Now before you leftists get crazy angry at all conservatives, allow me to say that many of us have never denied there is a great deal messed up with our current health care system. Our point has been that the government, as is usually the case, is not the answer.
The government is not known for making wise spending decisions. When the government is given a task, it seems that their answer is always to throw more money at the problem. When they run out of allocated funds, rather than question their current spending habits, they want to raise taxes. “We need a program. We have no money. Give us money.” It’s simple, but not the solution for health care, public schools, or…well…anything else. I’m not sure I have the answer, but I’m pretty sure the answer involves getting rid of insurance companies. Let me tell you what happened to me yesterday.
I have obstructive sleep apnea (OSA). What this means is when I hit a certain stage of sleep, my throat relaxes so effectively, it closes off my airway. This makes it rather difficult for my involuntary bodily functions to operate. The oxygen levels in my blood drop significantly (also known as “O2 Sats”), which is not good for me. Part of the reason I have sleep apnea is because I carry extra weight. I’ve modified my eating habits in order to help lose the weight, but the greatest invention to help us OSA-sufferers is the CPAP machine. (CPAP stands for Continuously Positive Air Pressure.)
What this machine does is blow air up my nose all night, keeping my airways open. Sounds uncomfortable, and there are some people who really can’t get used to it, but I love this machine for several reasons. First off, it helps me breathe. Anything that helps me breathe is good in my book. Second, it’s white noise. Not a lot of noise, mind you, but enough that it definitely helps Kim and I sleep. When I’m not there, she has a hard time sleeping without the noise. Finally, I’ve conditioned myself in sort of a Pavlovian manner with this mask. When I put the mask on, my body knows it’s time to sleep. Used to take me hours to get to sleep. Now, I don’t know how long it takes me, but my guess is approximately 20 minutes. I love this machine, and have had relatively few problems with it, even when we went to Scotland.
However, things do wear out, no matter how awesome they are. My molded plastic mask is one of those things. It’s cracked in a couple places, and since I’ve had it for about 4 years, I think it’s time for a new one. I call my insurance company, and they tell me I need to see my Primary Care Physician to get a prescription for a new mask. No problem. I go see him, he congratulates me on my impending fatherhood, and I get my prescription. No muss, no fuss.
The doctor’s office steers me toward a certain healthcare provider, to whom they fax my prescription, and tells me I should wait for a call from them. I get the call from them, and they’re asking me which machine I wanted to order. This sort of takes me aback, since the prescription was not for a new machine. I don’t need a new machine. Most importantly, I don’t want to pay the 50% copay for a new machine! I just need a new mask, I tell her. She is sort of surprised, but switched gears pretty fast. She wanted to know what model of mask I needed, and what model of machine I had, so I could be sure I got the correct filters. I had to call her back the next day so I could find the information on my CPAP machine. When I let her know everything the following day, she let me know how much this was all going to run me with my 50% copay for durable medical equipment.
$113.
Now, what this means is that they’re going to bill me $113, and then will turn around and bill my insurance company $113. For those with the same public school education I got, I’ve already done the math. The cost for a mask, a hose to connect it, and 3 filters (2 disposable, 1 reusable) is $226 total. Doesn’t seem too bad, right? After all, this thing helps me breathe. You really can’t put a price on that, can you? No, but others can.
In my research to figure out which model of mask I already had so I could just get a replacement, I discovered a site that seemed to be an online store for CPAP machines and accessories. The mask itself cost $69.99 from this online store. I checked with their policies, and they don’t even deal with insurance companies. I was sort of flabbergasted at this. I went through the site and found everything I was planning on ordering from the healthcare provider and added it all to my shopping cart. The filters were the same but came in a 2-pack for the reusables and a 6-pack for the disposables, and the hose I was getting was one of the top-quality hoses with less internal friction resulting in less noise. So I’m getting better and more, and the total cost was……get this…..
$108.
That’s right. Not $108 for me, $108 for the insurance company. $108 total! Now, explain to me how a company can sell the same equipment, brand new, for twice the cost like this? Simple, insurance companies. Because no single person is bearing the cost of this equipment, companies like this healthcare company feel they can make a LOT more money by marking up this equipment to ridiculous amounts. Obviously, the free market would dictate a much lower price for this equipment. After all, the online store from whoch I ended up purchasing my equipment is still making a profit. It’s not like their motives are entirely altruistic. (They do have an information forum they maintain as well as a 1-800 number for anyone to ask questions about CPAP equipment on for free, but they are still in it to make money.) Ultimately, I’m going to do everything I can to avoid going through healthcare providers that deal with insurance companies, to see if the free market will net me the same equipment for lower prices.
As I said, I ultimately bought my new mask, hose and filters from this site, which is http://www.cpap.com. I’m saving money by going through them, and so is my insurance company. I’m making the request today to be reimbursed for my out of pocket expenses, but I saved them over $50 on the deal. They shipped my order the same day, and I should have it by the middle of next week.
I’m all for getting rid of insurance companies, but I still don’t think government is the solution. If I don’t go to the doctor in 5 years, I shouldn’t have to keep paying insurance premiums, which go to someone else, just so my insurance company can balk at paying claims when I do need them. I’ll save my monthly premiums and pay for my own healthcare when it comes to it. I know this doesn’t address people with chronic and costly problems, though I wonder whether saving the insurance premiums and gaining interest on this money would be a better solution for them as well. I’m not purporting to have the answer, but this price gouging is ridiculous. Government, however will just be another form of insurance companies, only it’ll be illegal to not pay their premiums, because they’ll come in the form of huge taxes….bad solution.