Do Sleep Doctors hate APAP machines?

[zonk]

Doctors are just like any other professionals, they are service providers and its up to me the consumer to shop around for the best deal and being sleep deprived or didn't know is not good or valid excuse. just my 2c

[DCwom]

DCwom, I'm not sure what you're saying but you seem to be saying that "capitalism" is to blame for the corruption and twisted priorities of our "medical system"...

If you think we have real "capitalism" in the U.S. medical markets today, I think you need to re-evaluate this position. What we have is a socialistic and heavily regulated and governmentally-controlled medical system. Hardly capitalism at all - and definitely not a "free market". (and next year when Obamacare begins, it will be even more socialized).

Um, that's not what I said, I think you've somehow gotten me confused with some quoted material. Today's medical quandary is the result of lots of factors not an economic system. As for capitalism, no county has pure capitalism or pure socialism, heck, look at what the Chinese have done to communism

And for the record I am not a supporter of Obama-care, quite the opposite actually.

Where did this come from? Huh Everything that is sold and bought is a "good" or a "commodity",

I use the word "commodity" as most investors do, as in pork bellies, wheat futures, etc. An Apple iPhone is not a commodity in investment lingo, because it has a single supplier, i.e. no one else makes it, where as coal, oil, etc are pretty much the same thing regardless who digs it out of the ground and sells it.

Trying to steer back to the original thread a little, my point was that there is little investment/innovation in a "commodity" because it can't be recouped by higher prices. So CPAPs being something akin to a "leaf blower" are more of a commodity than an APAP which offers additional features. Whatever form of capitalism we have has undoubtedly played a hand in the development (and marketing) of APAPs, i.e build a better mousetrap...

[SuperSleeper]

DCwom, my apologies if I attributed something incorrectly to you.

My whole point was that when you said, "Its about what the market will bear", I wanted to point out that we do not have a real "market" when the prices and reimbursement schedules are dictated by government (which is what we currently have in the U.S.)

[Dreamcatcher]

The Reverend is on top form today, did you stand on your soap box when you shouted that one out

Its not just America that has a false market anything in the UK thats deemed Medical is usually bumped up with as many zero's on the end as they bloody like. The way to get a true price is to price up the parts add some for labour and there you have a proper prise for an apap machine. I'd be amazed if each machine was built for more than £100 the rest is Bulls@@t tax.

[DCwom]

DCwom, my apologies if I attributed something incorrectly to you.

My whole point was that when you said, "Its about what the market will bear", I wanted to point out that we do not have a real "market" when the prices and reimbursement schedules are dictated by government (which is what we currently have in the U.S.)

I agree that the market is throttled by medicare schedules and private insurance companies that tend to follow those same schedules. However its important to note that the prices are not actually fixed by the government. The reality is that providers attempt to fit within the schedule's limits so they can sell products and that's when things get sketchy. Price setting is probably in Obama-care 2.0

[mjbearit]

I'd be amazed if each machine was built for more than £100 the rest is Bulls@@t tax.

Please don't think I am going to argue about overpricing, but in truth, I believe that medical manufacturers probably do not have it as easy as we might think. In the US our FDA has a list of certain materials that are allowed in the manufacture of medical or consumable items. I would imagine that every country has their own and while common sense should tell us that we are all people and therefore should all have the same requirements, I'm betting that list changes from country to country! So first of all a large company has to satisfy a materials list for all countries it intends to sell in. Secondly there are probably special processes required to make a widget stronger for a medical device than for a cookoo clock. Thirdly the manufacturing environment has to have special requirements. Probably different levels of clean rooms. Clean rooms are extremely expensive to build and maintain and the higher the level, the more costly. Then there are the 8 million regulations you have to deal with. Sheesh! So no I don't think the mfg cost is 100 pounds, but it's not any 1200 either!

[DCwom]

I'd be amazed if each machine was built for more than £100 the rest is Bulls@@t tax.

Please don't think I am going to argue about overpricing, but in truth, I believe that medical manufacturers probably do not have it as easy as we might think. In the US our FDA has a list of certain materials that are allowed in the manufacture of medical or consumable items. I would imagine that every country has their own and while common sense should tell us that we are all people and therefore should all have the same requirements, I'm betting that list changes from country to country! So first of all a large company has to satisfy a materials list for all countries it intends to sell in. Secondly there are probably special processes required to make a widget stronger for a medical device than for a cookoo clock. Thirdly the manufacturing environment has to have special requirements. Probably different levels of clean rooms. Clean rooms are extremely expensive to build and maintain and the higher the level, the more costly. Then there are the 8 million regulations you have to deal with. Sheesh! So no I don't think the mfg cost is 100 pounds, but it's not any 1200 either!

You can add, extensive testing of both the design and production parts, libraries of records and of course liability insurance. In my particular area of medical device manufacturing the return rate is about 15-17%, this is an astronomically high return rate for a product and it all gets folded into the cost of the final product.

Another thing that affects the price is volume, there just aren't that many units made to spread the fixed costs across. Apple can spread its fixed costs across millions of iPhones, where CPAP/APAPs units are manufactured in the thousands, and maybe only hundreds for some models.

[Dreamcatcher]

So I guess theres no point in converting my hoover (Vacume cleaner)

Is a PC not more advanced than a leaf blower(APAP) it only costs a few hundred to build one as I have 4 in the house. Maybe its time they started selling them in Kit form so we can build our own. I know there will be overheads but is it really NASA Tech. or just NASA prices ($50000 for a spanner or toilet seat ???)

[big_dave]

So I guess theres no point in converting my hoover (Vacume cleaner)

You could if you want to redo the basic research on CPAP.
That's how Dr. Colin Sullivan built the first CPAP machine.

Edit: Tried to include a link, but it was 404 when I clicked on it.

[DCwom]

So I guess theres no point in converting my hoover (Vacume cleaner)

Is a PC not more advanced than a leaf blower(APAP) it only costs a few hundred to build one as I have 4 in the house. Maybe its time they started selling them in Kit form so we can build our own. I know there will be overheads but is it really NASA Tech. or just NASA prices ($50000 for a spanner or toilet seat ???)

Actually NASA tech may be a good analogy, a CPAP shares some attributes of a life support system. As for the PC comparison the PC has been relentlessly re-engineered to be cheaper and cheaper and the volume is sky high so they've approaching the raw material + labor = price point. A CPAP/APAP has a processor in it, not to mention a bunch of mechanical "stuff" to quietly generate, measure, heat, humidify and regulate airflow. An APAP must also sense the patients breathing to adjust the blower motor's speed, etc. Another point that should not be dismissed is that when a PC fails you lose some data, but when a CPAP fails you are messing with a vital human function, (note that failures aren't isolated to the unit just turning off, toxic fumes, etc have to be avoided).