Blog #13 'How to Make a Killing: Blood, Death, and Dollars in American Medicine' by Tom Mueller, book review (advanced galley copy)
- Written by: Super User
New York Times best-selling author Tom Mueller very well could be rocking the foundations of many a corporate boardroom with this book. From two schools of thought on how kidney dialysis should be run back in the '70's, Seattle vs. Boston - a titanic battle, to the present day the author takes us on a journey across the landscape (hellscape?) that is modern kidney dialysis. Add in a history of how modern dialysis came about before the advent of things like for-profit dialysis and we see how a miracle of medicine can be corrupted by greed and smokescreens, blinding us to the fact that kidney dialysis is an area of medicine hampered by a severe lack of choice! (much like utilities in this writer's opinion - can you flip a switch when tired of your old electric company? Nope - much like kidney dialysis patients trying to change clinics)
After an intro, the book starts way back with a story of the primal 'Inner Sea'. It then ends the 2nd chapter with things like quick intros to a couple of leading nephrologists (doctors Leonard Stern and John Agar)- and the mortality rates here (US), and other parts of world (it should get your attention). These nephrologists will appear again and again throughout the book.
From there we are introduced to patients and what must be the worst of patient abuses - terminations. And we also meet somebody else who will be seen throughout the book - former dialysis tech Arlene Mullin. She rose from the ashes to fight patient terminations and many times she was the person who rounded up help to stop patients from certain death! (full disclosure, Arlene is someone this writer has known for over twenty years - honored to know her) We also see staff as victims who are seen falling by the wayside of what has been called 'fast, assembly line medicine'. All to the beat of a showboating CEO who seems to be more interested in cheer leading than actual medicine. As you will see in the book he might not be the worst of lot. (hard to believe)
We become acquainted with people like Dr. Pim Kolff, inventor of one of the first dialysis machines, and Dr. Belding Scribner who invented a patient access that allowed a ramp-up in dialysis for longer term care. Dr. Scribner by the way helped head up the Seattle group that nearly put the kabosh on for-profit dialysis. The people I've mentioned so far are just a few of those who will shock. but maybe inspire you to action!
However the meat of this book for this writer were the horrific patient and staff abuses, and scandals that have been allowed to persist for decades! All for outrageous prices! But this is balanced by rays of hope seen at the end of the book!!
Not sure what we have had, and currently have, is what Nixon (as comedian John Oliver said, "Yes, NIXON!") envisioned when he signed the bill bringing dialysis to anybody who needed it, into law.
Tom Mueller's book out now!
Blog #12: Tell our Federal Reps to ask Warren Buffett and Charlie Munger why the huge dialysis company DaVita shouldn't be BROKEN UP!
- Written by: Super User
The following (below the dashed line) is what has been written to a federal Congressman. There is hope this example inspires others to write their federal reps and senators. (link for federal contact info) It could be as simple as asking those in congress to ask Warren Buffett and Charlie Munger the following (they own 40% of DaVita):
"There are a lot of reasons DaVita (the huge kidney dialysis company) should be broken up (the numbers, scandals), are there any reasons left indicating DaVita SHOULDN'T be broken up into something like small care co-ops?" (text example that can be copied and pasted into a contact webpage)
(above question also in bold and underlined at the bottom of the blog) (this and four other ways to participate)
Rep. (Jason) Crow,
I've been writing you about my thoughts about DaVita (headquartered in Denver) and kidney dialysis. I've spent over twenty years seeing all kinds of reasons why the huge dialysis companies should be busted into little pieces. Lately though before the little scouting mission I did in Omaha on May 6th. I - and I hope others - started writing Warren Buffett, Charlie Munger, Berkshire, and CNBC asking why DaVita shouldn't be busted up! I haven't heard anything back, I'm sure they have just been busy. But I'm sure the "Billionaire Information Packet" I left in front of the administrative offices of the Berkshire Omaha event is being studied as I write! (I crack me up)
However I have to wonder if the above people might be able to find time for somebody with a little more clout than I have - who better than my federal representatives? I'm sure there must be some good explanation as to why the dialysis mortality rate has plateaued at such a high level for so many years - among other questions. (I've got my guesses)
Speaking of other questions, I can point to questions I've been trying to get answered for years from Kent Thiry, former CEO of DaVita. I'm sure he too has just been busy! Who knows? Maybe he could find time for you!
With Tom Mueller's book 'How to Make a Killing: Blood, Death and Dollars in American Medicine' coming out in August, I wouldn't be surprised to find out Congress has even more reasons to do some inquiring! This looks like an issue that could be bipartisan and could bring together fiscal conservative Republicans and Democrats who care about responsible health care. It could be a break from the partisan wars!
But my first question for Berkshire and DaVita would be: "There are a lot of reasons DaVita should be broken up (the numbers, scandals), are there any reasons left indicating DaVita SHOULDN'T be broken up into something like small care co-ops?". It sounds like a question a federal representative could be asking now!
Blog #11: ‘Save the Billionaires (or not)’ Walk May 6th in Omaha Nebraska, Post-Walk update and observations (2023)
- Written by: Super User
A Quick Minute Look
(Why a Walk? Warren Buffett's Berkshire owns 40% of the huge dialysis company DaVita - while less than 1% of the Berkshire portfolio. DaVita has been plagued by scandals and horrifying stats)
The Walk (from Omaha NE's Justice Center to the CHI Health Center during the Warren Buffett event) turned out fine from my point of view! The band was there and three people: me, myself, and I! So not a lot of jostling and elbows. I was a little surprised since the lead article on the DialysisEthics site got well over 2000 hits! But a scouting mission was just fine with me - next year I should have a friend or two along - and a better idea of how it should go. I'll share the peace of mind I felt after the event was over - this after insomnia had been my unwelcome friend. I do hope the Walk helped supercharge the emails sent to CNBC and Warren Buffett - but I may never know.
But New York Times best-selling author Tom Mueller had this to say about the event: "Well done!" "A lone voice shouting in the wilderness is a powerful image. All prophets are that voice." And here I thought I was just Don Quixote out having a good time! Tom's book 'How to Make a Killing: Blood, Death, and Dollars in American Medicine' is out August 1st. That's not a very encouraging title about dialysis is it?
The band was at the starting point and played to a few pedestrians and cars passing by and we had a dancing homeless guy who really enjoyed it! (I think they made his day!) I handed out flyers to the people passing by (so few).
I then did the walk and handed flyers to people as they passed by. I think it is much easier handing out flyers about dialysis than something political - no arguments. The best part was running into quite a few people (more than I expected) who had relatives who did or had done dialysis. We had great conversations!
I got in surprisingly easily. I had my brokerage statements with me (one share of brk.b) I did like the RVs and the cowboy hats. However I was having a hard time giving anybody this 'billionaire information packet' - all refused. But then I walked by the administration offices - doors were locked.
So I shoved the packet into the door handles and left. I'm sure it is sitting on Charlie Munger's or Warren Buffett's desk right now!
Next year's event is a ways off! But here is a suggested reading list if anybody is interested:
- a starting article: Warren Buffett: America's Folksiest Predator by Matt Stoller August 9th, 2020
- 'Goliath' by Matt Stoller (may we raise the spirit of Texas Congressman Wright Patman)
- 'Division of Light and Power' by Dennis Kucinich (his fight as mayor for Muni Light was epic and read like a thriller) (utilities and dialysis clinics both carve out a geographical area)
- 'Monopolized' by David Dayen (started reading it, sounds like dialysis isn't the only area seeing the effects of concentrated corporate power!)
- And a fourth that might be a little bit of a surprise. (or not)
- Written by: Super User
Some of us associated with DialysisEthics were interviewed by author Tom Mueller. There was hope the author would find we were a bunch of misled people. We could just slink off to the shadows with egg on our faces and never be heard from again! Some of us have spent over twenty years staring at some God-Awful stories. Not to mention articles and media we've had to endure and the horrifying numbers we have dug up. Surely someone would come along and convince us kidney dialysis is a land of great medical care - freeing us from a twenty-some year prison we have been in! We were hoping to hear "you people are full of it and currently things are great, and here is why!"
But no! Tom Mueller came out with this book due in August: "How to make a Killing: Blood, Death, and Dollars in American Medicine". That's not what we were hoping for! And it gets worse! The author goes on to say:
"How did a lifesaving medical breakthrough become a for-profit enterprise that threatens the people it’s meant to save?
Six decades ago, researchers achieved the impossible: a treatment that made kidney failure a manageable condition instead of a death sentence. And yet, in the hands of a predatory medical industry, this triumph led to skyrocketing costs and worsening care.
A gripping microcosm of American health care gone wrong, How to Make a Killing recounts how the optimism of the 1950s and 1960s—when transplants and early dialysis machines offered hope—gave way to anguished debates about the ethics of rationing (and profiting from) life-saving care. After Congress made renal disease the only “Medicare for All” condition, Big Dialysis proliferated, and the Hippocratic oath gave way to the profit motive.
A triumph of investigative research, Tom Mueller’s book features an unforgettable cast of characters: CEOs who dress as Musketeers to exhort more aggressive profit-seeking, nephrologist insiders who reveal the substandard care this causes, and heroic patients who risk their lives to reveal the truth."
So I guess it is back to putting the shackles back on and being glad we have three hots and a cot. Maybe the duopoly dialysis companies will convince Mr. Mueller they are made of sunshine and lollipops (like Warren Buffett's castle) - they sure haven't been able to convince us! We were hoping for a savior, but all we got was another instigator and troublemaker! (like we have been labeled) But seriously, welcome to the club Tom! We are glad to have you!
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