Renal Dialysis: Medicare Does Everything Wrong

From USA Today, here is just one example:

Barry Straube, chief medical officer at the federal Centers for Medicare & Medcaid Services, says 25 million Americans have kidney disease, but Medicare benefits don't kick in until patients are at the most advanced stage. Many patients with earlier-stage kidney disease aren't treated for high blood pressure or diabetes, which cause two-thirds of kidney failures.

Comments (9)

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  1. Devon Herrick says:

    I wonder if the people with early stage kidney disease even know they have it? Public health experts claim that most people with hypertension and diabetes don’t know they have either disease, so it would stand to reason they also don’t know they are at risk for kidney failure.

  2. John R. Graham says:

    The USA Today article states that “when President Nixon signed the 1972 bill establishing the End Stage Renal Disease Program, only 10,000 Americans were on dialysis…..Only the wealthy could afford long-term tratment.” USA Today wants us to believe that the government rescued dialysis patients from some awful fate.

    The truth is different, according to a fascinating chapter by Richard A. Rettig in the book Medical Politics (Institute of Medicine 1991,pp. 176-214, at Dr. Rettig reports that effective dialysis was an emerging technology in the 1960s. The innovators founded the American Society of Nephrology in 1966 (p. 181). “Nephrologists trooped to Seattle in the early 1960s to learn how to perform dialysis, and programs sprang up across the country, each growing over time as means were found to finance treatment….” In the late 1960s, …..”there were fewer than 1,000 patients being dialyzed in the entire country, but that number had been increased to approximately 10,000 by the time the 1972 legislation was adopted.”

    The USA Today article reports that there are 350,000 patients undergoing dialysis today. The overall population has increased by 45% (from 210 million to 305 million), so we can reasonably assert that the eligible population for dialysis in 1972 was about 240,000 patients. At the rate of growth prevalent until 1972, it would have taken 7 more years, until 1979, for the private sector to cover everyone. But it’s reasonable to assert with confidence that the pace would likely have accelerated as the technology was broadly accepted as effective.

    So, things were actually progressing pretty well until the government crowded out private coverage. I suppose dialysis patients were just unlucky, that significant medical breakthroughs were happening just as the government succeeded in its first phase of taking over Americans’ access to medical services.

  3. Ken says:

    Count on government to muck things up.

  4. Devon Herrick says:

    Dialysis is costly and cumbersome primarily because there is no private market for dialysis patients. The only market for dialysis is Medicare, which reimburses through dialysis centers. Dialysis patients have to visit the dialysis center several times a week (three or four hours at a time. A better option for patients is to be hooked up to a portable machine every night while asleep.

  5. Vicki says:

    For USA Today, this was a very good article.

  6. david mccallum says:

    what are some of the diagnosis and associated costs of the complications of ESRD?

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  8. Ezgi says:

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