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Leon Trotsky 2012 posted:It was mostly being used because the companies rent the machines, provide them to patients, and pay for the machines. But, lots of patients don't use the machines. They check to see if someone has not turned it on for over 3 months and then say that they need to use their machine or pay for it to sit there if they aren't going to use it. The article had them denying a new mask, prescribed by a doctor, and failing to update the settings remotely, again prescribed by the doctor. Updating these settings remotely was used as the justification for the new tattling machine. The tattling machine told them that he only used this machine (that was not working properly for him) for 3 hours and 3.5 hours instead of the 4-hour minimum. The doctor had prescribed the new mask and change of setting because it wasn't working for the patient previously. That's some Kafka-level bureaucracy to force a user into usage compliance before you'll issue them a fix to make the machine work properly. The first time he got the insurer on the phone, the reaction should have been "Oh I see your doctor changed the prescription and settings, it's certainly not reasonable to require you to meet this arbitrary metric to fix your problem" That's like "We've noticed that your blood sugars have been high lately, we're not going to update the basal rate setting on your insulin pump until you get that fixed"
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Nov 21, 2018 17:30
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Leon Trotsky 2012 posted:Did you read the article? This is more of a "if everything goes wrong and they have a database that we just gave them, then would GATTACA be real?" situation that people also worry about for blood donations, genealogy websites, and social media. Stop making excuses for corporations profiting from people's misery
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Nov 21, 2018 17:32
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Pablo Nergigante posted:Stop making excuses for corporations profiting from people's misery What are your thoughts on smart bottles that track adherence for expensive prescription drugs? It's a win for patients because the presence of monitoring makes them more likely to take their medication. But it's also a win for insurance companies that know patients are a taking medication they're [in part] paying for and will minimize incidence of secondary health complications from nonadherence. And it's an obvious win for pharma as they make more money if they get 12 TRx per year rather than 11 TRx because people forget 1 out of 10 days or so. Just because it also benefits insurers and pharma in addition to patients smart bottles should be forbidden or discouraged? Would it be okay under a single payer system where the goal was to limit waste and constrain aggregate healthcare spend (taxes)?
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Nov 21, 2018 18:55
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Leon Trotsky 2012 posted:Did you read the article? This is more of a "if everything goes wrong and they have a database that we just gave them, then would GATTACA be real?" situation that people also worry about for blood donations, genealogy websites, and social media. Some perspective on this - the Medicare threshold is 70% usage over a 30 day period, and modern CPAP machines monitor compliance either with remote monitoring as the twitter author describes, or by recording usage on a chip which you bring to your doctor. If you aren't compliant (i.e. you didn't use it enough during the period you were monitored) then yes, you're required to either return the machine or pay fees. I don't understand why Trotsky got probated for a month for this, what he said is essentially true  Pablo Nergigante posted:Stop making excuses for corporations profiting from people's misery Medicare sets the minimum standard for this, not really the corporations (although I guess you could say they lobbied Medicare for this but I don't think that's the case). Flesh Forge fucked around with this message at 19:36 on Nov 21, 2018 |
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Nov 21, 2018 19:33
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Flesh Forge posted:I don't understand why Trotsky got probated for a month for this, what he said is essentially true He is a loving awful lying troll who loving poisons these forums, just because he occasionally says things that are technically accurate is no excuse to defend him, dude is a loving Holocaust denying piece of poo poo. I'd much rather the forums not have to refute false information that he spreads every time he posts, it makes for a better D&D experience if people aren't running around lying/trolling constantly to disrupt the discourse because they think it's fun. Like, loving click the rap sheet, am I the only poster here who remembers who the loving lovely liars are? Why do you expect them to suddenly become good posters the half the time when they're not lying?
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Nov 21, 2018 19:38
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That's fine I guess  but he's not wrong in that particular post.
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Nov 21, 2018 19:41
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Flesh Forge posted:That's fine I guess aside from the part where he claims it's entirely normal and good, yes
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Nov 21, 2018 19:42
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Flesh Forge posted:That's fine I guess You have missed my point entirely, congratulations. Seriously do other people just not have pattern recognition or something? Am I the only one who can see a pattern of lying/trolling/shitposting and then mentally file the poster into a garbage bin, never to trust them again? "But he was technically correct" is missing the forest for the trees here. Yeowch!!! My Balls!!! posted:aside from the part where he claims it's entirely normal and good, yes Also this, he's not even correct because he's implicitly making a value judgement that this situation is normal and fine. E: VVV Oh, now I get why you defended him. A fellow bootlicker! WampaLord fucked around with this message at 19:47 on Nov 21, 2018 |
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Nov 21, 2018 19:42
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Yeowch!!! My Balls!!! posted:aside from the part where he claims it's entirely normal and good, yes But it is entirely normal, and this type of measure to reduce cost is generally good e:If you guys are saying "this is morally wrong and I don't like it" that's great, say that, but it is literally the norm.
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Nov 21, 2018 19:46
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WampaLord posted:You have missed my point entirely, congratulations. there is a caste of liberal whose moral compass, in its entirety, is the need to defend Normalcy. what is Normal must, necessarily, be good. because I am normal. and therefore I must be good. if normalcy is not good- if normalcy in fact includes hovering over the sick in the hopes you can deny them further medical care thanks to their sleep habits- then I might not be good. they tend to get really upset when someone isn't reassured by the statement "all procedures were followed."
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Nov 21, 2018 19:48
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Yeowch!!! My Balls!!! posted:there is a caste of liberal whose moral compass, in its entirety, is the need to defend Normalcy. what is Normal must, necessarily, be good. Agh I should have known better than to talk to your dumb rear end.
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Nov 21, 2018 19:50
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Flesh Forge posted:e:If you guys are saying "this is morally wrong and I don't like it" that's great, say that, but it is literally the norm. That is actually what the person who posted the article said, and then LT2012 shat out a bunch of "technically correct" bullshit to imply that this is the norm and should continue, other people think this is an outrageous situation and yet another symptom of the profit motive in healthcare being loving terrible. Like, do you not understand when you say "But this is normal" you're defending the lovely status quo? And that's not a great look, to defend insurance companies in 2018? Do you get that? I feel like a lot of people on this forum go "I'm just describing what the situation is" not understanding they are implicitly defending the status quo every time they do it. CPAP machines reporting on your sleep schedule to your insurance company so they deny you benefits IS NOT NORMAL OR GOOD
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Nov 21, 2018 19:50
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burn down health insurance companies and salt the ashes? but they're following all the rules they wrote! there must be some mistake. you must be being unreasonable. the system says you die bankrupt. so you must deserve to die bankrupt. unlike me. who is normal. and follows the rules. and cannot possibly imagine a situation where I'm taken out-of-network for an emergency, or just get coverage denied on grounds some insurance guy somewhere thinks he needs to keep the provider network honest. those things happen to Bad People. you can tell. the system wouldn't punish them if they hadn't made a mistake.
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Nov 21, 2018 19:53
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Compliance should be the goal. If you have sleep apnea, CPAP's loving great for your health.
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Nov 21, 2018 19:54
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WampaLord posted:CPAP machines reporting on your sleep schedule to your insurance company so they deny you benefits IS NOT NORMAL OR GOOD This. Your doctor? Fine. Good, even, as they will understand more about how the treatment is working for you. The manufacturer? Sketchy. They should be requesting it from your doctor with your explicit consent. Your insurance company shouldn't ever be able to see the information, just the bill.
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Nov 21, 2018 19:56
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WampaLord posted:
As it was explained to me it was reporting to a cloud portal that my sleep doctor had access to; he then filed the appropriate paperwork with insurance. I wonder if the office filed something incorrectly leading to this crazy loop. Everyone’s insurance is different though. With mine they rented it until my first follow up, then my doctor filed some form that said “yes he is compliant” and they paid for the machine subject to normal copays for durable medical equipment.
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Nov 21, 2018 20:00
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WampaLord posted:CPAP machines reporting on your sleep schedule to your insurance company so they deny you benefits IS NOT NORMAL OR GOOD Maybe you don't have any contact with CPAP users but a) you need to use the equipment a certain amount for it to be therapeutic at all, i.e. if you use it 1 night out of 10 then it does not provide any long term benefit to your health; b) the machines and their supplies are very expensive; and c) people literally do get them as prescribed, stick them on a shelf and never use them. When people waste expensive resources, yes, even fully socialized medicine systems will withhold them. Accretionist posted:Compliance should be the goal. If you have sleep apnea, CPAP's loving great for your health.
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Nov 21, 2018 20:03
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Dirk the Average posted:Your insurance company shouldn't ever be able to see the information, just the bill. How do you feel about Medicare itself seeing this information and enforcing compliance Medicare sets this standard.WampaLord posted:E: VVV Oh, now I get why you defended him. A fellow bootlicker! 
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Nov 21, 2018 20:06
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Dirk the Average posted:This. The insurance company's idealistic goal is cost containment. This will be true in some form in single payer, as well. UK's NICE rejects therapies or enforces step edits using HEOR analysis. It is not good for anyone if the patient is being allocated resources, be it a medical device or drug therapy, and then is not using it. Improving health outcomes while minimizing waste is good. But this is how these things go. Goons, leftists, and leftist goons have very strong opinions on end goals but are often disinterested or lack the background knowledge to engage in the technocratic details of implementation given finite funding.
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Nov 21, 2018 20:17
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there is something so painfully illuminating in the finest defense of trying to get people denied medical care for their sleep habits being a shrug emoji. "i don't give a poo poo about this. so why should anyone else."
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Nov 21, 2018 20:19
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Flesh Forge posted:Maybe you don't have any contact with CPAP users but a) you need to use the equipment a certain amount for it to be therapeutic at all, i.e. if you use it 1 night out of 10 then it does not provide any long term benefit to your health; b) the machines and their supplies are very expensive; and c) people literally do get them as prescribed, stick them on a shelf and never use them. When people waste expensive resources, yes, even fully socialized medicine systems will withhold them. My beef with it is that the NHS can put it on a rent to own plan and not be a big deal because the NHS isn't going anywhere. Meanwhile since ACA and employer plans can change every year it throws a lot of these payment plans into chaos. Some people I know have had to restart the clock on the lease when they changed insurance plans on their CPAP.
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Nov 21, 2018 20:24
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Accretionist posted:Compliance should be the goal. If you have sleep apnea, CPAP's loving great for your health. gently caress my health, without the CPAP I sleep so poorly I can't trust myself to stay awake driving. I can't even imagine feeling bad enough to go through the hassle of doing a sleep study then not using the thing
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Nov 21, 2018 20:33
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Flesh Forge posted:But it is entirely normal, and this type of measure to reduce cost is generally good “Burn down the insurance companies and salt the ashes” is pretty obviously a moral value judgement, yes. Your insurance company spying on you in your sleep looking for opportunities to take away medical equipment prescribed by your doctor is morally heinous and if you think it’s a good idea you’re a cold-hearted rear end in a top hat. And don’t argue with me that the insurance company is trying to drive compliance for the sake of the patient. They’re a corporation looking to maximize profit by denying payment in every way they can get away with. Dirk the Average posted:This. Agreed 100%. The doctor should be the final authority on how patients are treated. Insurance companies have no business making medical judgements or superseding a doctor’s orders. KingNastidon posted:What are your thoughts on smart bottles that track adherence for expensive prescription drugs? It's a win for patients because the presence of monitoring makes them more likely to take their medication. But it's also a win for insurance companies that know patients are a taking medication they're [in part] paying for and will minimize incidence of secondary health complications from nonadherence. And it's an obvious win for pharma as they make more money if they get 12 TRx per year rather than 11 TRx because people forget 1 out of 10 days or so. Do patients see it as a win? Were their opinions surveyed or consulted prior to development or deployment of these things? What happens when these “smart bottles” detect noncompliance? Do they report to the doctor or to insurance? I’d be ok with this only if a doctor decided it was necessary to ensure compliance with treatment. If this was the brainchild of for-profit insurance companies solely looking to save a buck in spite of doctor or patient opinion they can get hosed.
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Nov 21, 2018 20:53
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Flesh Forge posted:But it is entirely normal, and this type of measure to reduce cost is generally good That you don't see how this is extremely hosed up is a little concerning tbh. It's almost like people don't have full understanding of how medical technology works and require professional assistance from doctors, not to be treated poorly because they make mistakes.
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Nov 21, 2018 20:57
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Rhesus Pieces posted:“Burn down the insurance companies and salt the ashes” is pretty obviously a moral value judgement, yes. Okay, but "this is normal/this is not normal" is pretty obviously not, and that's what I replied to, not "burn down the insurance companies". quote:Your insurance company spying on you in your sleep looking for opportunities to take away medical equipment prescribed by your doctor is morally heinous and if you think it’s a good idea you’re a cold-hearted rear end in a top hat. if their goal was to take it away then why do you think they gave it to the patient in the first place 
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Nov 21, 2018 20:58
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Lightning Knight posted:That you don't see how this is extremely hosed up is a little concerning tbh. It's almost like people don't have full understanding of how medical technology works and require professional assistance from doctors, not to be treated poorly because they make mistakes. Speaking of not having full understanding, it is uh, improbable that any insurance provider will extend you the coverage of some expensive rear end home treatment like a CPAP machine and then withdraw it based on one day's worth of monitoring and lack of compliance, and the twitter anecdote that you dudes are flipping out about is pretty disingenuous
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Nov 21, 2018 21:00
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Flesh Forge posted:Speaking of not having full understanding, it is uh, improbable that any insurance provider will extend you the coverage of some expensive rear end home treatment like a CPAP machine and then withdraw it based on one day's worth of monitoring and lack of compliance, and the twitter anecdote that you dudes are flipping out about is pretty disingenuous So now you're calling that dude a liar? https://twitter.com/ericuman/status/1065258162675228674 Jesus gently caress, just stop! Stop defending insurance companies! No one is forcing you to continue to double down over this, just take the L and go "wow, profit motive in healthcare is hosed up!" E: VVV Hahaha a tone argument, loving of course
WampaLord fucked around with this message at 21:05 on Nov 21, 2018 |
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Nov 21, 2018 21:02
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I am suspicious of his story based on my experience with obtaining CPAP coverage, yes. e: Wow y'all some rude motherfuckers in here.
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Nov 21, 2018 21:02
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I assume what happened is that the machine uploaded the summary data that was in its flash when it got a data connection. This indicates that they were not using the machine, according to the tweet because they needed a new mask. Sounds like they need to talk to their doctor.
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Nov 21, 2018 21:10
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WampaLord posted:E: VVV Hahaha a tone argument, loving You're goddamn right a tone argument, yes. Would you rather I posted screenfulls of gently caress YOU gently caress YOU gently caress YOU
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Nov 21, 2018 21:11
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Flesh Forge posted:You're goddamn right a tone argument, yes. Would you rather I posted screenfulls of gently caress YOU gently caress YOU gently caress YOU Ugh, these people are being so RUDE about having their insurance denied, well I never! Can't they just die quietly so I can have a nice polite discussion about my favorite insurance companies and how awesome they are?
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Nov 21, 2018 21:12
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No, those people are fine, you're a prick though
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Nov 21, 2018 21:19
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Flesh Forge posted:How do you feel about Medicare itself seeing this information and enforcing compliance I'm not happy about it. That should be fairly obvious.
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Nov 21, 2018 21:21
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WampaLord posted:So now you're calling that dude a liar? Stories don't need 'good guys.' They can all suck. Based on my experience, I think he's embellishing, too.
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Nov 21, 2018 21:23
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KingNastidon posted:The insurance company's idealistic goal is cost containment. This will be true in some form in single payer, as well. UK's NICE rejects therapies or enforces step edits using HEOR analysis. It is not good for anyone if the patient is being allocated resources, be it a medical device or drug therapy, and then is not using it. Improving health outcomes while minimizing waste is good. Therapy should be between the patient and the doctor. If the patient is not compliant with treatment, that is something that the doctor needs to work on, not the insurance company or NHS equivalent.
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Nov 21, 2018 21:25
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So what's the solution here, to you people? Let everyone have CPAP parts willy-nilly when they don't use them? Around 50% of CPAP users are non-compliant and do not use the device enough to be therapeutic. Let's go to the magical single-payer land now--are you proposing that there be no cost controls on them? Someone, somewhere, presumably has the power to say "you aren't even using the damned thing, no we're not spending more $$ on you." So far we've had "not insurers" and "not Medicare" so who gets to refuse you access to an ongoing expensive treatment that you refuse to use correctly? Or is that "nobody" in your book, and we all have a dusty CPAP decorating our bedside table? I loving love mine, but if I wasn't using it, I'd totally get taxpayers not wanting to keep funding my wasted replacement parts or initial unit fee. Edit: ^^^ Okay, so there's one answer. Your doctor can refuse you treatment if he thinks you're not compliant.
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Nov 21, 2018 21:29
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Flesh Forge posted:No, those people are fine, you're a prick though insurance companies deny people coverage based on their sleep habits? i sleep someone calls the people doing this a nasty name? real poo poo
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Nov 21, 2018 21:33
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The underlying issue is when and how to ration. Under full UHC, we'd still have rationing. When and how do you go about that?Sundae posted:Edit: ^^^ Okay, so there's one answer. Your doctor can refuse you treatment if he thinks you're not compliant.
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Nov 21, 2018 21:37
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Yeowch!!! My Balls!!! posted:insurance companies deny people coverage based on their sleep habits? i sleep "Those insurance companies are garbage." - Ok "You, YWOUCH MY BAWLLSZ!!!, are a dumb piece of poo poo garbage nerd poo poo head" - Semantically exactly the same thing
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Nov 21, 2018 21:38
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Non compliance because the patient doesn't like the noise is a huge difference from the patient not using it because the settings and mask are wrong but insurance refuses to allow the switch. If someone truly doesn't use it for 3 months and has no desire to then sure the doctor can refuse to renew prescriptions. I like how insurance forcing people to rent the machine for 5x what it is worth goes undiscussed tho. What problem are insurance companies solving there? Or how about not allowing the patient to just buy it out of pocket in that case? And it is clear why insurance would allow it at first but then revoke it. At the initial filing they have no room to deny the claim but they absolutely want to. So they'll throw as many hoops in your way to jump through to discourage you using it (like charging 5x the cost) or gotchas to revoke it (like not updating settings and such so the machine is unusable for you but then saying you're noncompliant). The underlying problem people have isn't the idea of some cost controls where they're sane; but the usage of this sort of thing as a way to deny access. A $5 copay helps control costs; charging $2500 for a $500 machine is denying access.
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Nov 21, 2018 21:40
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