You were looking at the asking price (I call it the visiting Arab rate) that almost nobody pays, and certainly not Medicare.
Your "cost" was probably not $1M+, but the billed amount was. Read the Medicare and your part C policy carefully and look a the "Paid" amount, not the "billed amount".
For example, a 100 pack of 10cc syringes with needle is about $30 +/-. For 100. Fresenius billed over $50 per needle, just for the supply when itemizing in center treatments. The insurance always listed that an $0 - included in another service, and Medicare never paid it - nor was I on the hook.
There is nursing care with PD. The home care RN at the clinic I used had about a dozen patients. She monitored their labs, coordinate care with them, worked with suppliers and the attending MD. etc. Assume it costs $96K/year for an RN (once you factor in health insurance, employers portion of SS, office space for him/her to work out of, etc.) and that works out to $8K/year for RN support alone.
Private insurance paid for my D at 10%-15% of the asking price, accepted as payment in full. Medicare paid well under 10%, also accepted as payment in full.
Insurance companies and drug manufacturers...ARE THEY OUT OF THEIR EVER-LOVIN' MINDS?? I mean, WTF!
Their mission is to maximize senior executive compensation, not take care of patients. The later is a byproduct. Even business school "theory" of how things should work states the mission is to maximize shareholder value. As an investor, hold on to you wallets when you hear a company you invest in start to talk about "stakeholders".
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