It should be recognized that the advent of LTOT created a new health care system that is based on powerful scientific data. Oxygen therapy studies such as those by the Nocturnal Oxygen Therapy Trial Group and the British Medical Research Council study clearly demonstrated that LTOT improves both the length and quality of life of hypoxemic COPD patients. Keeping patients at home and out of the hospital or nursing home has both psychosocial and economic benefits. Efforts should be towards enhancing, not limiting., the availability of LTOT.