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So insurance companies should pay out more in benefits?

OK, let the insurance companies pay more.

Where do you think they get the money to pay benefits? Grow it on trees?

No, they get if from us.

I am already paying $16,000 per year insurance premiums.

I don't want to pay more to have an employee of a DME hold my hand.

Are you willing to pay much higher premiums?

My hubby has cigna. We just received his machine via Lincare. In-network with Cigna via carecentrix.

roster wrote: Are you willing to pay much higher premiums?

No, but giving us the choice of DME's would foster true competition, making all the DME's negotiate fees with the insurers. I'm not against just having them ship it to my door, I'm very much against having no choice in *who* does the shipping.

No competition equals higher prices for everyone, including us insurance subscribers.

What you have to understand in the Cigna situation is that (just like Kaiser) Cigna is the DME and Crapria is just the supplier. Crapria provides the CPAP and supplies at very low cost to Cigna patients. In exchange, Crapria benefits from huge volume, limited formulary of machines and masks, guaranteed repeat business as the exclusive supplier, and a setup that requires little or no annoying and time consuming patient contact.

Kaiser does exactly the same thing, but at least Kaiser has a patient education component and the sleep techs at Kaiser do meet with you, do mask fittings any time you need it( and let you take the samples home to try) and generally give support. Sounds like Cigna skipped that step! Cigna 1, Crapria 1, patients get a big fat ZERO.

TalonNYC wrote:No, but giving us the choice of DME's would foster true competition, making all the DME's negotiate fees with the insurers. I'm not against just having them ship it to my door, I'm very much against having no choice in *who* does the shipping.

No competition equals higher prices for everyone, including us insurance subscribers.

Let's discusss why your choices are limited. First, all fifty states heavily regulate companies selling health insurance. The regulations favor one or two well-established insurance companies in the state. Check the market shares in each state and you can easily see who your state legislature and bureaucracy are in bed with - crony capitalism. The states also do not allow you to purchase health insurance from anyone except a company within your state borders. Bottom line, state governments have killed competition and make it very difficult for new competitors to enter the market.

Second, the business of a DME should be very easy. You bring your prescription to them and they supply a product with some advice on how to use it. Not very difficult, eh? But no the DME business is licensed and heavily regulated to the point that brick-and-mortar DMEs consider insurance companies and licensing boards to be their customers. They do not think of the patient as their customer. They are not trying to make the patient happy and healthy. They are just trying to keep the licensing boards happy and hold onto their insurance contracts.

Insurance deregulation is badly needed, but what could be done immediately is to drop the prescription requirement and FDA approval requirement for CPAP machines. Then the patients would see CPAPs sold at Best Buy, WalMart, Target, etc. and the prices would fall, quality and innovation would improve, and you could walk into a local store and see all the models displayed.

We need the Feds and state governments to get out of the way.

Rooster, I agree with your whole post. Competition is the key, and for that we need total Insurance reform. I'm not naive enough to hold my breath for it, but I can hope =)

TalonNYC wrote: I'm not naive enough to hold my breath for it,

Now that you have been diagnosed, you need to quit talking like that.

Down here, the legislators and bureaucracy in Raleigh have been in bed with BCBSNC. Many of their friends and relatives work there. If anything comes along that might cause BCBSNC to have to shed jobs, the Raleigh machinery gets cranked up to prevent it and it costs us guys big money.

I bought a life insurance policy from a Chicago company using a broker in San Francisco. It is an excellent policy with a low premium. Try to do something like that with health insurance - no way. Our state government keeps us locked into a few companies in the state.