Freakonomics Radio 457. Is Dialysis a Test Case of Medicare for All?
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Apr 8, 2021 
Ryan McDevitt, an economist at Duke University, and Jeff Gillian, a kidney specialist and chief medical officer at DaVita, dive into the controversial dynamics of the dialysis industry. They analyze how low Medicare reimbursement rates have pushed the industry toward profit-driven practices, often at the expense of patient care. The pair discusses troubling data on the consolidation of dialysis providers, ethical dilemmas in treatment decisions, and legislative challenges aimed at improving patient outcomes within a profit-centric system.
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Medicare's Dialysis Exception
- The dialysis industry's relationship with Medicare is unique.
- Medicare covers dialysis for all ages, unlike most other ailments.
Reimbursement Rate Discrepancy
- Medicare's reimbursement rates for dialysis are significantly lower than private insurance rates.
- This incentivizes dialysis companies to prioritize privately insured patients.
Dialysis Duopoly
- DaVita and Fresenius dominate the dialysis market, owning most clinics.
- Over 30% of DaVita's stock is owned by Warren Buffett's Berkshire Hathaway, indicating its profitability.