulated markets tend to really work arising from the actual global homolgation of electronic equipment, and that practical experience doesn't align with your strongly held beliefs..... I'm automagically an employee of Resmed!

So just to clear things up for the conspiracy theorists, I don't work for anyone, anywhere, connected in any way with the supply of any sort of medical product.

Cheers,

Bill

This is all part of the "system". I bought my machine online for just under $300. When I tried to get my health insurance to reimburse me they wouldn't. They said I had to buy it or rent it from one of their suppliers. The supplier wanted over $1K for a machine!
Then they told me they only pay anything over $1000. What a racket.

I even contested it... I tried to make them see that not having this machine was as much a risk to my health as not taking my blood pressure meds or not having surgery. This is not a luxury people!!!! They pretended to consider it, then sent me the refusal letter.

SERIOUS QUESTION:

There is a local DME who gives AMAZING patient services to CPAP users and loves every one. They also boast a 95% compliance rate. They have a robust supply replacement in place and all of the local doctors think this DME is the best.

Question: They bill insurance $1100 for a CPAP. This cost covers not only the equipment, but all of the costs incurred in providing this excellent patient support like 3 delivery vans, 4 RTs on staff, local advertising, patient lunches, etc.

I guess they're thiefs huh and don't deserve to bill for the $1,100. I wonder what would happen to this great level of patient care if they had to start billing $500 for a CPAP "because someone saw it cheaper online."

What say you?

You copied and pasted that well from your earlier post.

SERIOUS ANSWER:

If someone wants to use them, fine. Personally, I don't want to pay for their vans, RTs, local advertising, and I will buy my own lunch thanks. I will buy online and get what I really want and keep 500 hard earned dollars for my use.

Anonymous wrote:SERIOUS QUESTION:

There is a local DME who gives AMAZING patient services to CPAP users and loves every one. They also boast a 95% compliance rate. They have a robust supply replacement in place and all of the local doctors think this DME is the best.

Question: They bill insurance $1100 for a CPAP. This cost covers not only the equipment, but all of the costs incurred in providing this excellent patient support like 3 delivery vans, 4 RTs on staff, local advertising, patient lunches, etc.

I guess they're thiefs huh and don't deserve to bill for the $1,100. I wonder what would happen to this great level of patient care if they had to start billing $500 for a CPAP "because someone saw it cheaper online."

What say you?

Only $1100.00?
Most of the charges we see here are about $2300 for the (basic) CPAP, another $400 for the humidifier and about $300 - $400 for the mask.
Then, they just hand the stuff to the sleep-deprived user-to-be and send them on their way.

ANY business has to make a profit to stay in business.....it's the amount of profit in this industry that has everyone upset.....and the amounts that insurance entities (including Medicare/CMS) are willing to pay.

For comparison purposes, when I bought my REMstar Pro 2, humidifier, mask, software, reader, extra hoses, filters, etc., my entire bill was less than $1000.00......from CPAP.COM.....and the prices were higher then.
Even online sellers have a considerable amount of overhead.


Den

NYLady wrote:This is all part of the "system". I bought my machine online for just under $300. When I tried to get my health insurance to reimburse me they wouldn't. They said I had to buy it or rent it from one of their suppliers. The supplier wanted over $1K for a machine!
Then they told me they only pay anything over $1000. What a racket.

I even contested it... I tried to make them see that not having this machine was as much a risk to my health as not taking my blood pressure meds or not having surgery. This is not a luxury people!!!! They pretended to consider it, then sent me the refusal letter.

See it's just this sort of thing that really ticks me off. I pay my health insurance out of my own pocket to the tune of $528 per month, I'm self-employed. My insurance company made me go to a specific vendor to get my machine. Incidentally they covered my sleep test, machine and mask, which is a relief, but I digress... When I went to order more filters for my machine, it took almost a month and they charged $35 for ONE of the small white filters! I got 4 or 6 (I forget) from Cpap.com for $16 and it only took a couple days. My machine and mask were also seriously marked up.

Why are people not allowed to get it from the place with the best price??

Now, I am not sure about socialized medicine, I'm not touching that subject with a 10 foot pole, but one thing is obvious, our system is broken and dominated by for profit corporations who are screwing us all, whether you pay you own, get it through work or have medicare.

The amount of waste is pathetic.

Don't even get me started on Prescriptions. Our tax dollars fund a lot of research, yet we pay more for that medicine than other countries? What the heck is that nonsense??

I know some people who work as reps for Big Pharma, if you had any idea how much money they spend on perks for doctors you'd be sick. I keep my opinion to myself around them, but what they do makes me mad.

For Americans, Republican, Democrat or Independent. Keep this in mind come election time, it's important issue that needs to be addressed. So when you're talking to your friends, your family or co-workers, even better if you happen to get a chance to even talk to a candidate or your congressman, ask them why this is even an issue in one of the richest countries on the planet.

You've gotta take a good look at those statements. There's this "Billed Amount" that takes our breath away and makes us see red. Then there is the "Allowed" amount which is what our insurances actually pay and then there may be a "CoPay" that we have to pay.

With Medicare there are four amounts on the statement: Billed, Allowed, Paid and CoPay.

For my Resmed S8 Elite in Oct 2006 when it was selling for about $600 maybe at cpap.com:

Its a 13 month capped rental.

Billed: $135.00 - Allowed $99.95 - Paid $79.96 - CoPay $19.99

Medicare reimbursement went down in 2007 and again in 2008. I don't have the 2008 reimbursement since my Elite was paid off by then. But in 2007:

Billed $135.00 - Allowed $74.96 - Paid $59.97 - CoPay $14.99

So 2006 rates 13 x (79.96 + $19.99)

And 2007 rates 13 x (59.95 + $14.99)

And 2008 rates are lower.

Don't look at the statement from the DME supplier, look at the statement from your insurance company. See what was REALLY paid PLUS what you had to pay there was a copay. Mind you, this was just for the Elite, not the humidifier, mask, etc.

billbolton wrote:So, just because I have some understanding how regulated markets tend to really work arising from the actual global homolgation of electronic equipment, and that practical experience doesn't align with your strongly held beliefs..... I'm automagically an employee of Resmed!

No, it has nothing to do with your misunderstanding of markets.

I came to that conclusion long ago based upon your intimate knowledge of everything ResMed and your lack of postings showing any remotely comparable knowledge of any other manufacturers’ products. Plus your unwavering support of anything ResMed does.

Wayne