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Permalink Reply by RockRpsgt on September 3, 2010 at 7:33pm

People do have a choice Mike. They have a choice to go to the doctor or not. Without the prescription the patient would not benefit from insurance support. Not everyone has an extra $600 to $1000 lying around. that is just for CPAP. Less people would be able to afford the therapy they need. As has been demonstrated on this site and many others once you have the machine you are free to do what you want with it. There are no sleep police as far as the end user is concerned. The information to operate the machine is not that well guarded. I tell my patients all to often just get the machine and do whatever it takes to make it yours. Once that happens you are a "free agent" to do wiht it as you please. If the machine becomes open to anyone at Target, walmart, or Sears what little suppport and education there is would be gone. The internet would become the only source of information for bad sleep.

the system is unbeatable as it stands. believe me I try everyday. The key is to figure out how to work it so that everyone benefits.

.... 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. .... "

This machine already exist. I believe we call them ASV and VPAP units. They are the hardest to get. The new Respironics auto-VPAP is an amazing piece of equipment.

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Permalink Reply by Mike on September 3, 2010 at 8:18pm

i suspect if the model switched to direct to consumer sales, the price point would go down significantly -- i'm no economist, but it's common sense that if you have insurance companies willing to pay $2,000 for a device consumers would only pay $200 for, but the market is dominated by insurance companies/ home care companies and not end users, that the price point will be higher than if the consumer himself/ herself were solely responsible. also, remember how many uninsured Americans there are out there, and how many have policies with high deductibles or that don't cover durable medical equipment. hey, come to think of it, I'm now one of those Americans.


Rock Hinkle said:

People do have a choice Mike. They have a choice to go to the doctor or not. Without the prescription the patient would not benefit from insurance support. Not everyone has an extra $600 to $1000 lying around. that is just for CPAP. Less people would be able to afford the therapy they need. As has been demonstrated on this site and many others once you have the machine you are free to do what you want with it. There are no sleep police as far as the end user is concerned. The information to operate the machine is not that well guarded. I tell my patients all to often just get the machine and do whatever it takes to make it yours. Once that happens you are a "free agent" to do wiht it as you please. If the machine becomes open to anyone at Target, walmart, or Sears what little suppport and education there is would be gone. The internet would become the only source of information for bad sleep.

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Permalink Reply by RockRpsgt on September 3, 2010 at 9:54pm

Like rooster said the $2000 price tag is supposed to come with a certain standard of service. Anyone can opt out of that service and purchase a machine at a much cheaper price. I have yet to hear of anyone without insurance being forced to pay that price. I myself have negotiated much better deals for my uninsured patients. I could be wrong but believe it cost around $200 just to manufacture one machine. I am sure that the price would come down. i just think that your price might be a little on the over-zealous side.

Getting rid of the prescription, and lowering the price will do little if you can't convince a person that their sleep is bad. The most common thing said to me is "I don't need that!" the average cost of the entire package for someone with insurance is around $500. Even at that price Mike you are beating your head up against the wall with sleepsearch.

Mike said:

i suspect if the model switched to direct to consumer sales, the price point would go down significantly -- i'm no economist, but it's common sense that if you have insurance companies willing to pay $2,000 for a device consumers would only pay $200 for, but the market is dominated by insurance companies/ home care companies and not end users, that the price point will be higher than if the consumer himself/ herself were solely responsible. also, remember how many uninsured Americans there are out there, and how many have policies with high deductibles or that don't cover durable medical equipment. hey, come to think of it, I'm now one of those Americans.


Rock Hinkle said:

People do have a choice Mike. They have a choice to go to the doctor or not. Without the prescription the patient would not benefit from insurance support. Not everyone has an extra $600 to $1000 lying around. that is just for CPAP. Less people would be able to afford the therapy they need. As has been demonstrated on this site and many others once you have the machine you are free to do what you want with it. There are no sleep police as far as the end user is concerned. The information to operate the machine is not that well guarded. I tell my patients all to often just get the machine and do whatever it takes to make it yours. Once that happens you are a "free agent" to do wiht it as you please. If the machine becomes open to anyone at Target, walmart, or Sears what little suppport and education there is would be gone. The internet would become the only source of information for bad sleep.

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Permalink Reply by Kath Hope www.hope2Sleep.co.uk on September 5, 2010 at 8:05pm

Absolutely BRILLIANT interview Mike. Well Done and I agree with all you said! Keep up your great work on your side of the world and I'll keep up mine on this side :)

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