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Main Forum / UNOS execs overpaid for kidney shortage, etc...
« Last post by cschwab on October 13, 2012, 10:13:54 AM »
October 12, 2012
It happened again! I got distracted by what's going on in the transplant industry in the U.S. The industry executives and managers have been very successful in casting the Organ Procurement Organizations as being beneficent life savers. The truth is most of these so-called non-profits are anything but altruistic or beneficent. The most egregious practice they engage in is to keep the cadaver organ market short of numbers. This ensures, through the law of supply and demand, that the ORGAN PROCUREMENT FEES levied for organs will always be high.
 
Why are executives and managers of these OPO being paid such outrageous salaries? $800,000.00 per year for a relatively small non-profit? We are not talking about the American Red Cross or a worldwide UN health agency. We are talking about 58 regional Organ Procurement Organizations covering a few counties in the geographic area. Why are these executives and managers able to through lavish parties for themselves and there friends under the guise of promoting organ donation as 2 agencies in California did recently. One for Rose Bowl Week parties and the other spending over $80,000.00 on a retirement party for a former CEO?
 
Now the big daddy of scamming the system, the private government contractor holding the government contract to control organ procurement and allocation, United Network for Organ Sharing (UNOS), announces a NEW allocation protocol for kidneys. IT'S NOT NEW! It has been in practice since at least 2004. It was formally announced at an UNOS meeting, which I attended, in Dallas on February 7, 2007. The thrust of the protocol is to make organs available based on age. Talk about death panels! Anyone 50 years of age or older will be at a disadvantage. This policy is built on a platform of blatant discrimination!
 
Next installment I will describe what Life Years From Transplant (LYFT) is all about as well as the ECD organ scam for older patients!

Robert Hickey blog
http://www.innovativestrategies.us/
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Main Forum / Re: FRKPA meeting Sept. 30th
« Last post by cschwab on October 02, 2012, 09:06:17 AM »
It was a great meeting and we had a good turnout!  The Fresenius dietician gave an excellent talk on the benefits of plant protein.  It was  big change from what I remember of my daughter's experience back in 2000; I remember her being told to eat meat, meat, and more meat!

I knew enough to be dangerous going into the meeting, but one of the big things I learned was about phytates.  I recall her saying they have the advantage of binding with phosphorus in plant protein and making the phosphorus unusable - a big plus for those on dialysis!  I asked about the lack of B vitamins in plant protein and she confirmed this could be taken care of with a renal vitamin - believe the same goes for iron?  Someone asked about the problem with beans containing potassium.  She answered that the amount of potassium varies by the type of bean, but if you wind up eating beans with high potassium just have them in moderation.  She also stated to look for plant protein with a high ratio of protein to potassium.  Also I recall from back when combining different plant proteins makes a whole protein.

She also recommended this book:  The Vegetarian Diet for Kidney Disease: Preserving Kidney Function With Plant-based Eating [Paperback]
Joan Brookhyser Hogan (Author)
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Main Forum / Re: Need Help? Call Dialysis Advocates' 800 number
« Last post by cschwab on October 01, 2012, 05:58:08 PM »
I'm not sure yet what the future holds yet.  I might leave this site up but close registration - we will see.
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Main Forum / Re: Need Help? Call Dialysis Advocates' 800 number
« Last post by angieskidney on September 28, 2012, 06:01:21 PM »
Quote from: cschwab on September 24, 2012, 07:26:13 AM
Dialysis Advocates has just updated it's website with a lot more info: http://dialysisadvocates.com/
I love that site name! It is perfect! What does this mean for the future of Dialysis Ethics 2? Are you eventually going to move everything over there so the spammers stop targetting your site (I think it is the name they are targetting really because they know the old site was spammable).
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Main Forum / Re: Need Help? Call Dialysis Advocates' 800 number
« Last post by cschwab on September 28, 2012, 02:06:02 PM »
Also some of the lawyers connected with Dialysis Advocates are involved with the Granuflo class-action lawsuit.  They would like to hear from people who may have had problems with Granuflo.
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Main Forum / The DaVita Difference: The Transfusion King
« Last post by cschwab on September 28, 2012, 12:34:15 PM »
By Peter Laird, MD

The major concern voiced about the renal bundle prior to implementation was withholding needed medications to maintain basic vital processes. The renal bundle is largely due to the abuse of EPO for the maintenance of hemoglobin levels in dialysis patients. Erythropoietin comes from health renal tissues that are absent in the majority of patients on hemodialysis with the exception of many with polycystic kidney disease. Under the renal bundle, EPO went from a separately billable income generator to a cost center for dialysis centers.

In the latest USRDS report noted by Gary Peterson on RenalWeb, blood transfusions increased throughout the industry, but the greatest increase is among patients at DaVita, a for-profit dialysis company.

"Since adoption of the bundled payment system, the number of transfusion events has increased, reaching 24 percent by September, 2011. Some providers are associated with a significant increase in transfusion rates over the one-year time period (the rate increased 46 percent in DaVita units), while others show minimal changes (4 and 7 percent in Fresenius and hospital-based units, respectively)."

Looking at further indicators of why DaVita has such an outrageous transfusion rate, one of the answers to that issue is not only in the 37% reduction of EPO use, but much more in their concomitant severe reduction of IV iron products by a factor of 42%.



Tracing the history of EPO abuse at DaVita leading to the moniker, the King of EPO, their gratuitous allegiance to profiteering, now evidenced by the 46% increased transfusion rate is nothing short of a shocking indictment of this company and their business plan. We all understood that the renal bundle would dramatically lower the usage of EPO, but the majority of practitioners expected an increased usage of IV iron products to maintain quality of life in dialysis patients.

Scott Rasgon at Kaiser Sunset maintained stable Hb levels with simple over the counter Vitamin D-3 supplementation while greatly reducing EPO usage. I have been fortunate to maintain my Hb levels with IV iron supplementation for nearly six years of dialysis to date. Patients understand well the quality of life issues associated with higher Hb levels. Sadly, there are absolutely no studies comparing the risk and benefits of EPO to the risk and benefits of transfusions.

Since transfusions are no longer allowed in many free standing dialysis units, hospitals and third party insurance companies pick up the tab on most of the transfusions that DaVita generated since implementing the bundle. This may make great business sense for DaVita generating further profits for their investors, but it makes no sense at all for the dialysis patients suffering with such severe anemia that they need such a large number of transfusions. As a practicing physician, I readily understood the risks of blood transfusions not the least of which is the risk of transmissible agents such as hepatitis and HIV. It was my goal to minimize the need for transfusions whenever possible.

Alan Nissenson has promoted the benefits of the DaVita model securing high quality of care as their model. In this instance, I must challenge their allegations of high quality care when they not only severely reduced EPO usage, but also withheld IV iron which is an effective and safe alternative and adjunctive therapy for renal associated anemia. I am sure that this has greatly increased DaVita profits, but at what expense to their patients.


http://www.hemodoc.com/2012/09/the-davita-difference-the-transfusion-king.html
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Main Forum / The DaVita Difference: The Billing King
« Last post by cschwab on September 28, 2012, 12:26:51 PM »

By Peter Laird, MD

Each month, Kaiser sends an explanation of benefits for my dialysis services. I see my dialysis team once a month, I do all of my inventory ordering, I perform all of my own medical treatments and I draw my own labs. My wife often wonders why she doesn't get paid to be my assistant since "we do all of the work." Her question is even more pointed when we saw the bill to Kaiser for August 2012 in the amount of $72,490.40.  (this is ONE MONTH'S bill, see annual costs: http://dialysisethics2.org/open_images/Costs%20and%20deaths.jpg


In Australia and other nations, patients are given financial incentives to perform dialysis at home since it saves the health system tens of thousands of dollars every year. I am sure that is a non-starter politically here in America, but where can a dialysis provider supervising home hemodialysis patients only on a monthly basis have the audacity to generate such an outrageous bill? Indeed, my entire annual cost of dialysis and related medical costs is well below $72,000 each year.

At the same time, DaVita denies me enough supplies to last that one month period with one box of masks, 50 in each, which is less than needed for both my wife and I. One box of alcohol pads likewise fails to cover my monthly needs.  They further provide my dialysis needles on a one month basis compromising their integrity since they are not shipped in their original packaging of a box of 100. Did they use gloves and wash their hands before they placed them in a cardboard box not intended for this purpose and then shipped it to me through the mail system? Does this compromise my clean supply table every day as I attend my dialysis set up diligently in accordance to rules of sanitation?

Needless to say, Kaiser does not pay that bill in entirety due to contractual agreement. Yet for some health care providers, they do not have the ability to deny all of these claims which would total over $800,000.00 for a year of home hemodialysis treatment. With Kent Thiry publicly stating in a recent presentation that the business of DaVita is not about the patients, their greed and profiteering is evident each and every month when I obtain my explanation of benefits.

I understand that it is not about the patient each and every day that I fax my daily dialysis flow sheet so that the nurses at my unit can enter it into the DaVita billing system. Yes, DaVita is the king of dialysis billing. My impression of their entire system is that it is geared to billing much more so than to patient care. After all, Kent is right, it is not about the patient. That is the DaVita difference.

http://www.hemodoc.com/2012/09/the-davita-difference-the-billing-king.html
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Main Forum / Re: Need Help? Call Dialysis Advocates' 800 number
« Last post by cschwab on September 24, 2012, 07:26:13 AM »
Dialysis Advocates has just updated it's website with a lot more info: http://dialysisadvocates.com/
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Main Forum / Kidney dialysis patients more likely to survive in Connecticut
« Last post by cschwab on September 21, 2012, 12:05:31 PM »
(found this while I was searching for something else)

Published: Tuesday, April 17, 2012

By Mary E. O
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Other Health News / Re: Robin Hood Tax
« Last post by cschwab on September 19, 2012, 09:20:29 AM »
As Jim Cramer might say, I guess we either give everybody "machine guns" - or at least slow them down with a Robin Hood tax.
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