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Author Topic: Good News?  (Read 1674 times)
plugger
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« on: July 10, 2019, 08:47:02 AM »

This looks like good news?

"President Trump is set to sign an executive order later Wednesday morning that is also designed to move many of the more than 500,000 people receiving kidney dialysis away from commercial centers to less expensive in-home care."

https://www.washingtonpost.com/health/trump-to-order-overhaul-of-organ-transplant-and-kidney-dialysis-systems/2019/07/09/6fa803d0-a1c8-11e9-bd56-eac6bb02d01d_story.html?utm_term=.e3a72443b9a0
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Rerun
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« Reply #1 on: July 10, 2019, 10:09:33 AM »

Awesome! 

   :waving;     :yahoo; 
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Charlie B53
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« Reply #2 on: July 10, 2019, 04:37:34 PM »


While the intentions are good I have to remember how badly the Government screwed up what used to be a very simple gas can.
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iolaire
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« Reply #3 on: July 10, 2019, 05:01:10 PM »

Someone quoted in the story said their family was not offered home treatments. As far as I know itís now mandated by Medicare.
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Transplant July 2017 from out of state deceased donor, waited three weeks the creatine to fall into expected range, dialysis December 2013 - July 2017.

Well on dialysis I traveled a lot and posted about international trips in the Dialysis: Traveling Tips and Stories section.
Simon Dog
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« Reply #4 on: July 10, 2019, 05:20:32 PM »

less expensive in-home care.
Key is "less expensive" - though it is billed to the patient or patient's insurance at the same rate.

Funny the order didn't get into "imminent death" donation.

Quote
Someone quoted in the story said their family was not offered home treatments. As far as I know itís now mandated by Medicare.
It could have been ignorance on the part of the MD or a well-reasoned judgment that the patient was not a suitable candidate for home treatment.

From what I have seen of in-clinic patients, it's going to be hard to get the transplant or home treatment ratio up to 80%.  One RN at the clinic told me "look around, there aren't too many of you people who can take care of themselves here" ... and he was referring to general self care, not running a dialysis machine.
« Last Edit: July 10, 2019, 05:23:07 PM by Simon Dog » Logged
iolaire
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« Reply #5 on: July 10, 2019, 05:46:35 PM »

Yes Simon Dog. I know other countries have much higher home treatments I wonder how they manage that for people who have challenges or people without help.

My worry is this could be the start of the end for Medicare for All dialysis patients
« Last Edit: July 10, 2019, 05:48:05 PM by iolaire » Logged

Transplant July 2017 from out of state deceased donor, waited three weeks the creatine to fall into expected range, dialysis December 2013 - July 2017.

Well on dialysis I traveled a lot and posted about international trips in the Dialysis: Traveling Tips and Stories section.
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« Reply #6 on: July 10, 2019, 06:27:55 PM »

It was encouraging to see the HHS Secretary Alex Azar has up close and personal experience with his father being on dialysis.  And from his wiki page I see he was confirmed twice by the Senate unanimously for the Deputy Secretary of Health and Human Services (at least both sides liked him then).  I would guess he was the one who really pushed Trump to do this and maybe Trump has pulled a Nixon on us, when Nixon did the right thing and signed the bill to start the ESRD program in '73.

But I did see a red flag with how they are pushing peritoneal dialysis, recall that can have a problem with infections. Is the technology better now? Is my memory exaggerating the problem with peritoneal?
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Rerun
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« Reply #7 on: July 10, 2019, 09:30:23 PM »

Just remember to use a clean towel every time you shower.  No hanging it up for the next time.  Also put some white vinegar in you wash to disinfect the towels.  If you have white towels use a little bleach.  Just a couple of tips.

We'll see.  It is just nice to be on President Trump's radar.  He is doing more than he promised.

 :thumbup;
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Simon Dog
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« Reply #8 on: July 10, 2019, 10:22:45 PM »

I suspect a big part of the push for PD is that it can be easier to train a patient to do the hookup than it is to teach someone how to start their own IVs and monitor all aspects of a hemo treatment.   
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Rerun
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« Reply #9 on: July 11, 2019, 06:03:20 AM »

President Trump is also pushing for an Artificial Kidney.   BOOM Done!   Finally! 

   :bow;   :waving; 
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Alexysis
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« Reply #10 on: July 11, 2019, 11:19:30 AM »

I certainly hope it isn't going to be a policy where people all have to go on PD first. I have polycystic kidneys, and I am a very poor candidate for PD. I would need to do overnight as well as 2 or 3 changes a day! How do you manage that AND hold a job? Also, I'm really not able to self-cannulate, nor is anybody else at home. I really don't see how home-based dialysis is an option for me unless they send a nurse to my home 3x a week to put the needles in.
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lulu836
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« Reply #11 on: July 11, 2019, 01:04:01 PM »

I feel the same.  :thumbdown;  I seriously doubt I will live until 2030 and I'm not convinced any of them have thought this  out
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« Reply #12 on: July 11, 2019, 02:11:50 PM »

This won't help me either.  But after 33 years I'm thrilled that maybe my great nieces and nephews, cousins or anyone else related or non-related has to go through what I've had to endure.  An artificial kidney would be great.  I hope? 

At least we are being noticed as an area that is stagnant and needs a kick in the pants to get moving on Something! 

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rcjordan
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« Reply #13 on: July 12, 2019, 07:54:59 AM »

>"look around, there aren't too many of you people who can take care of themselves here"

I'd be shocked if the program adds a significant number of patients to the HHD rosters.  The combined requirements for technical capabilities, a dedicated caregiver/cannulation, supplies storage, and trash disposal really add up to be a formidable barrier.
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« Reply #14 on: July 12, 2019, 01:14:17 PM »

Honestly, if this helps anyone to any degree then despite what I think of him otherwise, I will applaud his efforts here.
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Alexysis
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« Reply #15 on: July 12, 2019, 02:11:44 PM »

President Trump is also pushing for an Artificial Kidney.   BOOM Done!   Finally! 

   :bow;   :waving;

Well, his artificial hair seems to be working for him. He's probably waiting for somebody to come out with an artificial wife as well.......

BTW, I'm assuming this is partly due to detract attention from Melania's month-long absence for a "kidney procedure". I mean, we all suspect it was really for plastic surgery........
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Alexysis
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« Reply #16 on: July 12, 2019, 02:13:37 PM »

I feel the same.  :thumbdown;  I seriously doubt I will live until 2030 and I'm not convinced any of them have thought this  out

Considering the source, you KNOW they haven't thought this through!
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Michael Murphy
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« Reply #17 on: July 13, 2019, 05:21:24 AM »

Just remember trumps record on medical issues, he boasted his aca replacement would be the best insurance ever, it would have raised my total insurance cost from 370 dollars a month to 1850 a month (it would have allowed insurance companies to raise rates 5 times current charges for anyone over 65) . Then it would have reinstated the preexisting condition ban.  Both would be a death sentence for me canít afford it canít change companies.  Thank God McCain voted it down.  Recent stories have trump of trying to impose a life time cap on benefits.  Young on dialysis run out of benefits tough luck.  Diabetic your insulin prices are going through the roof despite White House promises has any thing been done nope.
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rcjordan
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« Reply #18 on: July 13, 2019, 06:03:15 AM »

After reading a few articles, the emphasis regarding home treatment seems to be on PD.
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Coastal US, NE North Carolina
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plugger
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« Reply #19 on: July 13, 2019, 06:39:43 AM »

Just remember trumps record on medical issues

As I told a couple of skeptical friends, I'm hopeful but wouldn't be surprised if it all goes south.  Right now to keep my spirits up I'm trying the mantra: "But Nixon started this thing", "But Nixon started this thing"...
« Last Edit: July 13, 2019, 06:41:30 AM by plugger » Logged

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*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years

On my tombstone: He was a good kind of crazy

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GA_DAWG
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« Reply #20 on: July 13, 2019, 07:57:24 AM »

I would certainly hope anything would promote the development of an artificial kidney, though I also know how long that has been sought with an artificial heart. Aside from that, anyone who thinks this White Houe is in anyway concerned with helping anyone other than themselves is deluded. One need only look at their replacement plan for the ACA that would have kicked 20 million people out of healthcare in one fell swoop to understand that. I also do not support the Medicare for all proposals, but think a public option into which people would pay their premiums, for those who can, should be implemented. The fact that Medicare and Medicaid can operate on 3% overhead while private insurance claims to need 35% tells all that is needed.  There are far too many who are not considered candidates for transplant or PD. There is no mention of what they are supposed to do.
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Alexysis
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« Reply #21 on: July 13, 2019, 09:39:11 AM »

Just remember trumps record on medical issues,......

Yeah, like that he weighs 239 lbs?
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plugger
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« Reply #22 on: July 13, 2019, 09:56:32 AM »

After reading a few articles, the emphasis regarding home treatment seems to be on PD.

I can only hope our friends at Home Dialysis Central are involved in this!  Over the years this is the place I would go when I had technical questions about dialysis - not just home dialysis.
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Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years

On my tombstone: He was a good kind of crazy

www.dialysisethics2.org
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« Reply #23 on: July 14, 2019, 07:51:15 AM »

Well, with all the negative thoughts here.....  It probably won't happen.   Thanks.  I hope you all have a better day.
« Last Edit: July 14, 2019, 09:09:34 AM by Rerun » Logged

lulu836
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« Reply #24 on: July 14, 2019, 08:21:23 AM »

Well, with all the negative thoughts here.....  It probably won't happen.   Thanks.  I hope you all have a better day.

Rerun.......I don't mean to be negative but as you well know everybody has their own "stuff" to watch out for.  In the sunset stage of my life  I have been declared a "brittle" patient and am disallowed from any more surgery of any kind.  So, I have to stay with the catheter (which everyone who doesn't have one despises).  If an improvement comes along in any dialysis or kidney disease procedures, I am all for it......just not for me.  As I've said before, dialysis grabbed me really, really late in life and before that happened I was extremely active and loved every minute of it.  I'm I'm still enthused about Life but just a little bit quieter about it.
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Of all the things I've lost, I miss my kidneys the most.
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