Wednesday, September 02, 2009

The Health of America, Part 17

A USA Today article published late last month criticized current kidney dialysis treatment:
Dialysis treatment in USA: High costs, high death rates

. . . Only 8% of U.S. dialysis patients treat themselves at home. The vast majority of the more than 350,000 Americans on dialysis are treated in centers, where three treatments a week, three or four hours each, is the norm -- not because it's optimal but because that's the way it has been done for nearly four decades.

A growing body of evidence suggests that longer and/or more frequent dialysis treatments, either at home or in a dialysis center, are far superior to the status quo. Although the USA spends more per dialysis patient than other countries, that does not result in higher survival rates or even, many argue, a better quality of life.

"The standard of care is really inappropriate," says Brenda Kurnik, [a] doctor, who practices in Marlton, N.J. "Basically, it prevents people from dying, and that's about all it does." . . .

[Foreign doctors] -- and many of their U.S. colleagues -- attribute the higher U.S. death rate in part to Medicare's own payment system and the resulting "one-size-fits-all" treatment.

The standard of care has become the three treatments a week for which Medicare pays, usually in a dialysis center, and no longer than four hours each. Home dialysis, which allows for longer, more frequent treatments, is more common in most countries with better survival rates.
So what's the problem? John Graham at Critical Condition explains:
The punch line? The U.S. government's Medicare program is the monopoly health insurer for patients who need the treatment. That goes a long way to explain why the protocol is frozen in time. Can you think of any medical specialty -- cardiology, psychiatry, orthopedic surgery, etc. -- where you can describe what's happening today as no different than four decades ago?
Remind me, once again, why progressives prefer a "public option" when Medicare remains a mess? And getting worse?


OBloodyHell said...

> Remind me, once again, why progressives prefer a "public option" when Medicare remains a mess?

Because so-called "progressives" are after power, and that's it. The path to it is irrelevant, the results of following that path are irrelevant.

"Kings are killed, Mr. Garrison. Politics is Power, nothing more."
- X, 'JFK: the Director's Cut' -

Even Ollie can be right once in a while.

Truman knew it --

"Professional liberals are too arrogant to compromise. In my experience, they were also very unpleasant people on a personal level. Behind their slogans about saving the world and sharing the wealth with the common man lurked a nasty hunger for power. They'd double-cross their own mothers to get it or keep it."
- Harry S Truman, pp. 55, American Heritage 7/8 1992, from a 1970 interview --

Carl said...