I dare you to make sense of this

[slomobile]

I need a cervical orthotic to keep my airway straight and open during sustained larygospasms and an emergency tank of oxygen standing by to make the most of the breaths I can get in during an attack. Happens maybe 20 minutes 6 times per week. My doctor ordered it. Insurance says no. I ask why. They point at this. They will not even allow me to pay cash. They literally decide who can breathe and who cannot.

https://www.cms.gov/outreach-and-educat ... m11064.pdf

I dare you to try making any sense out of that.

[martin007]

For me it's very simple.
"They do it because they can".
I have found myself like this several times in life.

Many people are narcissists and psychopaths.

> https://en.wikipedia.org/wiki/Narcissism

> https://en.wikipedia.org/wiki/Psychopathy

[Burgerman]

Go get a couple of oxygen bottles from your local welding supplies.

And... Next to my bed I have a supplemental oxygen generator. EBay. Its an old hostital style one but was sold as unused. Still boxed up. Cost me 299 UK pounds. It does 6 litres a minute. Thats not QUITE as much as you need to breath full lungs full of pure oxygen. But its almost enough And say a strong mix of oxygen and air gives you a way higher level of oxygen than just air at 21%. And if you are struggling to get air in, then it will probably BE enough for 100% concentration. I dont do the fce mask or the nose thing, just stick the tube in my mouth and breath normally.


Its one of these:
Noisy but reliable.

[LROBBINS]

U.S. healthcare is AFU and yours is just one example among many, many, many. For example:
https://www.nytimes.com/2024/03/14/opinion/health-insurance-prior-authorization.html

[Burgerman]

That happens here too. For slightly different reasons. But the fix is easy. Ignore the over regulated and corporatist self serving "system" for medical care and use the free market who will be only too willing to sell you an oxygen concentrator or to an oxygen bottle. Wave money at them instead of your insurer. They want to feed themselves. They will be dying to take your money and supply you oxygen as they do for welding or diving etc.

I had the same issues with our socialist over regulated NHS system. These are only interested in serving themselves as they do not get paid by the you the patient. Mostly they just employ ever more layers of paper pushers and fancy offices, new cars, great holidays and employment laws and have 4 people doing every job all holding hands. As long as they can push all responsibility for any decision to a group or panel, or the CCG, OR higher up the ever growing chain and keep as high an income and as easy a life as possible then they are happy. They hide behind rules, panels, letters, legislation, prescriptions etc. So eventually when theres non of that helicopter money left as they used it all on god knows what extremely wastefully, and you come last in the chain.

So there comes a time where you have to opt out of the idiots system. And look after your own interests. You cant do that with every medical thing. Partly because they make anti-capitalist laws like presriptions. I CANNOT buy many things in a free market without a prescription because they made it illegal! We are treated as children. But some things, like chairs and oxygen are available on the free market. Take charge.

[martin007]

That happens here too. For slightly different reasons. But the fix is easy. Ignore the over regulated and corporatist self serving "system" for medical care and use the free market who will be only too willing to sell you an oxygen concentrator or to an oxygen bottle. Wave money at them instead of your insurer. They want to feed themselves. They will be dying to take your money and supply you oxygen as they do for welding or diving etc.

I had the same issues with our socialist over regulated NHS system. These are only interested in serving themselves as they do not get paid by the you the patient. Mostly they just employ ever more layers of paper pushers and fancy offices, new cars, great holidays and employment laws and have 4 people doing every job all holding hands. As long as they can push all responsibility for any decision to a group or panel, or the CCG, OR higher up the ever growing chain and keep as high an income and as easy a life as possible then they are happy. They hide behind rules, panels, letters, legislation, prescriptions etc. So eventually when theres non of that helicopter money left as they used it all on god knows what extremely wastefully, and you come last in the chain.

So there comes a time where you have to opt out of the idiots system. And look after your own interests. You cant do that with every medical thing. Partly because they make anti-capitalist laws like presriptions. I CANNOT buy many things in a free market without a prescription because they made it illegal! We are treated as children. But some things, like chairs and oxygen are available on the free market. Take charge.

I agree 100% with what you said.

[LROBBINS]

Many dealers in the U.S. will simply not sell retail. But buying used can definitely be an option. A friend of ours in Florida did that to buy a power chair, hoyer lift, hospital bed etc. for his wife rather than dealing with the insurance scam hassles - oftentimes the cost on ebay (and the like) was less than the co-pay they'd have had using insurance. Sometimes the insurance co doesn't really have any significant expense at all - the co-pay on the list price is close to the actual discounted price the insurance co. pays. There's a good word for this system in Italian. It's neither socialism nor capitalism ma "corporativismo" or ("corporatismo" a neologism introduced because use of the old word was discredited by its centrality in fascism).

[martin007]

Many dealers in the U.S. will simply not sell retail. But buying used can definitely be an option. A friend of ours in Florida did that to buy a power chair, hoyer lift, hospital bed etc. for his wife rather than dealing with the insurance scam hassles - oftentimes the cost on ebay (and the like) was less than the co-pay they'd have had using insurance. Sometimes the insurance co doesn't really have any significant expense at all - the co-pay on the list price is close to the actual discounted price the insurance co. pays. There's a good word for this system in Italian. It's neither socialism nor capitalism ma "corporativismo" or ("corporatismo" a neologism introduced because use of the old word was discredited by its centrality in fascism).

Practices like that are becoming more and more widespread.
In some cases they are due to a lack of competition and in other cases to excessive regulation.
They are actually legal ways to "steal".
Society is corrupt and now we see the consequences.
Fortunately, sometimes it is possible to find alternatives.
You just have to use your head and reflect; that's still free.
Things in the West are going to get worse.
In Spain the laws protect fraudsters, idlers, thieves, criminals, rapists, etc...
Society punishes people who work hard and are productive.

[Burgerman]

From the figures I saw on here a couple of different times, then the co pay was MORE than the price I can buy a NEW similar chair myself.

But they get around that in the US by also charging an arm and a leg for things that are relatively cheap (or always included in the UK. Things like batteries or chargers). In the case of lights for e.g, its all included too. Unless you buy a 4mph basic chair. And even addons like recline or tilt etc are way way cheaper here than I see over there.

If I compare for e.g the prices of a sunrise Q chair, the BASIC price is pretty similar. But then the cost if extras such as batteries or chargers that are included here are astronomical prices and you get to pay extra for these essentials. When comparing say lift or tilt, the difference is huge. They do this to stop you buying these out of pocket. As the insurance/dealer/whatever silly prices scam would be ruined...

[slomobile]

I got hold of a D tank and E tank, a regulator, and a holder for the chair. Expired pressure test on the tanks so that may be an issue at refill time unless I get the concentrator that can refil a tank. I don't actually need much. Just wearing CPAP during the day helps a lot for the milder ones, but when it really clamps down hard, the pressure seems to make it worse and gag reflex kicks in. That makes me sound like a bullfrog

I heard those concentrators have a chemical in them, like a dessicant maybe, that wears out, or maybe fills up over time and needs to be rejuvinated.
We rented a concentrator for 3 years for my son because they absolutely refused to sell us one. That was the line they gave us to justify rental rather than purchase, "required maintenance". They never maintained anything in the whole 3 years.

[Burgerman]

Theres no dessicant. They just use 2 chambers full of some powder (cannot remember the name) that absorbs nitrogen. Then releases it when the pressure reverses and the machine dumps it back to atmosphere. You get the oxygen. Around 92 to 95% pure. If it drops to less for any reason the machine cries and gives a red light. Mine never did in a decade. Nothing to service.

[Burgerman]

Zeolite. As far as I am aware doesent wear out and if fully reversible. I suppose the compressor might die eventually? Or a solnoid valve wear out?
Wiki below:


Oxygen concentrators utilize a molecular sieve to adsorb gases and operate on the principle of rapid pressure swing adsorption of atmospheric nitrogen onto zeolite minerals at high pressure. This type of adsorption system is therefore functionally a nitrogen scrubber leaving the other atmospheric gases to pass through, leaving oxygen as the primary gas remaining. PSA technology is a reliable and economical technique for small to mid-scale oxygen generation. Cryogenic separation is more suitable at higher volumes and external delivery generally more suitable for small volumes.[5]

At high pressure, the porous zeolite adsorbs large quantities of nitrogen, because of its large surface area and chemical characteristics. The oxygen concentrator compresses air and passes it over zeolite, causing the zeolite to adsorb the nitrogen from the air. It then collects the remaining gas, which is mostly oxygen, and the nitrogen desorbs from the zeolite under the reduced pressure to be vented.

An oxygen concentrator has an air compressor, two cylinders filled with zeolite pellets, a pressure-equalizing reservoir, and some valves and tubes. In the first half-cycle, the first cylinder receives air from the compressor, which lasts about 3 seconds. During that time the pressure in the first cylinder rises from atmospheric to about 2.5 times normal atmospheric pressure (typically 20 psi/138 kPa gauge, or 2.36 atmospheres absolute) and the zeolite becomes saturated with nitrogen. As the first cylinder reaches near pure oxygen (there are small amounts of argon, CO2, water vapour, radon and other minor atmospheric components) in the first half-cycle, a valve opens and the oxygen-enriched gas flows to the pressure-equalizing reservoir, which connects to the patient's oxygen hose. At the end of the first half of the cycle, there is another valve position change so that the air from the compressor is directed to the second cylinder. The pressure in the first cylinder drops as the enriched oxygen moves into the reservoir, allowing the nitrogen to be desorbed back into gas. Partway through the second half of the cycle, there is another valve position change to vent the gas in the first cylinder back into the ambient atmosphere, keeping the concentration of oxygen in the pressure equalizing reservoir from falling below about 90%. The pressure in the hose delivering oxygen from the equalizing reservoir is kept steady by a pressure-reducing valve.

Older units cycled for a period of about 20 seconds and supplied up to 5 litres per minute of 90+% oxygen. Since about 1999, units capable of supplying up to 10 L/min have been available.

Classic oxygen concentrators use two-bed molecular sieves; newer concentrators use multi-bed molecular sieves. The advantage of the multi-bed technology is the increased availability and redundancy, as the 10 L/min molecular sieves are staggered and multiplied on several platforms. With this, over 960 L/min can be produced. The ramp-up time - the elapsed time until a multi-bed concentrator is producing oxygen at >90% concentration - is often less than 2 minutes, much faster than simple two-bed concentrators. This is a big advantage in mobile emergencies. The option, to fill standard oxygen cylinders (e.g. 50 L at 200 bar = 10,000 L each) with high-pressure boosters, to ensure automatic failover to previously filled reserve cylinders and to ensure the oxygen supply chain e.g. in case of power failure, is given with those systems.