Healthcare is Public Health - The State of Dialysis feat. Tom Mueller
Nov 2, 2023
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Tom Mueller, author of 'How to Make A Killing: Blood, Death, and Dollars in American Medicine,' joins the podcast to discuss the messed up world of dialysis in America. They explore the challenges faced in accessing dialysis, the dominance of Davida in the dialysis market, and the negative effects of dialysis service concentration. They also highlight the insufficient oversight in dialysis facilities and the problems associated with for-profit healthcare.
In for-profit healthcare, financial considerations often take precedence over patient care, leading to inadequate treatment and prioritization of shareholder profits.
The for-profit dialysis system in America is characterized by limited competition, unequal treatment based on insurance type, and inadequate regulatory oversight.
Deep dives
For-profit healthcare prioritizes shareholders over patients
In for-profit healthcare, the primary focus is on shareholders and maximizing profits rather than prioritizing patient care. Patients often come second in this model, with financial considerations taking precedence. This prioritization is driven by the duty of publicly traded companies to their stock analysts and shareholders. While for-profit models may work well in industries like manufacturing, they are not suitable for healthcare, where the consequences of inadequate care can be serious and life-threatening.
The critical importance of kidneys and the impact of kidney failure
The kidneys play a vital role in maintaining good health by filtering waste products and balancing water levels in the body. Kidney failure can have severe consequences, and in the past, it was often a death sentence. However, advancements in medical treatment have provided solutions such as kidney transplants and dialysis. Dialysis, in particular, acts as an external kidney, but it requires regular and frequent sessions to be effective. The need for dialysis emphasizes the significance of ensuring access to this life-saving treatment.
The dominance of for-profit dialysis companies and its drawbacks
Dialysis treatment in America is largely controlled by two major multinational corporations, Fresenius and Davita, and they dominate about 80% of the market. Such consolidation limits competition, reduces patient choice, and can lead to negative impacts on patient care. The profit motive often outweighs patient well-being in these companies, leading to prioritization of privately insured patients and neglect of publicly insured patients. This unequal treatment can create a two-class system where profitability dictates the level of care patients receive.
Flaws in the for-profit dialysis system and the need for change
The for-profit dialysis system faces several flaws and challenges. Firstly, the payment discrepancy between private and public insurance puts publicly insured patients at a disadvantage, as they are less profitable for dialysis companies. Secondly, involuntary discharge of patients, often due to complaints or disagreements, can lead to a loss of access to care and create barriers for patients seeking alternative treatment. Lastly, the regulatory oversight of the for-profit dialysis industry is insufficient, with industry capture, lackluster inspections, and weak patient advocacy. These issues highlight the pressing need for a shift away from a profit-driven model and towards patient-centered care.
A deep dive into the messed up world of dialysis in America.
Special Guest: Tom Mueller Author of "How to Make A Killing: Blood, Death, and Dollars in American Medicine " http://www.tommueller.co/about
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Photo Credit: Photo by Volodymyr Hryshchenko on Unsplash https://unsplash.com/photos/purple-bean-lot-LzHdxEBw1Xk?utm_content=creditShareLink&utm_medium=referral&utm_source=unsplash