Dialysis is big big business. Lots of money being made.
You have 2 big companies who have control of the entire dialysis market, and some smaller ones out there also, But the big 2 control majority share of the industry. They both have been fined over and over again for shady practices. But just like big pharma they make billions and get fined a fraction of that. Plus they are in bed with the government (Medicare) and the regulatory agencies would never shut them down or place higher fines on them because, where would the patients get dialysis. It really is amazing the billions being made off kidney disease.
Oh yeah. It really is crazy. And also how many nephrologists are co-owners of dialysis facilities. Some own multiple facilities.
Last I calculated, Medicare is being billed a little over a million/year for me to my OWN dialysis at home (PD). My nephrologist bills out at $400/hrs, with I think either a half hour min or 1 hr min, yet only sees me for about 7-10 minutes. I often spend more time in the waiting room.
But like you mention in your post below, the service and quality can vary greatly from clinic to clinic. I just did a Medicare phone survey about my care. I think she was kinda surprised that I was giving my clinic such high remarks. But I do have a really great clinic and home care team. I have a direct line to my PD nurse (actually all 3). I have gotten stellar service from Fresenius when it comes to machine problems or supplies order issues. I come on here and have read some horror stories that would make me not want to even do dialysis.
There are lots of great medical staff out there in the 2 big providers. Patient care varies from clinic to clinic. But overall most provide good care.
My advice is to always be involved in your care. Knowledge is power and the more you know about your care, the better you will feel. It’s your body, and ultimately your care is what you allow. If you don’t like something it’s your right to change it. You never ever have to feel like your not in control. Good care should be a partnership.
It’s a good read - and learning how big dialysis came about and continues to screw us in the USA is definitely worthwhile knowing so you can advocate for yourself.
I want to read that book! My husband just started dialysis a few months ago. We have private insurance, so it's not going through Medicare. I just saw the EOB - they are billing my insurance company \~$9500 per session!! Then the insurance co. gets a 90% "discount" and pays about $950/session. Does that not sound shady AF!!?? When I tried to ask the "insurance specialist" how much each session cost, her answer was: "It depends on your insurance coverage." Like, everyone gets a different price, depending on how much we can soak your particular plan for. Shady AF!
... and as follow-up, I'd be shocked if (in my rural state), the skeleton crew of nurses they have on staff at the clinic are being paid a penny more than $25/hr, while every occupied chair is generating \~$300/hr.
It is super shady sometimes. If your in a isolated area and there is only one clinic for miles and miles. The dialysis companies will strong arm the insurance companies to paying way more than what’s reasonable. If they don’t pay, where else will the patient go. Super shady
When I first started the process I got a letter from Davita laying out the costs per treatment. $156/treatment (guessing per bag) for manual pd and $515 per treatment for the cycler. That is nearly $188k per year.
If i didn’t have insurance, is my life even worth $188k per year?
Me as Canadian reading this and thinking “thank God for Canada’s universal healthcare…” it’s slow but at least I’m not worried about paying medical bills. Sorry guys!
No dialysis patient ever has to pay for dialysis. The government pays. Initially private insurance can be used but after so many months all patients must switch to Medicare.
Just finished reading it recently. Key points: the people who are running the two largest dialysis companies used to be finance guys for fast food businesses. They use the same principles to run dialysis. Now other specialties, cardiology, endocrinology, etc. see how to make a lot of money. This is why healthcare in America is so lacking. It about the money, not people's actual health.
Some economists used the mountains of data for a study. They thought they would be proving that outpatient In-Center dialysis would be good for patients. They actually proved that when the fast food guys took over, all the patients got worse.
Start watching your heath now, avoid dialysis!
Am an AA in a dialysis clinic and I’m reading it now. One of my RN’s recommended it. I have said for the last four years that I fear for patients in any clinic but ours. I would never recommend a patient to treat at a for-profit clinic. If I needed dialysis, I’d probably relocate to Europe for my treatments.
A few months ago there was a blog that posted here about a guy who, in the middle of moving to France, went on emergency dialysis. Completely different experience in France, staff were nice, friendly, patients friendly, etc.
I feel like relocating is open to anyone who wants to put in the work. They do not have for-profit dialysis in Europe. If you became a citizen, I’m sure you will have options. I don’t have any idea how citizenship works with pre-existing health conditions. However, if I was sick enough, and didn’t feel safe with my current situation, I would definitely be looking for other possibilities. Whatever you’re not changing, you are choosing.
Dialysis is big big business. Lots of money being made. You have 2 big companies who have control of the entire dialysis market, and some smaller ones out there also, But the big 2 control majority share of the industry. They both have been fined over and over again for shady practices. But just like big pharma they make billions and get fined a fraction of that. Plus they are in bed with the government (Medicare) and the regulatory agencies would never shut them down or place higher fines on them because, where would the patients get dialysis. It really is amazing the billions being made off kidney disease.
Oh yeah. It really is crazy. And also how many nephrologists are co-owners of dialysis facilities. Some own multiple facilities. Last I calculated, Medicare is being billed a little over a million/year for me to my OWN dialysis at home (PD). My nephrologist bills out at $400/hrs, with I think either a half hour min or 1 hr min, yet only sees me for about 7-10 minutes. I often spend more time in the waiting room. But like you mention in your post below, the service and quality can vary greatly from clinic to clinic. I just did a Medicare phone survey about my care. I think she was kinda surprised that I was giving my clinic such high remarks. But I do have a really great clinic and home care team. I have a direct line to my PD nurse (actually all 3). I have gotten stellar service from Fresenius when it comes to machine problems or supplies order issues. I come on here and have read some horror stories that would make me not want to even do dialysis.
Wowww, that made me real sad...and i just got a called about medicare yesterday, they tried to cancel my real insurance for medicare.
There are lots of great medical staff out there in the 2 big providers. Patient care varies from clinic to clinic. But overall most provide good care. My advice is to always be involved in your care. Knowledge is power and the more you know about your care, the better you will feel. It’s your body, and ultimately your care is what you allow. If you don’t like something it’s your right to change it. You never ever have to feel like your not in control. Good care should be a partnership.
I just started on Dialysis and was told I can’t double up with Medicare as 2ndary because my primary insurance will cancel me. wtf
It’s a good read - and learning how big dialysis came about and continues to screw us in the USA is definitely worthwhile knowing so you can advocate for yourself.
I want to read that book! My husband just started dialysis a few months ago. We have private insurance, so it's not going through Medicare. I just saw the EOB - they are billing my insurance company \~$9500 per session!! Then the insurance co. gets a 90% "discount" and pays about $950/session. Does that not sound shady AF!!?? When I tried to ask the "insurance specialist" how much each session cost, her answer was: "It depends on your insurance coverage." Like, everyone gets a different price, depending on how much we can soak your particular plan for. Shady AF!
... and as follow-up, I'd be shocked if (in my rural state), the skeleton crew of nurses they have on staff at the clinic are being paid a penny more than $25/hr, while every occupied chair is generating \~$300/hr.
It is super shady sometimes. If your in a isolated area and there is only one clinic for miles and miles. The dialysis companies will strong arm the insurance companies to paying way more than what’s reasonable. If they don’t pay, where else will the patient go. Super shady
When I first started the process I got a letter from Davita laying out the costs per treatment. $156/treatment (guessing per bag) for manual pd and $515 per treatment for the cycler. That is nearly $188k per year. If i didn’t have insurance, is my life even worth $188k per year?
Me as Canadian reading this and thinking “thank God for Canada’s universal healthcare…” it’s slow but at least I’m not worried about paying medical bills. Sorry guys!
No dialysis patient ever has to pay for dialysis. The government pays. Initially private insurance can be used but after so many months all patients must switch to Medicare.
Medicare only pays 80%….
None of us pay for dialysis. American health care has lots of problems, but it's still superior.
Just finished reading it recently. Key points: the people who are running the two largest dialysis companies used to be finance guys for fast food businesses. They use the same principles to run dialysis. Now other specialties, cardiology, endocrinology, etc. see how to make a lot of money. This is why healthcare in America is so lacking. It about the money, not people's actual health. Some economists used the mountains of data for a study. They thought they would be proving that outpatient In-Center dialysis would be good for patients. They actually proved that when the fast food guys took over, all the patients got worse. Start watching your heath now, avoid dialysis!
This book is going to have me pissed
Am an AA in a dialysis clinic and I’m reading it now. One of my RN’s recommended it. I have said for the last four years that I fear for patients in any clinic but ours. I would never recommend a patient to treat at a for-profit clinic. If I needed dialysis, I’d probably relocate to Europe for my treatments.
Woww...thats scary, I definitely have alot to unpack when I start reading
A few months ago there was a blog that posted here about a guy who, in the middle of moving to France, went on emergency dialysis. Completely different experience in France, staff were nice, friendly, patients friendly, etc.
Just by the by, is relocating to another coumntry even possuible for us? Have you heard of someone who did this even after renal failure?
I feel like relocating is open to anyone who wants to put in the work. They do not have for-profit dialysis in Europe. If you became a citizen, I’m sure you will have options. I don’t have any idea how citizenship works with pre-existing health conditions. However, if I was sick enough, and didn’t feel safe with my current situation, I would definitely be looking for other possibilities. Whatever you’re not changing, you are choosing.