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Permalink Reply by Rooster on
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j n k said:Don't let Rooster's political statements bother you, Mike.
You believe, as I do, that sick people need access to what makes them well, and that it is not the job of doctors, manufacturers, or other businesses to get in the way of that.
Different people have different ways of getting at that concept politically, religiously, and philosophically, but I consider it obvious common-sense love for fellowman, myself.
Thank you for expressing it so well in your interview.
I believe that individuals should be free to make decisions for themselves. This goes for the patients and the providers. The patient is free to decide what to do and who to pay for what services. The provider is free to decide what services he offers and what he charges for them. Of course if the provider delivers services that a patient is willing to pay the price for, that provider should flourish. If the provider fails to deliver this, the provider will flounder or go out of business because the patient is free to choose another provider.
I guess my brain thinks too simply to understand people who object to that type of "politics". What system would they put in place of it?
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Permalink Reply by RockRpsgt on
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Well, I do not agree that anyone should get a PAP unit without a prescription. I do not believe that these units should be sold at Walmart. Not just because they have horrible customer service. I do believe that the pt should have more control over the therapy. I think that after a certain level of knowledge is demonstrated that the pt should be allowed some leway to change his/her pressures (Most do anyway). that has always been my stand on these issues.
Great interview Mike!
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Permalink Reply by 99 on
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you are in charge of your health, bottom line?
you decide to see a doctor, the doctor assist in problem solving as they are the most quaified
you decide to follow through on the doctors instruction or recommendation.
ultimately your health is your responsiblity, not the doctors
you should make for your self a health file for everything you have or take
should you move doctors this health file is available for a to see
part the file can include a script that is upto date of current medication
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99, You wrote the truth very clearly. I think it's that new avatar. :)
I haven't seen "horrible" customer service at WalMart, only good customer service - plenty of well-lit parking space; clean facilities; restrooms conveniently located (not hidden away in a back corner); wide aisles; large selection; consistently low prices on basic goods; fast checkout; accurate pricing; if you can't find an item employees are readily available to direct you straight to it; large online shopping site with no S&H charges for store pickup; and conveniently located. WalMart has also become the largest corporate charitable giver in many of the communities it serves.
Now if you are looking for someone to hold your hand, explain product features, help you compare competitive products, chat about the local high school football team, do custom cutting of meats, have products available for in-store sampling, sell you lottery tickets, check your oil, - go somewhere else. WalMart doesn't offer those things. Their customers know that and they don't want to pay for these frills. It's hard to argue with a chain who has an estimated 750 million voluntary customer visits each year.
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Permalink Reply by Judy on
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And Wal-Mart sells lots and lots and lots and lots of foreign-made products. They're "world class".
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Sady people abdicat their responsiblilts to the doctor and he is only human
Rooster said:99, You wrote the tDuth very clearly. I think it's that new avatar. :)
I haven't seen "horrible" customer service at WalMart, only good customer service - plenty of well-lit parking space; clean facilities; restrooms conveniently located (not hidden away in a back corner); wide aisles; large selection; consistently low prices on basic goods; fast checkout; accurate pricing; if you can't find an item employees are readily available to direct you straight to it; large online shopping site with no S&H charges for store pickup; and conveniently located. WalMart has also become the largest corporate charitable giver in many of the communities it serves.
Now if you are looking for someone to hold your hand, explain product features, help you compare competitive products, chat about the local high school football team, do custom cutting of meats, have products available for in-store sampling, sell you lottery tickets, check your oil, - go somewhere else. WalMart doesn't offer those things. Their customers know that and they don't want to pay for these frills. It's hard to argue with a chain who has an estimated 750 million voluntary customer visits each year.
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Judy said:And Wal-Mart sells lots and lots and lots and lots of foreign-made products. They're "world class".
Judy, Thanks for mentioning that. That is a service for the customer that was left out of my list.
Bu they don't have Stihl chain saws. Have to buy those from our local farm supply and pay a pretty penny.
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i hope you had you chain saw at cut price, how many TPI was it (TPI = teeth per inch)
Rooster said:Judy said:And Wal-Mart sells lots and lots and lots and lots of foreign-made products. They're "world class".
Judy, Thanks for mentioning that. That is a service for the customer that was left out of my list.
Bu they don't have Stihl chain saws. Have to buy those from our local farm supply and pay a pretty penny.
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Yeah, but, Rooster, I'm not sure how old our Stihl is. It sure has cut PLENTY of trees and cord wood. It still has a metal housing rather than plastic. Hubby just took down a big ole humongous cottonwood threatening to take down our neighbor's horse pasture fence and is getting it ready for the log splitter now. It kept our furnace add-on woodburner going for the better part of 20 years. We had a McCulloch at first. The Stihl took down I don't know how many tall old Jack Pines on my daughter's property. This ole Stihl doesn't owe us a penny!!!
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Judy, I used to cut about 10 cords of oak every year for firewood for three families. Some of it was very gnarly white oak - difficult to cut and very difficult to split. If you remember Homelite, I used a Homelite 360. It was not as good as a Stihl, but I had a buddy who was an engineer for the Homelite factory and would get me saws below wholesale price.
So it is all about money value. If I had to pay retail, I would go with the Stihl, but at low factory prices the Homelite gave me more money value.
The same with WalMart and cheap imported goods. We contracted out the farm some years ago and I no longer cut much firewood. For the little cutting I do in my little village lawn, a cheap imported saw from WalMart is good money value. If I needed to cut ten cords of firewood, the Stihl would be better money value.
It is all about letting consumers have choices. I can see a place for DMEs who provide top notch services including mask fitting and advice and education. But their customers have to be willing to pay for that.
On the other hand, there are the experienced members of this forum who will do this all themselves and want to purchase their equipment from a discount source who offers nothing but the product. We all want those choices and the regulatory environment is in the way of our freedom and in the way of the providers' freedom to serve us.
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Very briefly:
Freedom works both ways. Just as I demand my freedom to make my own choices (As long as I am willing to suffer the consequences and as long as I do not infringe on others' freedom), ResMed should be free to control the prices at which their customers resell the equipment. It is ResMed's right to make its own decisions. In fact a recent Supreme Court ruling would seem to apply and confirm that ResMed has this right to control the reseller pricing. (It may be quite subtle, but I believe this point is where you and I have the most fundamental disagreement.)
So what are the rights of the buyers (patients)? The right of the buyer is to buy (with an obligation to pay) whatever product or service he chooses from whatever supplier he chooses. The supplier sets the terms/prices (at least initially) and the buyer decides whether they are acceptable. All is on a voluntary basis - no force is used (governments use force, meaning guns, handcuffs and prisons - 2.4 million people imprisoned in the U.S. currently). Free markets don't use force, fraud or deception.
The current government regulatory environment dictates who may make, sell and resell CPAP equipment. It dictates licensing, educations and terms of sale. It dictates who may buy equipment (those holding a valid prescription).
Strip away this regulation of markets and the buyer and the producer/sellers will have many more options. A robust "used" market will develop, the number of DMEs will increase because it will be easier, cheaper and quicker to get into the market. For the same reasons, the number of manufacturers and machines on the market will increase and the prices will fall. With all the new DMEs entering the market and competing, they will learn how to provide what the customers want. I am confident that some will be successful as discounters and others will be successful providing some version of "full service" with mask fitting, counseling, etc.
But enough of my rambling, Mike has already said it very well earlier in this thread:
" .... if you lifted all these regulations on the market, what you'd have in the year 2010 is a CPAP machine that is more than just a CPAP machine -- today's CPAP machine is a relic of our regulatory regime that is a "dumbed down" version of what should and CAN be on the market today: a machine that not only will diagnose OSA, but will determine the ideal pressure setting on a breathe-by-breathe basis and auto-titrate in real time. the only reason we don't have such a machine is that such a machine would be illegal and its makers would be thrown into federal prison because it would be deemed a "dangerous medical device" by the FDA. .... "
Let me add, if the business is unregulated, my prediction is that ResMed would cease to spend effort on trying to use the market regulations to their advantage (because there are no market regulations) and would focus on making and selling excellent machines at competitive prices. And if they didn't, other suppliers would knock them out of the catbird's seat.
Let's don't regulate more. Let's do away with the regulations and throw the suppliers to the mercy of the market.
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Permalink Reply by Mike on
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I think the reference to WalMart has become something of a distraction since WalMart gets a lot of bad press (perhaps deservedly so, but that's not the point). . . I don't care who sells the machines, really, whether its Target, CostCo, WalMart, your local supermarket, Amazon.com, whatever... the point is they should enter the stream of commerce without the requirement of a doctor's prescription. like many products, they might need to meet some sort of safety/ regulatory standard. But a doctor's prescription is an EXTREME form of regulation that is counterproductive if the goal is to get the millions of people who have Sleep Apnea breathing clear and easy at night.
perhaps that is the fundamental question: do we want people afflicted with this chronic health condition to know about it and do something to help themselves? i do. but i suspect the lobbyists for the insurance companies and physicians might not so quickly buy in to that simple concept.
Rooster said:99, You wrote the truth very clearly. I think it's that new avatar. :)
I haven't seen "horrible" customer service at WalMart, only good customer service - plenty of well-lit parking space; clean facilities; restrooms conveniently located (not hidden away in a back corner); wide aisles; large selection; consistently low prices on basic goods; fast checkout; accurate pricing; if you can't find an item employees are readily available to direct you straight to it; large online shopping site with no S&H charges for store pickup; and conveniently located. WalMart has also become the largest corporate charitable giver in many of the communities it serves. Now if you are looking for someone to hold your hand, explain product features, help you compare competitive products, chat about the local high school football team, do custom cutting of meats, have products available for in-store sampling, sell you lottery tickets, check your oil, - go somewhere else. WalMart doesn't offer those things. Their customers know that and they don't want to pay for these frills. It's hard to argue with a chain who has an estimated 750 million voluntary customer visits each year.
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