Article discussing legislation to limit profits of dialysis clinics

[LoneHighway]

Here is an article discussing proposed legislation restricting profit margins of clinics. There are ballot initiatives in CA and OH.

https://www.huffingtonpost.com/entry/just-how-profitable-should-your-disease-be_us_5b6d8edce4b002bcfeab61cb

[iolaire]

I liked the ProPublica story linked in there:
https://www.propublica.org/article/in-dialysis-life-saving-care-at-great-risk-and-cost

[Charlie B53]

I don't doubt that eventually a measure such as these will pass.  What an allowable profit margin may be is very argueable, from either side.

I often remember the huge changes Lee Iacoca made in Chrysler, cutting out so much well paid 'management' positions that didn't really create either product or profit for the company.  I have no doubt such fat trimming could benefit many many corporations world wide.

Without all the fat, lean companies could easily adjust product prices and become even more competitive in the marketplace than their overburdened competitors, even with a limited profit margin required.

Private insurance companies are very often literally raped by markets knowing the insurance company can be required to pay whatever inflated costs are billed.

I have no love for insurance companies, but some of the inflated costs they are required to pay are outrageous.  Companies that take advantage of insurance payments need to rein in their billing within reason.

Whatever happened to companies being satisfied with a reasonable profit margin?  It seems that corporate greed rules.  Shame.

[cassandra]

Thanx for the link Iolair and LoneHighway

[Simon Dog]

Private insurance companies are very often literally raped by markets knowing the insurance company can be required to pay whatever inflated costs are billed.

When I was on private insurance, both FMC and DaVita raped my carrier when I traveled and used clinics they had not negotiated contracts with.  The actual "paid price" ranged from $3000 to $5050 per treatment.

[iolaire]

So to me I view the proposed laws as similar to the Cost Plus contracts that the defense department uses, I believe they were used heavily in the post 9-11 wars.  i.e. the contractor is paid the cost of providing the service plus a fixed fee for managing the effort.  My concern (I have no direct experience with this.) for that is it basically motivates the contractors to increase spending so their cut (fees) are as high as possible.  I could see that happening immediately, i.e. the machines are now owned by DaVita Leasing so they can charge as much as they want to boost the spending of the clinics so the clinics 15% profit is as high as possible, then the dialysis supplies are sold by DaVita Medical Supplies so more profit is made.
The ballot initiative, which was spearheaded by the Service Employees International and the United Healthcare Workers Unions, would require dialysis clinics to issue refunds to patients or insurance companies if they have revenue above 115 percent of the costs of “direct patient care,” which includes wages and benefits of staff who administer treatment to patients, as well as drugs and supplies.

[iolaire]

Also this article today The Large Hidden Costs of Medicare’s Prescription Drug Program made me think of the story in this thread.  The point of the drug article includes that if a patient on Medicare Part D has over $5k in drug costs the expenses are primarily paid by the federal government so of course insurers want the patients to hit that $5k level so they don't have to pay as much.  The moral there is corporations will game the system to maximize profits.

[Rerun]

They are STILL trying to figure out how to pay the bill.  When the "bill" is a lie.  Truth in billing has to be addressed.  My monthly EOB for dialysis is 90K most months.  What if Medicare didn't intervene and say no no no.... you get 3K and only 80% of that and her private insurance can pay the other 20%..  So 90K down to 3K and they function fine with a profit!

It is greed.  If truth be told.... how much does it take to make a 12% profit at a dialysis center?  No one knows because they don't tell us that.  We are getting the profit margin of WHAT they TELL us it costs them. 

If milk cost $25 a gallon and Dairy Farmers told us it cost them $22 to produce a gallon of milk ...  how would we know? 

In 1961 a dialysis patient had to come up with $10,000 and that covered 2 years.  I read that somewhere.  Look it up! 

The poor technician who has our lives in their hands get paid the least.  That would not change but they should get paid enough to "want" to stay.  Right now they go hire the drug addicts under the Freeway because they know how to stick needles.

We need to figure out what their REAL profit is before we start screwing with it.  I agree they will just start a new game plan....
 

[Rerun]

Another thought....   What if the workers went on strike.  Most of us would have about a week to live.  This industry isn't like Boeing.  I remember when the dialysis industry was non-profit.  We got warm blankets, lunch, doctor went by everyday....  When it went to for profit I was for it because I thought it would create "competition" and strides would be made to make things better.  And it did.... we got better machines, EPO, and better transplant drugs.  But, no more warm blankets, no more lunch and a doctor once a month.  And the price sky-rocked......

I don't know what the answer is.  If they decide dialysis is just too expensive and you only get it if you want it for a bridge to a transplant so you can be a productive citizen again.... then I would be gone.  That might be okay as I just continue to hang on, and hang on, every other day.... just hanging on.  What A Life........

[Michael Murphy]

The bottom line is Medicare figures in costs and a reasonable profit,  compare those rates to what is medically billed and you see the problem.   Every one says they Medicare rates are a looser to those who accept them.  My question is then why do they advertise for patients if the rates are money looser, almost every medical advert claims they take Medicare.  The only Medicare rate that is absurd is any pharmaceutical when the republican congress during bush jr.  passed part d they required Medicare to pay full list price for ant part d drug.  That is why the big push to have drugs included in the bundle, since there cost is not covered under part d Medicare pays substantially less for them.  While I don’t support Bernie  the tremdous cost of medication and medical services could be better served by allowing everyone to pay 160 a month and go on Medicare.  And get a Medicare advantage to get the coverage they want. Currently I pay the SSA around 160 a month and Aetna 370 a month for no deductible coverage.  My choice I could get a less pricey advantage program but I like the fixed cost billing.