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Thread: D.A.N. America Warning!

  1. #41
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    Re: D.A.N. America Warning!

    Ok, what are the chambers who are in this dispute trying to bill out at then?

    This isn't exactly a secret - once you send someone a bill its not privileged information; indeed, without someone's explicit consent an offered price isn't even if the service hasn't been yet (or never is) performed.....

  2. #42
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    Re: D.A.N. America Warning!

    Not that it helps DAN America guys but DAN Europe got this sorted years ago - See below quote from DAN Europe site:


    "Many of you may have read about a recent series of press releases concerning DAN insurance for recompression services and an ongoing dispute between DAN America and one of the large, international chamber network operators – SubAquatic Safety Services (SSS).

    We want to assure you, that this problem only relates to DAN America.

    DAN Europe insurance is not adversely affected in any way nor is the good relationship we have with this international chamber network operator.

    The same is true for DAN Southern Africa, DAN South East Asia Pacific and DAN Japan.

    As many of us already know from personal experience with medical aids and medical insurance companies, the issue of treatment costs is constantly being debated.

    However, DAN Europe sought to engage this chamber operator in a series of negotiations several years back, and we have a sensible and realistic agreement with them that is respected by both parties.

    Unfortunately DAN America has not achieved this level of agreement and what you have read is the consequence of this problem.

    It is actively being addressed and should be resolved within the next two months.

    Importantly, DAN Europe members can be confident that your insurance is fully accepted by the SSS Network, its affiliates, and in fact all treatment centers we have worked with over the past 10 years of serving our members. It is only DAN America members that have been issued with the cautionary notification.

    Yours Sincerely,

    Alessandro Marroni, MD
    President & CEO - DAN Europe
    President, International DAN"

  3. #43
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    Re: D.A.N. America Warning!

    Quote Originally Posted by leadking
    Just to have everyone know what DAN is paying!

    The cost of a chamber ride is between $500-900 an hour with a USN table VI
    being 5 hours.
    That is a short treatment.

    The cost of someone getting a single treatment for a bend on mix here, is more than the combined cost of a 120m rated 5ft diameter chamber plus big Rix compressor and big gas banks we bought a few years ago, and the chamber operator and diver medical course costs for 3 people.

    And if you try and compete with the guys in Europe with a chamber, you find that these high fees are "jobs for the boys" and you get regulatory hurdles here there and everywhere.

    Cheers
    Alex

  4. #44
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    Re: D.A.N. America Warning!

    Well, whether $500 or $900 is fair or reasonable depends on many things.

    Take the cost of said chamber up front. Now add in whatever regular maintenance it needs to keep it in fully operational condition. Add the cost of the facilities to house it (marginal or full, depending on whether its in a hospital or stand-alone.) Multiply all that by the time value of the money it consumes over its useful service life (whether you borrow the money or spend money you'd otherwise spend on something else, money isn't "free")

    Now divide by the number of years, and you have the annual carrying cost of the chamber.

    Now divide THAT by the number of hours in use per year you anticipate (or know from past experience) the chamber does/will receive. Add to that the per-hour fully-sunk staffing and supply costs (including taxes, health insurance for the employees, sales tax on supplies consumed, etc) and you now have the fully-loaded "cost per hour" of operation.

    To this you must add a profit. Any business which cannot return at least 11% ROE may as well close because you can make THAT simply buying the S&P 500 and sitting on it for 30 years. A reasonable risk premium is anywhere from 1.5 to 2.0x that number - meaning you need to make somehwere between 16-22% to entice someone to risk their capital on this business.

    That's a "reasonable and customary" per-hour charge, computed on sound business principles, not "insurance-speak."

    If DAN will not pay that amount, then the chamber owner may as well sell the chamber, close it down, and put the money in the stock market.

    They would be better off.

    Note that the less a chamber is used, the more on a per-hour basis the fixed expenses cost...... keeping a chamber "available" in places where it is not used "all the time" is going to cost a LOT more than keeping one available where it has daily users (probably much if not mostly for non-diving-related purposes.)

    The range given is nowhere near sufficient to cover a chamber that has infrequent need in a remote area, but when you need it, you REALLY need it - and a chamber in a major city where there are all sorts of non-diving uses for it, along with the diving population that gets bent as well.

    From the range posted I conclude that DAN is trying to apply major metropolitan or major diving resort "cost structures" to chambers that might not see that sort of traffic. Essentially, they're telling these people to operate at a loss.

    They won't guys. Either they'll get what it costs to make a decent ROE or the chamber will close and then there will be NO hyperbaric facility there.
    Last edited by Genesis; 18th January 2006 at 02:25.

  5. #45
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    Re: D.A.N. America Warning!

    Quote Originally Posted by Genesis
    Well, whether $500 or $900 is fair or reasonable depends on many things.

    Take the cost of said chamber up front. Now add in whatever regular maintenance it needs to keep it in fully operational condition. Add the cost of the facilities to house it (marginal or full, depending on whether its in a hospital or stand-alone.) Multiply all that by the time value of the money it consumes over its useful service life (whether you borrow the money or spend money you'd otherwise spend on something else, money isn't "free")

    Now divide by the number of years, and you have the annual carrying cost of the chamber.

    Now divide THAT by the number of hours in use per year you anticipate (or know from past experience) the chamber does/will receive. Add to that the per-hour fully-sunk staffing and supply costs (including taxes, health insurance for the employees, sales tax on supplies consumed, etc) and you now have the fully-loaded "cost per hour" of operation.

    To this you must add a profit. Any business which cannot return at least 11% ROE may as well close because you can make THAT simply buying the S&P 500 and sitting on it for 30 years. A reasonable risk premium is anywhere from 1.5 to 2.0x that number - meaning you need to make somehwere between 16-22% to entice someone to risk their capital on this business.

    That's a "reasonable and customary" per-hour charge, computed on sound business principles, not "insurance-speak."

    If DAN will not pay that amount, then the chamber owner may as well sell the chamber, close it down, and put the money in the stock market.

    They would be better off.

    Note that the less a chamber is used, the more on a per-hour basis the fixed expenses cost...... keeping a chamber "available" in places where it is not used "all the time" is going to cost a LOT more than keeping one available where it has daily users (probably much if not mostly for non-diving-related purposes.)

    The range given is nowhere near sufficient to cover a chamber that has infrequent need in a remote area, but when you need it, you REALLY need it - and a chamber in a major city where there are all sorts of non-diving uses for it, along with the diving population that gets bent as well.

    From the range posted I conclude that DAN is trying to apply major metropolitan or major diving resort "cost structures" to chambers that might not see that sort of traffic. Essentially, they're telling these people to operate at a loss.

    They won't guys. Either they'll get what it costs to make a decent ROE or the chamber will close and then there will be NO hyperbaric facility there.

    Cheers, that is a great, well thought explination of what I had eluded to earlier............Thank you

  6. #46
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    Re: D.A.N. America Warning!

    Mike Bennet and Jorge Gomez-Castillo have recently pubilsed an article in the SPUMS journal (SPUMS J 2005; 35:194-8) about the costs of Hyperbaric Therapy at the Prince of Wales hosital in Sydney.

    They calculated that the cost of a single recompression for diving injuries is AUD$ 720 and the total average cost for a course of treatment is AUD$1440. The incremental cost for an additional treatment of a patient with a diving injury is $415.

    Dunno that this means anything much to the current debate but it provides an interesting perspective.

    Dave T

  7. #47
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    That all makes sense, the part I still don't quite get is why insurance companies in from one geographical area get different prices than insurance companies from another.

    What makes my treatment in Mexico more expensive when I reside in the US and insure through DAN America than when I reside in Germany and insure through DAN Europe?

  8. #48
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    Re: D.A.N. America Warning!

    Quote Originally Posted by caveseeker7
    What makes my treatment in Mexico more expensive when I reside in the US and insure through DAN America than when I reside in Germany and insure through DAN Europe?
    Hint: Four letters, the first one is "R" and the last "E", and you're the one who's having it done to you 'cause you're "A Rich American."

    BTW, what makes your treatment more expensive in a US Hospital if you are paying for it yourself .vs. being on Medicare or some other insurance plan?

    The latter, being entirely in the US, would be illegal if not for the health industry lobbying for, and getting, exemption from anti-trust laws....

  9. #49
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    Thumbs down Re: Charges by geographical area

    Sorry, didn't get your hint. :o
    The only thing with "R" I can think of here is RIP-OFF.

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    Thumbs down Re: D.A.N. America Warning!

    I recently made a claim to DAN that I feel is very relevant to my CCR diving. I have suffered hyperoxia induced myopia from (HIM). DAN has refused to make any compensation saying that my malady is unrelated to diving. They don't know that. You can see some of my other postings on the O2 thread regarding this. I'm very disappointed that DAN refuses to cover an injury that is so relevant to our CCR / constant PPO2 diving.

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