*** Making the System Work In Kidney Patients' Favor--13 years later ***

[Zach]

Interesting New York Times article from 1995.
Even back then, there was discussion about EPO being over-prescribed for the profit.



Making the System Work In Kidney Patients' Favor

By KURT EICHENWALD
Each time patients receive kidney dialysis at Kaiser Permanente in Los Angeles, they see something rarely found in most American dialysis clinics: a doctor.

At other clinics, part-time doctors drop by for a few hours a week, leaving treatment largely in the hands of poorly supervised technicians and low-level nurses. But Kaiser's dialysis unit in Los Angeles is staffed full time by at least two of its six kidney specialists, as well as by registered nurses, dietitians and social workers.

And unlike those kidney specialists elsewhere who often have a stake in the profits of dialysis, the Kaiser doctors cannot enrich themselves by cutting back on the amount of money spent on patient care. Instead, most are paid a salary of about $150,000 a year, far less than they might make under the profit-sharing or similar deals struck with the part-time doctors at other clinics.

"Here, you're not driven by how much money you can get from the patient," said Dr. Hock Yeoh, the medical director for the Kaiser unit. "You just do what is best for them."

Kaiser's Los Angeles clinic stands out as but one example of how dialysis could be done better in the United States, a country with an annual mortality rate for dialysis patients that is twice that of Japan and some European nations. With the American annual mortality rate above 23 percent, more than 40,000 of this country's 187,000 dialysis patients will be dead next year.

An investigation by The New York Times of the kidney dialysis business and its leading company, National Medical Care Inc., found an industry that has used equipment and procedures to cut costs and bolster profits often at the expense of patient health. National Medical Care denies that patient care is suffering and says it is committed to quality care.

FOR MORE OF THE ARTICLE, GO TO:

http://query.nytimes.com/gst/fullpage.html?res=9A0DE4D81E39F935A35751C1A963958260&sec=health&spon=&pagewanted=1

[MandaMe1986]

thanks for the article 

[kitkatz]

Spread that around, please Kaiser!