Dialysis and its discontents

For the good of the patient, of course! If you want to understand what ails the US healthcare system, look no farther than the dialysis industry. A recent New York Times article (UnitedHealthcare Sues Dialysis Chain Over Billing) provides a pre-made case study. In brief, a chain of dialysis clinics (American Renal Associates), pushed poor people out of government coverage and into private insurance with UnitedHealthcare so that the clinics could bill $4000 per treatment rather than $200. A patient advocacy group (American Kidney Fund), paid the patients’ insurance premiums using funds donated by American Renal. United is suing American Renal for overbilling. So who are the good guys and who are the bad guys here? From what I can see in the article (and there’s always more to the story) it looks like both American Renal and American Kidney are to blame. But to understand the motivation for their behavior, we have to look at the politics and economics of dialysis. Dialysis is a life-saving treatment for people with impaired kidney function, but it’s expensive. Medicare is mainly a program for the elderly, but it also covers the disabled and people with end stage renal disease (i.e., dialysis patients) regardless of age. That entitlement was added way back in 1972 to make sure patients didn’t drop dead for lack of funds for dialysis. Medicare coverage kicks in over time, so people with commercial insurance use their plans first before shifting over to...
Source: Health Business Blog - Category: Health Management Authors: Tags: Economics Policy and politics american kidney fund american renal associates davita dialysis extortion fresenius Source Type: blogs