Public health care insurance for xPAP alone.

[purple]

Given that a lot number of those with diagnosis do not continue on with treatment for some reason. A bigger question is that a lot of folks out there need the testing and machines, masks, and can not afford them or is it, can not afford them without huge sacrifices, which might or might not be made.

Supposing that it was a government insurance, and not bringing in all the controversy that comes with Obama Care, Medicaid, or Medicare, (Medicare being only available to a few, and Medicare demands huge sacrifices for those of us who have it.)

How should public health care for xPAPers be designed. Qualifications for testing. How much should be paid by individual, price controls, Costs for Replacement parts, how often, and rules for DME? Perhaps an organization that investigates complaints, against doctors, clinics, DME's?

Can anyone put a dollar number on how much a person should have to pay for treatment that is improvement of quality of life, and is in fact, life saving.

[LSAT]

[zoocrewphoto]

I think most who don't continue with treatment have the diagnosis and machine. The problems are usually issues of comfort and correct therapy settings that should be adjusted and helped by the doctor and DME. Not sure how insurance would change or help that. It seems to be equal opportunity for failure. You can have great insurance and have a crappy doctor and DME or no insurance at all, but managed to get a good doctor.

There are people who don't get a good diagnosis or titration due to money/insurance. But I think that is why many people don't START treatment as opposed to those who don't CONTINUE treatment. Two very different issues, causes, and solutions.

[Wulfman...]

Given that a lot number of those with diagnosis do not continue on with treatment for some reason. A bigger question is that a lot of folks out there need the testing and machines, masks, and can not afford them or is it, can not afford them without huge sacrifices, which might or might not be made.

Supposing that it was a government insurance, and not bringing in all the controversy that comes with Obama Care, Medicaid, or Medicare, (Medicare being only available to a few, and Medicare demands huge sacrifices for those of us who have it.)

How should public health care for xPAPers be designed. Qualifications for testing. How much should be paid by individual, price controls, Costs for Replacement parts, how often, and rules for DME? Perhaps an organization that investigates complaints, against doctors, clinics, DME's?

Can anyone put a dollar number on how much a person should have to pay for treatment that is improvement of quality of life, and is in fact, life saving.

That's a complex series of questions.......and probably not answerable on this forum. But, I think your first sentence contains one of the key "problems".

In my opinion, INSURANCE pays too much and consequently, many of the people who need it don't have enough invested in their therapy to take it seriously. Same thing with supplies......even after the users are into their therapy.......as long as insurance is paying, the costs are going to be unrealistically high and the users don't take care of their equipment and supplies or use them nearly as long as they could before replacing them.

I think this is true with virtually all aspects of healthcare. Since about the time Medicare was initiated, we've seen the costs of healthcare and hospitalization increase at a monumental rate. Most of the healthcare costs are based on what Medicare says they will pay for various procedures. Along with this, part of the problem is the cost of liability/malpractice insurance on the part of the doctors and hospitals. Granted, nobody wants to have the wrong body part removed or have surgical instruments left inside them, the whole thing has gotten out of control.

Another factor in the increased costs are that the hospitals and doctors are literally forced to keep upgrading their facilities and computers and software. In my own area, our local hospital (which is owned/managed by a large group) has recently been involved in a massive building program. We see more consolidation of doctors' offices merging in with some hospital group and essentially every doctor has to have "residency" status with the hospital to be able to use the facilities. I'm also hearing about doctors' salaries being cut recently, too. A number of them are "retiring" or planning to in the near future.

But, it's getting more complicated and becoming a huge mess.

I guess that's about enough from my soapbox for now.


Den

.

[purple]

The only issue I am concerned with, How much money should a person have to sacrifice to be able to attempt treatment, and continue treatment.

We have those who come on the forum, who know they need Sleep Apnea treatment, and are thinking of trying to get a machine, set it on Auto, and it will treat them. Usually these individuals can not afford treatment because they are students, employed, but do not make huge sums of money, or need employment, and possibly have trouble getting and keeping employment because of Apnea. That is, in some cases, some are young enough to have a lot of working years ahead of them, which is aided by treatment, some trying to take care of children.

Anyway, I am sure that the costs of Apnea, with todays Medicare costs are pushing me near the edge of not getting the treatment that I need for Apnea.


How much should I be required to sacrifice of what would be below poverty income without any medical costs, to be able to get todays standard of available care? I do not think it is a dollar amount, nor a percentage of income. No one set prices of Medicare costs when the cost of gasoline was $3.60 +. I feel it is how much money is left after I make basic payments, power, phone, water, Etc. That is, how much does that money buy? When more than half my SS payment is gone for health care costs. WTH.

I am more concerned about those who are cursed with making a good effort to carry their fair share fo the load of their lives, who also need treatment and can not afford it?

[Wulfman...]

The only issue I am concerned with, How much money should a person have to sacrifice to be able to attempt treatment, and continue treatment.

We have those who come on the forum, who know they need Sleep Apnea treatment, and are thinking of trying to get a machine, set it on Auto, and it will treat them. Usually these individuals can not afford treatment because they are students, employed, but do not make huge sums of money, or need employment, and possibly have trouble getting and keeping employment because of Apnea. That is, in some cases, some are young enough to have a lot of working years ahead of them, which is aided by treatment, some trying to take care of children.

Anyway, I am sure that the costs of Apnea, with todays Medicare costs are pushing me near the edge of not getting the treatment that I need for Apnea.


How much should I be required to sacrifice of what would be below poverty income without any medical costs, to be able to get todays standard of available care? I do not think it is a dollar amount, nor a percentage of income. No one set prices of Medicare costs when the cost of gasoline was $3.60 +. I feel it is how much money is left after I make basic payments, power, phone, water, Etc. That is, how much does that money buy? When more than half my SS payment is gone for health care costs. WTH.

I am more concerned about those who are cursed with making a good effort to carry their fair share fo the load of their lives, who also need treatment and can not afford it?

I think a person (with a little reading and self-education) could get him/herself set up from about $500 (or a little less) to about $1000......presuming they just had the "garden variety" of OSA......and no doctors or sleep studies were involved.
They wouldn't even need an Auto......just a data-capable straight-pressure CPAP would do.


Den

.

[hyperlexis]

There already exists such a plan, and costs. It's called Medicare.

[purple]

Clearly. Medicare does not pay enough for a person whose income is actually Social Security to both afford Apnea treatment, and any quality of life. Actually, without any medical costs, Social Security does not pay enough for quality of life.

[Goofproof]

Den makes sense, more people would make their treatment worked if they had more of a investment in their health. In my case, not making xpap work would have been a early death sentence, self inflicted, so I made up my mind to make it work. It becomes a time to put you big boy pants on and help yourself. The government can't lead your life for you, but they can enslave you. Jim

[robysue]

Den makes sense, more people would make their treatment worked if they had more of a investment in their health.

I disagree with the statement. I say this as someone who has to make 50% copays on all of my equipment, although my insurance only required $20 copays on the sleep tests themselves.

When the cost of prescribed treatment is perceived as unaffordable, it causes resistance to getting tested; it causes resistance to starting treatment; and it causes resistance to following through with treatment. This is not just true of xPAP equipment and sleep apnea; it is true for any kind of ongoing medical treatment that the patient regards as unaffordable. And then add to the worries about how to afford care for a life-long chronic condition the worry about losing health care insurance and not being able to afford it on the private market due to "preexisting conditions" or having coverage for those preexisting conditions specifically excluded from the policy purchased on the private market.

In other words, if you add "significant cost" to all the negative stereotypes and perceptions of xPAP therapy, I think you'll see fewer people being willing to be tested for apnea and fewer people being willing to consider starting PAP if they're found to have apnea.

Increasing effective treatment of OSA will require "the system" to provide new PAPers with appropriate equipment, appropriate education, and appropriate follow-ups, all of which add to the expense of initiating therapy for any individual patient.

[chunkyfrog]

IMHO, it is only a matter of time until the truth that we already know, is revealed,
that the true costs of treatment never begun or not continued, far exceeds
the expense of affordable, effective treatment for those who need it.
When that happens, it will be interesting to see what happens next.
It has already happened in some other countries--ours, as usual, is behind.

[purple]

Robysue, without a doubt, the goal of your health insurance company is to discourage you from seeking/continuing treatment.

[chunkyfrog]

Wouldn't it be something is insurance companies were held responsible for past malfeasance?

[purple]

My goal was to fix a dollar number for what people should be required to pay as their part of treatment. I feel the whole goal of deductibles and Co Pays should be to discourage the wasting of health care by hypochondriacs. As deductibles/Co-Pays are presently set, they discourage people from getting health care they need, and which if properly applied would save the whole system/country money. The added benefit being to make those who are already trained and willing to work, to be able to continue to work and pay taxes.

I do not want to discuss the whole range of public health care issues, like doctors compensation, the malpractice lawsuit industry, ObamaCare. Or even other medical conditions. Just the reasonable cost of what an individual should pay for xPAP diagnosis and treatment. How to deal with the insured is also another topic.

[robysue]

Robysue, without a doubt, the goal of your health insurance company is to discourage you from seeking/continuing treatment.

It sure feels this way.

I also have three headache-related prescriptions. One the insurance company refuses to cover at all. (They're not alone: every other insurance company my neurologist's office deals with refuses to cover Deplin since it is a "prescription medical food". The other two are both generic drugs, which my insurance company keeps telling me in their advertising should cost me only a $5 copay; but each of my generic drugs require $60 copays and one is a maintenance drug that's costing me $60 OOP each and every month. Rationale? The drugs are tier 3 even though they are generics. And this is after the doc trialed me on the approved $5 copay generic drug and intolerable side effects started within the first 10 days of taking it.

And all this is from a company that gets top-notch ratings from Consumer Reports ....