Blog #37 Dismantling of the Veterans Administration and for-profit Kidney Dialysis

Kidney Dialysis Intro:

Over the decades I’ve been lucky enough to see how healthcare ought to be run with my care from the VA system. But have had the total opposite experience with the care I’ve seen for people like my daughter who has been dealing with kidney disease.

I’ll start with my daughter’s example. She has a transplant now but for awhile had to undergo dialysis at a time when kidney dialysis had some of the worst numbers for mortality! And at this late date the US still has “one of the highest mortality rates for dialysis care in the industrialized world”! All this for the highest prices of course. In my decades of watching this, kidney dialysis has been the most egregious example of privatized, dancing-for-wall-street, for-profit healthcare gone a muck I know of! Crank up the assembly line, use as few people as possible (with as little training as possible), run staff ragged, get those patients out as fast as possible, and maximize those profits! My daughter was lucky enough to avoid some of the worst these for-profit clinics have to offer, but I know of so many others who weren’t so lucky.^[4] And looking back over these 25 years, I still think my daughter’s care could have been a darn sight better.

Now contrast that with my own care at the VA. The VA was there when I needed help while I was between jobs. It was there when I was jobless and my wife insisted we drop COBRA coverage on her and our sons to make sure our daughter would stay covered. It was there for me for a torn ligament in my knee and bouts of gout. And it may have kept us from going bankrupt when I had a heart attack 16 years ago – an incident I haven’t repeated since. I have always found the VA care top notch!

Yes, I’ve read about the problems the VA has had over the years. But put humans into any system and there are going to be problems. I believe my experience with the VA is more the norm than what some in the media have led us to believe. And it looks like I’ve got plenty of company. Here are just a couple of quotes from a 2024 article I’ve only recently read (I could find more):

“Patient Satisfaction Survey: VA outperformed non-VA hospitals in the most recent Centers for Medicare & Medicaid Services Hospital Consumer Assessment of Healthcare Providers…”

“Hospital Quality Ratings: In this year’s CMS Overall Hospital Quality Star Ratings, more than 58% of VA hospitals included received 4- or 5-star ratings compared to 40% of non-VA hospitals.”

I’ve also consistently read over the years the VA is providing our care at lower costs than non-VA patients.

So what are we doing with this shiny example of what healthcare could be for people like the rest of my family? It looks like the VA could be experiencing privatization and the outsourcing of patients to Community Care – something I understand will drive up costs. And I don’t need a crystal ball to tell you what might happen to care, I need only to take a look at for-profit kidney dialysis. It looks like the wall street bean counters are once again practicing medicine and eyeballing a big pile of money to be made off the backs of us vets.

And I’ll finish by adding I’m not the only canary in a coal mine. A fellow veteran from the organization Common Defense also wrote a letter to the editor printed in the Virginia-Pilot about a VA clinic in Virginia where they are already seeing 6 month waits for an initial appointment due to staff cutbacks! This is a strategy familiar to many of us, create a problem then say it was fixed with something like more expensive Community Care.

Then there is a fellow veteran and dialysis patient I met a few months ago. He experienced for-profit dialysis for a bit and was never so glad to get back to the VA!

I hate to say it, but it looks like we are on a path to kill what has been working.

(References for the above Reporter-Herald Guest Commentary)

Kidney Dialysis Intro: