[bluesquared]

In a somewhat similar manner, my CPAP has a 4G modem that's a huge double-edged sword (for Americans only, you can see where this is going...).

On one hand, it is nice to have an app that shows my stats, and my doctor can also remotely access how my therapy is going.

On the other hand, it also phones home to the manufacturer & my insurance. When I don't hit my usage target for a specific time period, insurance stops paying for it and I have to personally pay out of pocket. So now you add the stress of not only complying with sleeping with an uncomfortable apparatus on your face but also if you don't keep it on enough (I take it off unconsciously in my sleep) you start paying thru the nose for it. Vicious cycle...

[te_chris]

Jesus Christ that's dystopian.

[ars]

Not really. The device belongs to the insurance company and they're only willing to pay for it if it's actually being used. They are quite expensive machines, and they don't want people having them in their house, and not actually using them (CPAP has a very low patient compliance rate).

And that's why they have tracking built-in. You're perfectly able to buy the machine yourself without insurance and then you don't have to turn on the modem.

And also after you've used it for a while they give it to you and then you can turn off the modem.

[rootusrootus]

IMO it's a misuse of the technology. Controlled remote access was a good idea for doctors to see how therapy was working and adjust when necessary. I'd argue that newer APAP machines are so good at self-adjusting that it's less clear that remote access is necessary. And using it for insurance purposes should never have been permitted to begin with. Price it into the premium and skip the dystopian monitoring part.

Personally, I just bought my machine outright. Yeah, it was close to a thousand bucks. But it's been going strong for years, so I'm happy with the investment. It has never been allowed to connect back to resmed.

[ars]

I agree APAP is so good you no longer need a Dr. involved. People should be allowed to purchase an APAP machine if they want it, with no prescription.

However I disagree about insurance - they are paying for it, so they can chose how they want to monitor usage. If you don't like it, then pay for it yourself, exactly like you did.

Also, the older machines don't have remote access, they have a little card you have to bring periodically to the Dr. so they can confirm to insurance you are actually using it. Remote access was meant to make it less annoying for patients, and cheaper too since you don't have to go to the Dr. so often.

Pricing it into the premium is a terrible idea - it would raise premiums for everyone, for very little gain.

[rootusrootus]

> Pricing it into the premium is a terrible idea - it would raise premiums for everyone, for very little gain.

Enough to matter? Let's put this in context. A typical CPAP machine will go for years before needing to be replaced, and can be purchased retail for about $800. Compared to routine medical expenses, that's nothing. Heck, the reduction in costs for monitoring compliance would probably lead to -lower- premiums, not higher.

[jrockway]

I think the modem worked its way in there because some employers mandate compliance and that's how they check. (Think safety-critical jobs like driving a train; if you're diagnosed with sleep apnea and don't use the prescribed mitigation, you can't drive the train. Too many people feeling "fine", falling asleep, and running their train around a 30mph curve at 80mph.) Insurance companies obviously love the excuse to not pay, but that's probably not the primary purpose for telemetry.

You can buy your CPAP outright for around ~$1500. This is a problem for many people, but probably not HN readers. The telemetry basically facilitates an interest-free loan that lets you pay for the machine over a couple years. More favorable financing than a credit card, so people aren't getting super screwed here.

[wildmanx]

CPAP: Continuous Positive Airway Pressure. A device to push air into your lungs usually during sleep to treat or give support with different conditions.

https://en.wikipedia.org/wiki/Continuous_positive_airway_pre...