Why a Prescription for XPap Machine?

Oh man, I just looked back that that short novel, I was on a roll wasn't I?

You know even if the DME's wanted to follow the money they are cutting their nose off to spite their face.
Think of all those mask fees and consult fees they are missing because people give up and throw all the supplies in the closet and don't buy anymore. Not to mention all the people they piss off that have good paying insurance that could used but instead prefer to pay out of pocket and not deal with DME's.

Hmm let's sell 10 basic CPAP's or get rental money for a few months and sell a couple of masks and give a don't give a crap attitude to those people and watch them quit or leave your service.
OR
Let's sell 10 data capable machines (the price difference is not all that huge), encourage and instruct patients on what to look for in what data is available, really educate and work on mask comfort. Keep them happy and compliant and buying masks and supplies (where the greatest markup is) Duh......

Short sighted idiots. Too bad I don't have a DME business...

I won't even go down the MD road. There are good ones, bad ones, mediocre ones and stellar ones. Crap shoot what we get. We either change or deal with what we have. I long ago learned that it is foolish to enter into a battle that I stood no chance of winning. I choose instead to expend my energies in areas where I stand the most chance of attaining some level of success. Life gives us enough banging of the head against the wall experiences, I see no sense in going looking for more. I am lazy.

silver pelt, welcome to our world(or little piece of it) err i mean the forum
glad to see you are taking a proactive approach.
yes years ago the knowlege just wasn't there. lot's of folks here probably had osa or sbd for years before being diagnosed. we lost a lot but can we really blame anyone for it? had the knowlege been in place and just ignored , then yes. hopefully someday we will all be able to hang up the hose. things change and ya never know.

i DO hope you checked out our sponsor cpap.com. also cpapauctioon.com has some good deals too.It is an auction site so buyer beware. there is a lot of freedom on this forum you won't find anywhere else. johnny and his staff do a wonderfull job.

tomjax wrote: They do NOT require a prescription!!!

They require an ORDER.

There is a big difference in an ORDER and a Prescription.

Yes, I should have used the term order instead of prescription when I started this thread. However, the requirement is the same. No piece of paper, no machine.

I'm thinking that much of this is because insurance companies want verification from a medical professional that an item is actually needed before they'll consider paying for it. I believe power chairs and scooters are also handled in basically the same way. Fair enough, but anybody can purchase a power chair out of his own pocket if he decides to do so without an order. Not so with XPAP machines.

It seems to me that just because the insurance industry (including the government's Medicare/Medicaid monstrosity) want an order before paying for the machines, then private pays should be able to purchase XPAPs on their own without an order. And they shouldn't have to go to Craig's List to do it.

OwlCreekObserver wrote:private pays should be able to purchase XPAPs on their own without an order. And they shouldn't have to go to Craig's List to do it.

Agreed, OCO.

But, considering my recent purchase of a basically brand-new Remstar M Series Auto for practically no money from a CL seller, I'm really glad that CL is an option.

HEALTH CARE (the real kind)

Want cheaper? European and Nordic countries--a fraction of the cost. Why? Single-payer,
private and govt. regulated, private with oversight committees, but all without profits. And usually no
pay for service; that just encourages greed and sloppiness. (As a teacher i get paid a salary for a complete
service, not by how many German or French verbs i teach.) We pay $400 B a year onpaperwork. Then add
the industries' profit.

Want better? USA is 37th from the top. Just above Slobovia. Why? See above.

Want the best? Snag the platinum free REAL medical care we taxpayers provide for elected and appointed
officials ( Bushes, Clintons, Obamas, Cheneys...) Oh, you would not like it: it is socialized Medicine. McCains
(multi-millionaires) don't refuse it, nor does any other official. Come to think of it, McCain as an example
has never had a nickel that was not socialized. That includes my father, who was career officer. We had great
medical care and never got a bill. Germany has that system also; and the doctor COMES TO YOUR HOUSE. And
you have already paid for medical care, university tuition, affordable insurance, all with your taxes

Teachers and police officers pay @ 40% of our incomes in taxes. Add the rest. (Last year i had to pay out of pocket of $10,000.) Can you guess who pays the most? [ Disregard the bull sh*t our keepers are stuffing down our throats.]

Cheers. Yours for a decent, affordable, practicable and responsive medical care system.

Leonbergergirl wrote:HEALTH CARE (the real kind)
. . . Want the best? Snag the platinum free REAL medical care we taxpayers provide for . . . .

Hey, I love a good rant as much as anyone, but I think you're mixing apples, oranges and possibly a cucumber or two here.

First of all, the information you heard about congressional medical care is incorrect. Martin Frost was a Democratic congressman from 1974 to 2005 and he wrote this article in response to the false rumors about congressional health care.

As outlined in this CNN article,the President, Vice President and their families have a full time medical staff available to them -- not exactly doable for society as a whole, but I doubt that the Obamas and the Bidens have turned it down as a matter of conscience.

As for the "free" medical care in the military, my 23 years of experience with the system weren't quite the same as your father's. In many cases, especially in recent years, military members are covered by Tricare, which is like any insurance plan with co-pays. If you're interested, you can read an in-depth explanation of the system at this site. For those who believe that it's still too good a deal, then I certainly encourage them to consider serving in uniform so they can take advantage of it.

OCO

I hate to be a spoil sport but... I can see a couple of cases where the prescription is necessary. First the Remstat
manual I read had a notation that cpap therapy may be counter indicated for some people with low blood pressure or
words to that effect. Then in my case if I had bought a cpap without the sleep study I might have felt better but not
known I also required oxygen! On the other hand I also wish I could buy another cpap without the paperwork.

tomjax wrote:

They require an ORDER.

There is a big difference in an ORDER and a Prescription.

Not really, no exactly a total difference between term order and prescription. These terms are often used interchangeably in the world of medicine. Prescription is probably used more in conversation with patient from health care provider. Order is more often used in conversation between health care providers such as MD to nurse, MD to pharmacist or DME. Order will most likely be term used for procedures and prescription is unlikely to be used when requesting procedures. A medication prescribed at time of a hospital discharge will be sent to an internal pharmacy as an Order. If patient is going to acquire prescribed medication, patient will most likely be told the document provided is the prescription for the discharge meds. The form I was handed to acquire my APAP could have been called an order or a prescription. It was not label as either. If the ordering/prescribing doctor would have verbally labeled the document as he gave to me, he would have likely called it a prescription for my APAP. If he (his nurse or social worker) had communicated with the DME directly, they would have referred to it as an order.

It would be nice if XPAP's were available OTC. That may occur at some time. Many of the OTC medications and products could only be purchase by a prescription before OTC availability. One downside of OTC, is most insurance companies will not pay anything for OTC medications/products. Even thought I think the price of my DME APAP is outrageous, in the end I will pay a total of $335 for my ResMed Auto, Mask, Humidifier out of pocket.

The other downside to medical supplies transitioning to OTC, they sometime do so at or near the prescription cost. Zertec is an example of this.

When I got my first nebulizer for asthma treatment, I could only get it with a prescription/order. My insurance paid for it 100%. When I wanted a portable nebulizer since I am not near a power outlet 24/7, I didn't have to have a prescription for it. I paid $220 out of pocket for it. I could have got reimburse at 40% of DME benefit because of using out of network provider, but didn't want to deal with the hassle. When my kitty need saline nebs, I picked up a kid friendly decorated nebulizer at a grocery store/pharmacy combo for 29.99 because it was not selling at it's $99 price without a prescription. If I had insurance on the kitty and it was a covered item, I could have selected to get it as an OTC w/o prescription item. It potentially could have been more out of pocket as a prescription item vs. OTC item depending on the specific coverage/copayment requirements of the used insurance plans.

This stuff can make our heads swirl

elg5cats

OwlCreek Observer writes:

In many cases, especially in recent years, military members are covered by Tricare, which is like any insurance plan with co-pays. If you're interested, you can read an in-depth explanation of the system at this site. For those who believe that it's still too good a deal, then I certainly encourage them to consider serving in uniform so they can take advantage of it.

Well, i may be a bleeding heart liberal, but surely our military personnel should get fully paid topnotch medical care;
our comparatively or very rich civiilian Elected Ones should have to endure the "health care" profit market, just like the rest of us schlubs (but in actuality most Electeds pay only $40/month.)

Statistically, for some thirty years now, all working people in USA, including even our military, unfortunately, have watched our health care and salaries and sick leave and vacations and pensions and retirement healthcare systematically depradated and often taken completely from us.

I really really don't deserve being reduced to near penury, and i am sure you don't either.

Putting all other considerations to one side & looking at the current reality. It is *only* AFAICT in the USA that cpap prescriptions are law. In Australia & Europe & UK AFAICT that law does not exist.

So are lots of people being harmed or killed by the lack of the law outside the US ? - I suspect not.

But in a litigious country like the USA, I can sort of see a need for the law (sort of ) !.

DSM

Do you REALLY want to follow the money? Honestly?

Then ask: Why do pharmaceutical companies so eagerly seek to be able to market their products "over the counter" whenever possible, rather than by prescription?

Yes, prices go way down when a product switches from Rx to OTC. But that is more than compensated by an increase in the size of the market. In addition, there is MUCH less restriction by regulators, which costs money. Manufacturers would be able to advertise much more easily direct to the public, and sell more units.

No, it's not the "medical industry" that wants to keep products "prescription only." However, the process of Rx to OTC switch is expensive: a company must prove that a product is "safe enough" for use without medical supervision. (Admittedly, once it happens, it would "lower the bar" for other companies, so no one wants to be "first" and bear the full expense. Also, it would "lower the bar" for new manufacturers to come in with their own machines, who would not face the same government review process required for prescription machines. There are no "pure motives" in real life.)

Not everything in this world is a matter of "following the money". Sometimes, it's just a matter of following the inertia. There are not always demons to blame. Just physics: a body (or a body of law) at rest ....

[EDIT: By the way, insulin does NOT require a prescription in the US.)

I don't understand ANYBODY that is bitching about the current heath money collection system (no care in it that I can see) but instantly raises hell about any gov't system that would probably work just fine. After all, they have been running a system since 1965 and most of the people on it are happy with it. That system doesn't "control" your options, your Doctor choices, or anything else, so what most of you are gripping about is the boogie man.

JeffH