http://www.nytimes.com/2007/09/16/business/16dial.html?ex=1190606400&en=635385abacef579c&ei=5070&emc=eta1
The Dialysis Business: Fair Treatment?
By ANDREW POLLACK
Published: September 16, 2007
It's posted here too: http://ihatedialysis.com/forum/index.php?topic=5013.0
Thanks for posting the whole article. I didn't think the article was very revealing.
"Medicare and Congress are moving to stop separate Medicare reimbursement for Epogen to end the incentives to overuse the drug. Law enforcement authorities, including those at the Justice Department and at the Health and Human Services Office of Inspector General, are conducting criminal and civil investigations into how DaVita and some other dialysis providers bill for Epogen.
All of this casts an unfavorable spotlight on the dialysis business, which might be the closest thing the United States has to nationalized health care. Medicare pays for almost all dialysis, even for patients younger than 65."
So the possibility that the federal government reimburses for some amount of medication above what a conservative dosing scheme would utilize is what "casts an unfavorable spotlight on the dialysis business"? WTF
Isn't the mortality rate a bigger problem then the feds maybe spending too many shekels on Epo?: "Dialysis is a dreary experience, one in which people with failed kidneys sit for hours hooked to machines that cleanse their blood, assisted by technicians who often have to work a second job to make ends meet. More than one in five of the nation’s dialysis patients die each year — a rate as much as double that in Europe and Japan — for reasons that aren’t clear." That sounds like a bigger problem then when exactly to tapper epo dosing.
And doesn't the DOPPS results show that mortality is tied to dose of dialysis? That American dialyzors get less dialysis per kilogram of body weight. "For reasons that aren't clear"? Sounds to me like the reporter was tired of reading about dialysis reimbursement. The statement that "Medicare pays for almost all dialysis, even for patients younger than 65." tells me that the reporter was only interested in epo reimbursement not industry profits - he ignored the 10-15% of dialyzors that are private pay who dirve industry profits. Pollack writes that "Epogen accounts for 25 percent of DaVita’s revenue and up to 40 percent of its earnings" must mean that he is including private pay revenue in his figures but he never mentions the private pay issue. I think the usurious rates charged private payors is the cancer that will destroy the provision of dialysis in this country.
Frustrating.
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