POLL: OTC CPAP?

I voted no, mostly because I have seen a lot of posts on different forums from people who are really clueless and are assuming they have apnea for some fuzzy reasons and have some strange ideas about how to go about therapy. I feel most people need the guidance of professionals in their therapy. Many of these boards are composed of highly intelligent, highly motivated people who want to take control of their own health and who are often more informed than the professionals. However, I don't believe the average person is necessarily motivated enough and probably does not even desire to direct his/her own therapy.

SleepyCPAP wrote:I voted yes mostly for the supplies. I can be swayed by the intelligent arguments about the machines themselves, but masks, hoses, filters, humidifier tanks don't need a prescription. I understand that could mean higher out of pocket for some folks, but I'm hoping the cost comes down too. I can imagine a trip to another city, finding my hose has a tear, and I'd really like to head over to the 24-hour drug store and pick one off the shelf. Convenience.
--SleepyCPAP

I agree with this, although perhaps not so much for masks, since an ill-fitting one would be bad news. For experienced users, yes, they know what works for them, but some might not even know what size they have. I wonder how an experienced user would "prove" they know what they need and what the result of an uneven policy would be.

OTC CPAP? A great idea that would avoid incredible amounts of waste and pain.

I've only been diagnosed recently, but after reading the various posts on this and other forums, I'm struck how many if not most OSA sufferers allow gatekeepers to suck dollars out of them either directly, or indirectly (as through insurance companies). They make their treatment decisions based on what a DME will "do" or a physician will "allow" or an insurance company will pay for. They imaging insurance money as "free" money while neglecting to consider the exorbitant costs for their premiums. They seem hell bent on furthering the notion that they work for the DME and physician and not the reverse. In the process, they're buying sub-optimal treatment that's fully certified and substitute partnering relationships with "daddy" ones. Phrases like "don't let others manage your risk", and "the perfect is the enemy of good enough" came quickly to mind.

How many times have you heard on this forum that "I can't afford a sleep study, and for now can't get what I need"? But a resourceful person, some study, and a data capable machine purchased at competitive price (especially if used), and the data gathering capability of the machine would allow a "poor man's sleep study". If you're poorer than that, and can't afford data capability, buy something really low budget and titrate pressures on how refreshed you feel in the morning. This way preferable to the other option: no treatment at all or treatment delayed.

A good friend and experienced OSA patient hearing of my diagnosis warned me not to get trapped by DMEs and insurance companies. "They will lease the machine to you and you'll pay, over a year or two, far more than the machine is worth"

I bought an Auto BIPAP outright at a steep discount am unsure whether my insurance would cover the cost. I have insurance, and prescriptions are required, so I enlisted the help of my doctors to write evaluate my condition and issue the necessary prescriptions. The machine, the goodies and the accessories cost me about $1600 -- a fraction of the price of a car or a vacation. The same machine is available "offline" for $700 or so. I suspect this is affordable (for such a dangerous condition as severe OSA), for most.

I have a co-worker that told me of a friend that works for a well known supplier of CPAPs, and makes around $400K per year pushing CPAPs. Third party payers and patients who think insurance money is free money (and not paid by them and others) are flooding the market with other people's money, bidding up prices. There's just too much "other people's money" lying around and we're all getting violated at checkout.

Instead of installing "gate keepers" and third party payors, why not promote competitive prices and personal responsibility instead of puffed prices and well fed nannies. Let us hire the help we desire, buy the machines we want, and own our own treatment. Outcomes would be better and far less money would be wasted. And prices for machines would surely come down.

In the aggregate, "other people's money" is really our own.

That's my rant.

I agree that CPAP equipment and supplies should be OTC.

Anyone who would go and buy one without expert advice is taking a serious self-inflicted risk.
The insurance coverage chatter misses the point of insurance. An insurance policy should cover those things that are unexpected and at least somewhat catastrophic. We used to be able to get policies that had a large deductible so that routine expenses were our responsibility and major ones got covered.

A good analogy would be a policy that covered light bulbs. That would seem to reduce your cost of replacing burned out bulbs but in reality the insurance company would estimate the annual cost of bulbs, add an overhead surcharge, and pass that total on to the annual premium.

The machine might come under the catastrophic cost umbrella, but routine costs such as masks, filters, hoses are just like lightbulbs.

Sure some companies would offer "bricks" (like car companies offer basic autos) but others would offer ASV capable machines (like Lexus or Cadillac, etc,). It's the consumers choice. There would also be a thriving used CPAP market available without restriction for those willing to accept used equipment to achieve a significant price reduction.