Easy! Not to say that how you feel isn't more than justified. But you can catch more flies w/honey than w/vinegar. And almost always if you go looking for a fight its not hard to find one. DIPLOMACY is the key. Be FIRM but DIPLOMATIC. And you are more likely to run into problems w/the local DME supplier than the insurance.

Most insurances contract w/local DME suppliers by insurance (HCPCS) code at one set agreed upon price, NOT by brand or model. All CPAPs, from bare bone, compliance data only CPAPs thru fully data capable APAPS are HCPCS code e0601. Obviously, the DME suppliers's profit margin benefits from foisting the bare bone compliance data only devices on their clients.


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.

Do not worry, I have always gone by that saying.  But being that I used to work for a DME company and in the health care profession I just get crazed when ever I talk or blog about it.  I am going to definitely start out with the sugar and spice approach, then be well equipped with a lot of info if the time comes.  Thanks for the comments all.


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Sleep deprived for now!!!

Just to give a little perspective on "universal health care".  Number one, I'm no communist (well I'm Canadian and to many that's the same thing.. )

Have we heard horror stories of health care wait times up here...Yup...have I ever experienced it?  Nope

MRI ordered,  MRI given within three days, same with bone scans, cat scans, EEG's, etc etc.

Sleep study ordered.  Sleep clinic calls within hours of arriving home from Doctors "Can you come in tonight?  ummmm NO"  I went in two days later.  Upon arriving home, got a call approx 8 hours later.  We found significant evidence of sleep apnea, we need you back here ASAP.  I was back in again two days later.  I could have gone the same night.

Saw the sleep specialist within two weeks, had my machine within 3 weeks.  Done.  Not exactly a long wait time.

Our universal health care system costs significantly less per capita than the insurance based system in the US (government money I mean...the US government spends significantly more per capita even with all the insurance stuff).  In a REAL emergency I've never had to wait in an ER, honestly I can say I've never experienced anything negative with our system itself.   Pompous, god complex doctors???  That's a whole other ballgame but I don't think that has anything to do with universal access to our health care.

Are there problems?  Yes, are areas underserviced?  YES...but from what I've been reading on here there are alot of underserviced areas for medical needs there too.

Anyway...my own little perspective.


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Executive in charge of talented offspring donning a Resmed S8 Elite II CPAP, and the oh so sexy Nasal Swift for Her Lt, with the pretty blue headgear. Oh, by law up here in Ontario they are required to give us heated humifiers...Mine is the H4i.

I have insurance that has a high deductible and encourages us to shop around for better prices for healthcare.  I never thought about shopping for a doctor or clinic but because of the OOP expense to me, I found that where my doctor would send me, the hospital, a sleep study was $3000. A local specialty clinic charges $1,700. I found an oxygen supply business that has take home studies for $500. Were the conclusions less complete than if I went to the hospital? I don't think so. They were able to record my interruptions, oxygen, sleep position and I don't' know what else. The end result was the same as if I went to the hospital.  I'm on a CPAP machine. My point is that if no insurance were available for sleep studies, there would be lower cost to have it done. Insurance inflates prices and deprives treatment to many people who can't afford it, even if they have some level of insurance.

I'll give an example of how it works.  Think about cars. Most people with a decent car have collision and comprehensive insurance on it. My wife broke the power mirror on her car.  A body shop wanted over $500 to replace and paint it.  I found an identical mirror for around $30. How much more to mix up paint and install it? If there were no auto insurance pumping up body shop fees, it'd probably cost a third of that to fix and still allow for profit based on the market. Insurance distorts the market and thus distorts pricing.

Locally a healthcare system wanted to build a new hospital.  The other healthcare system says their hospital is adequate for the needs of the community and spent much money lobbying politicians and advertising to get the people to vote against a necessary zoning change for the land. They succeeded in convincing people that the competition would increase the cost of healthcare!  Can you imagine that? Up is down. Black is white and people bought into it.

There's a reason doctors and hospital management drive around in Mercedes and BMW's and I have two cars with over 100,000 miles!

And there is also the grueling, long and arduous, almost barbaric, schooling and training doctors go thru before being allowed to "practice" medicine to say nothing of the crushing debt they incur paying for that schooling and training. As for the Administrators and Business Managers?? Expensive middlemen who have little to offer true medical care.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.

Vicki wrote:

THAB,

You are right, we don't need socialized medicine, but what we need is well thought out (and there are plenty of excellent ideas) universal health care.  I know too many people who are unable to afford health care insurance and whose lives have been devastated because of it.  My close friend who just had her second surgery yesterday for advanced thyroid cancer comes immediately to mind.  They are about to lose everything because of her medical bills.  So not only is she simply trying to stay alive, but she and her husband are breaths away from losing the house over their head.

People post here all of the time that they can't get a sleep study or a CPAP because they do not have heath insurance.  BTW, send them to www.awakeinamerica.org if you see a post along those lines.

Vicki

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Brandon
Rem Star

[quote="
If you believe a government sponsored "universal health care" system will improve OSA diagnosis and CPAP issuance, I would have to vehemently disagree with you. Id argue things would actually get worse. Ever hear about those Canadian and British socialist medicine horror  stories? Six month waits for a simple MRI?
Fred[/quote]

Get the government out of your Doctors office.  If you want to see government health care at work, go to VA hospital and see the corruption, long lines of waiting people, Paper work to the roof, true health care is non-existent in the government VA hospital.

Well, I have been denied insurance from 3 seperate companies for preexisting conditions.  2 of those denied me based on the Sleep Apnea alone.  Blue Cross Blue Shield basically told me that I would be able to get on one of their plans with a waiver and ended up denying me due to another issue of high triclycerides.  Because they initially told me that I should be able to get insured with a waiver, I opted out of my employers group plan policy because it costs $460 per month.  So now I can't get any health insurance because I missed the enrollment period waiting on BCBS.  I made the mistake of trusting BCBS and opted to let me previous insurance expire when I should have enrolled for my new group plan until I could transition to BCBS.  Hindsight is 20/20.

We need some type of reform and what's being considered now doesn't sound sufficient enough.  Regulation to ban pre-existing conditions sounds great but I haven't heard of any ban on raising premiums  either so what's to stop them from gouging us?

I wouldn't mind a system similar to Canada or the UK.  

Maybe a hybrid system where people need private insurance for day to day healthcare needs like regular doctor visits and then let the Gov. provide care for the more serious specialist and hospital care needs.  In France they do house calls where the Doctor comes to your home.  If we had something like this, we could probably save on ER costs.  If we had more 24 hour urgent care type clinics we could probably save even more.  Heck, why not have a more cost effctive clinic in the hospital NEXT to the ER?  When you walk through the door you get sent to the ER or the Clinic depending on the severity of your needs?  

I'm just thinking out loud now but there's no excuse for our current system.  In my shoes, a universal health care system is a LOT better than what I have now.  And before you tell me to go get a job, i do have a job and I've only been without a job twice which never lasted longer than 6 weeks.  I've never received welfare benefits, unemployment or food stamps.  I work hard and I pay my taxes.  I never asked to get OSA and there is no reason why I should be worried sick every day that I don't have health insurance.


_________________
Brian
Severe OSA
19 cmH2O
Respironics M Series Plus
F&P Forma Full Face Mask

ApexAZ wrote:

Well, I have been denied insurance from 3 seperate companies for preexisting conditions.  2 of those denied me based on the Sleep Apnea alone.  go get a job, i do have a job and I've only been without a job twice which never lasted longer than 6 weeks. .

Get Back on your job health plan, then get a lawyer..Don't trust anyone including your lawyer. Use email so you have proof of what they tell you or record all phone calls.  You should be able to sue your Job and the insurance Co.

  Government health care would screw you worse than an insurance CO.

Apricate wrote:

ApexAZ wrote:

Well, I have been denied insurance from 3 seperate companies for preexisting conditions.  2 of those denied me based on the Sleep Apnea alone.  go get a job, i do have a job and I've only been without a job twice which never lasted longer than 6 weeks. .

Get Back on your job health plan, then get a lawyer..Don't trust anyone including your lawyer. Use email so you have proof of what they tell you or record all phone calls.  You should be able to sue your Job and the insurance Co.

  Government health care would screw you worse than an insurance CO.

I can't get on my employer insurance because I missed open enrollment.  I missed open enrollment because I still had insurance from my previous employer and Blue Cross Blue Shield assured me that I would be able to get on a PPO plan with a waiver for the Sleep Apnea.  Again, looking back, I should have enrolled for my group plan first and then pursued the individual plan, but there isn't much I can do now.

Hiring a lawyer isn't really cost effective either.  You're basically telling me that I shoud pay $460 a month for my group insurance AND lawyer retainer fees?  How is that an acceptable, cost effective solution?  That's exactly why cost is spinning out of control!

I am sorry but putting profits before my health needs (i.e. status quo) isn't acceptable.

What insurance are you on, Apricate?



Last edited by ApexAZ on Thu Oct 01, 2009 11:38 am; edited 3 times in total
_________________
Brian
Severe OSA
19 cmH2O
Respironics M Series Plus
F&P Forma Full Face Mask

whoops double post


_________________
Brian
Severe OSA
19 cmH2O
Respironics M Series Plus
F&P Forma Full Face Mask

I would like to add my 2 cents on this topic.I live in Mass. and everyone in my state has to have insurance.If you don't have it they take 900 dollars out of your tax return.Any way my wife didn't have insurance and she was able to get a plan through the state at very affordable group rates .AS every body knows group rates are the key to making insurance affordable.I am not aSocialist and if the govt. can offer people insurance at group rates I'm all for it.I sould also mention my wife got to choose from 5 different private insurance companies.

I spent the first forty years of my life "enjoying" the benefits of socialized medicine, and the last twelve "enjoying" the benefits of private insurance.

It seems to me that which you shout "we don't want socialized medicine" it seems that you really do.  It seems that you want everyone to enjoy the benefits of all the health care they demand, when they demand it, and at a price they can afford.  Or is it that you want this for yourself, and no-one else matters?

The price I paid for socialized medicine in the UK was taxation - some of my income was taxed at 70%, and when I spent the remaining 30c on each dollar I earned, I paid 17.5% sales tax (VAT), and significantly more if I was buying gas ($6 a gallon in 1998 - when it was less than $2 a gallon here).

In my younger years, my health was better - my doctor's visits few, my only surgery a three day hospital stay at the age of seven, relatively inexpensive dental and eye care, minimal contributions towards prescription medicines - and the piece of mind that I would never be bankrupted by health costs should any major accident or illness befall me.

Here in California, I don't pay such high taxes, but I do see more than 10% of every paycheck taken in health care insurance for my wife and I, and another 15% deducted for a "flexible spending account" which pays my deductibles on office visits, prescriptions and most recently a minor outpatient surgery.

I need to budget carefully, so before the surgery I asked what my out of pocket costs would be and I was quoted $545.  They even tried to collect that on the morning of the surgery - but the credit card machine was down.   Now, I find my insurance is paying just over $20k of the $22k bill - leaving me with a balance of just over $1700 - for which I had budgeted less than a third.

My previous wife (in the UK) suffered a stroke at 35 years of age.  She was comatose and on life support for six weeks following her collapse, underwent a number of surgeries, and remained in hospital for almost six months before being well enough to return home.  Two weeks into the coma, family signed organ transplant documents, but doctors continued to work for another month.  After one surgery, she regained consciousness, and after another two weeks later reliving further pressure, she regained limited speech.  Twelve years later she lives independently and runs her own business.

I mention this because socialized medicine meant that at no time, before, during or since this horrendous episode was the cost of care an issue.  There was no bill, no insurance, no co-pay, no managed care by a non-medical person.  She simply received the best care available under the system, and lived.  (Her story, in her own words can be found elsewhere on the internet on a similar forum for stroke survivors)

I work as a Public Safety Officer on a University Campus - recently a student visiting from Europe slipped while opening a box with a pair of scissors and stabbed herself in the heel of her thumb.  She took a taxi to the local ER, and despite paying cash for her treatment (yes, cash - real dollar bills) which included six stiches, she had to wait nine hours in the ER while the hospital was forced to treat non-paying patients.

My recent surgery had me in the hospital for five hours, from admission to discharge, and less than 45 minutes actually undergoing surgery - and the accounting shows the costs to be over $22,000!  How can the hospital supplying a Band-Aid at almost $20 be compared with buying a box of a hundred at Walgreens for $2, that's a huge markup - especially as the 'labor' portion was charged elsewhere - $20 was just the sterile supplies cost!

Insurance depends entirely on everyone paying something towards the needs of a few, with someone in the middle making money doing it.  It doesn't work when everyone wants to pay the same, but nearly everyone wants to spend more than they pay.  The community as a whole either has to decide that they have a moral obligation to share essential costs like healthcare among everyone according to ability to pay, or have the courage to say that you can't receive care if you can't pay.  Everyone cannot pay $200 a month for health care and then use $1000 worth of services.  Insurance shares the risk to us all (and the cost for a few) among us all.  Once the system is abused, by the insurer wanting more profits, the service provider wanting more profits, and the insured wanting more services it ceases to work.

My preference is to see something closer to "socialized medicine" where I contribute my small amount into a very large pool, from which my needs and the needs of everyone else are met.  This requires mediation of the amounts collected, the charges made by providers and the use made of the system.

Many Americans seem to think (as I learned as a Fire Department Medic for six years) that dialling 911 is the first treatment for every ailment.  I've responded to calls and been told "I woke up yesterday with a cold and my doctor can't see me until next week - do you have anything for a cold?"

Or are we so selfish that we think WE have to have something more than everyone else?

What we need To do is stop the ins. and drug company from stealing from us!
And stop Government from doing the same. Get the government out of my doctors office.
  I had a heart attack and drove myself to the hospital.   The doctor said if i had called 911 i would
have been dead before i got to the hospital 30 miles away.
  It is a violation of the Constitution to force us to buy anything!

Ah, but then, Apricate, if you don't want to be forced to buy anything, WHY should the rest of us HAVE to pay to buy it for you when you NEED it??

But, since WE DO pay for your medical need, that you were NOT willing to pay for, you certainly have no RIGHT to insist that you receive the BEST of care, you SHOULD be grateful that you get ANY care at all, don't you think?

On the other hand, we in the USA, do have the RIGHT to LIFE, liberty and the pursuit of happiness. So ... how do we as a country provide that RIGHT to LIFE??? By EVERYONE, including you, paying for that RIGHT to LIFE which means Medical Care amongst other things, don't you think?

SOMEONE has to pay for the medical care in one form or another. Ain't nothing in life is free, Santa Claus is dead.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.