DialysisEthics2_Forum
Other => Historical Posts => Topic started by: admin on September 28, 2009, 05:10:45 PM
-
FYI
Joined: 15 Feb 2003
Posts: 72
Posted: Sat Feb 15, 2003 6:47 am Post subject: Major Dialysis Program Issues
--------------------------------------------------------------------------------
Dialysis in the United States is supported and regulated by Medicare. The program goes back to 1972. At that time, legislation was passed that enabled dialysis treatment to be reimbursed under Medicare. Prior to that time, about half of end stage renal disease (ESRD) patients died because they could not afford treatment. The program has expanded greatly since its early years, with about 350,000 patients currently receiving treatment.<
><
>However, the current program is substandard and leading to many deaths and decreased quality of life for patients.<
><
>Major Points:<
><
>1. The death rate on dialysis in the U.S. is over 22% a year (higher than the death rate in combat in Vietnam). This compares with under 10% a year in other industrialized countries with a variety of health-care systems. Canada, the U.K., Germany, France, Japan, etc. all have much lower mortality rates than the U.S.<
><
> a. The difference can not be accounted for by the fact that we dialysize more patients with complicaitons.<
><
> b. The extra deaths each year amount to about 40,000. This is twice the US homicide rate of 18,000.<
><
> c. The average dialysis patient lives less than four years. <
><
> d. A disproportionately large number of dialysis patients are African-American.<
><
>2. Americans are underdialyzed. Dialysis is strictly rationed to three days a week. Other countries provide more dialysis.<
><
> a. Legislation (HR 1759 and SR 1303) has been proposed to correct this situation. It was stymied in committee.<
> b. The impact of the rationing is that many patients are being treated against medical advice (AMA) as their doctors would like to prescribe more frequent treatments.<
><
>3. There is little oversight of dialysis centers. Some centers have had mortality rates as high as 50% a year without being closed.<
><
>4. There is reuse of dialyzers, which is a procedure that has not been approved by the FDA. It is potentially dangerous, as toxic chemicals are used in the cleaning of dialyzers between treatrment.<
><
>5. There are inadequate grievance and complaint procedures to ensure the confidentiality of patients and to protect them from retaliation.<
><
>6. There are no national standards for the training of dialysis staff. Technicians have the most contact with patients and often begin work with inadequate education and sporadic training, support and supervision.<
><
>7. There are conflicts of interest throughout the system - with leading regulators, for example, having served on dialysis corporations. <
><
>8. There is little support for rehabilitation of patients - almost no effort to keep them working or getting them back to work; no reward or funds for rehabilitation.<
><
>9. Likewise, there is very little effort spent on helping patients and their families adjust to dialysis. They often begin treatment with little or no orientation on how to cope with the process.<
><
>Robert N. Sollod<
>Professor of Psychology<
>Cleveland State University<
>2121 Euclid Avenue<
>Cleveland, OH 44115<
><
>r.sollod@csuohio.edu<
>216-523-7266<
><
><
><
><
> Edited by: realdialysisethics at: 2/19/03 9:51:00 am<
>
****************************************************************
patient
Joined: 29 Oct 2002
Posts: 137
Posted: Sat Feb 15, 2003 7:16 am Post subject: Major Issues
--------------------------------------------------------------------------------
All patients should be aware of this and do whatever is necessary to get all of these conditions changed. The truth is coming out and we need to keep it rolling.
****************************************************************
jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Wed Feb 19, 2003 8:23 am Post subject: Some...
--------------------------------------------------------------------------------
...great points are made, especially about Bills HR1759 and S1303. Now is the time folks to get these through!! Like it says in another thread and NNN&I, these will be seeing the light of day in congress. I have already written two of my area congress people and Senator John Kerry who is running for president. This whole article by Dr. Sollod should be included. Keep it rolling like Patient has said!!!
****************************************************************
Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Fri Feb 21, 2003 2:36 pm Post subject: I agree!
--------------------------------------------------------------------------------
that some pts. may need extra txs., but many just need adequate dialysis. We have the technology to provide that but in many cases it's not being done. Use the adequate dialyzers, dialysite prescriptions tailored to the individual pt., ect ect. Our clearances can be a lot better than 65% even though we are incenter pts.! Why should we be settling for less? More importantly, why is Medicare settling for less? Perhaps if dialysis pts. were doing the deciding (we know how it feels to be dragging around!) changes would be forthcoming. No, instead we have people who aren't on dialsysis, and likely think they never will be so have no real reason to do what's right. Just my opinion, but if our government cared at all about dialysis pts. or how taxpayer's money was spent they would be listening to dialsyis pts. and their families! HELLO, is anyone in power listening? I'm going to voice my opinion and see where it gets me. Maybe they'll listen, maybe not but at least I'll know I've tried. Lin.
****************************************************************
Sick of it
Joined: 11 Feb 2003
Posts: 46
Posted: Sun Feb 23, 2003 6:19 pm Post subject: Great Points
--------------------------------------------------------------------------------
I feel like he has read my mind. We need more of this type of information. Also it is very important to know where was this presented and in what form? IE Article, News Paper ect. I would appreciate knowing this to reproduce it in its entireties.<
><
>Please respond here.<
><
>Keep up the good fight. Thanks