Dialysis is the only program under Medicare to be covered regardless of the patient’s age. Because someone with kidney failure cannot survive without either a kidney transplant or dialysis (in-center hemodialysis or a home therapy), in 1972 Congress made sure that almost all Americans who require this therapy are able to receive it.
As a dialysis provider, we care for our patients like they are family. We are concerned for their well-being and they are concerned for ours. Already, we receive a remarkably small “bundled” payment for all of the care we provide. If Medicare cuts to dialysis happen, continuing our good work might be impossible.
Everyone will suffer if these cuts occur. Dialysis centers — which are important businesses in the local community — will close. Patients could be forced to travel long distances for care and will be forced to make difficult decisions about what to do.
I hope our elected officials take this issue seriously and safeguard dialysis care from cuts.
The steep rise in the government's cost for Medicare is based on the prices charged by private, for-profit medical providers.
Prices for medical care in the US are double those in the other modern industrialized nations; unfortunately, life expectancy, infant mortality, and other health indicators are poor in comparison.
We spend twice as much and get much worse results - something is amiss. And as Ms. McGee points out, in medicine the concern should be the patient.
Unfortunately, the current system of incentives in medical payment generates over-treatment and preventable medical errors. It invites and enables corruption. Those things hurt our society, economy, families, and the sick.
This has been true of renal dialysis. Recently, an Atlanta physician and nurse came forward to expose corruption at DaVita, a company providing 1/3 of the nation's dialysis. Through deliberate waste, manipulation of regulations, and overcharging, DaVita fleeced taxpayers, under the guise of doing good, to serve private interests.
Ms McGee complains that the shift to 'bundled payments', which is a core part of the cost reduction strategy of Obamacare, is a threat to Medicare dialysis patients. No, it is only a threat to overcharging, malicious waste, and bad medicine.
Bundled payments are 'skin in the game' for medical providers. The sharing of payment means accountability to medical standards of effective treatment and more communication about treatment of a patient among providers.
Ms McGee says that Medicare cuts are on the table in the current budget negotiations; she believes those cuts will hurt her patients. She does not have the facts.
The savings in Medicare, proposed by the president, will come from eliminating the rigged market in which Medicare must pay the prices demanded by the drug companies. A competitive market such as the VA and Medicaid operate in will save us over $200 million.
So, Atlanta nephrologist, Dr. Alan Vainer, and Nurse Daniel Barbir, who have revealed fraud ($800 million worth!)at DaVita, are doing a service to patients, Medicare, and our society. They are assuring Medicare will be there for you and your children.
If you are interested in knowing more about what drives prices in medical delivery, Google Dr. Atul Gawande's article, "The Cost Conundrum." Dr Gawande, a surgeon, writes an interesting and human story about the country's most expensive healthcare market in the country's poorest county.
Michael L. Reynolds
Rome, Ga