ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Tue Apr 22, 2003 11:28 am Post subject: costs
--------------------------------------------------------------------------------
here i go again and i expect most people will put their head in the sand but i think this is the most important thing facing dialysis today so take me apart. i would like for it to be wonderful world where the dirty word money did not come up but the bills have to be paid and the workers do not work for free. the only way the govt gets money is from taxes or running the printing press. so lets look at the costs i took the information from a previous post. it cost about 67000 per year for a patient, there about 380000 dialysis patients now this comes to about 25 billion a year 5 billion more than the war. it costs about 250000 for four years treatment for a patient. this is about 100 per person. about 250 dollars for each worker per year the growth is 6 to 7 percent a year about one and half billion a year. this will take all the raise a worker can expect. if we add to the treatment costs you can see where we are headed. the only solution i can see is self care and home care which costs less and put the patients back in the work force. there is no free lunch, someone pays.
*****************************************************************
Making Sense of All this
Joined: 23 Apr 2003
Posts: 1
Posted: Wed Apr 23, 2003 9:00 am Post subject: Treatment Charges.
--------------------------------------------------------------------------------
All the costs will continue to go up including the cost of treatments. Would it not be better to pay for extra treatments which would improve the health of dialysis patients thus reducing the high cost of problems associated with dialysis itself. This would also allow more patients the freedom to dialyze at on their own schedule which would in turn permit the possibity of working. Home Hemo programs are definitely a must not only for the patients, but for the centers who need the chairs for those unable to do home hemo and saving money from less dialysis problems.
*****************************************************************
umnot quite
Joined: 23 Apr 2003
Posts: 1
Posted: Wed Apr 23, 2003 9:50 am Post subject: ESRD Cost facts
--------------------------------------------------------------------------------
ridgerunner, I'm sure it is more fun to base your posts on anonymous Internet postings but if you are interested in the facts check out:<
>www.usrds.org/2002/pdf/12.pdf<
><
>...Most of this increase in the cost of ESRD program can be directly attributed to the growth of the patient population<
><
>...per member per month (PMPM) dialysis expenditures fall into a narrow range around $1,100 (or about $14,000 per year per person.)<
><
>However, the main short coming of your analysis is that you do not acknowledge that reimbursement is identical regardless of the cost of treatment. If home dialysis was free it would not matter to the tax payer because the reimbursement would be the same.
*****************************************************************
Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Wed Apr 23, 2003 11:44 pm Post subject: Forgotten fees
--------------------------------------------------------------------------------
The fees paid by private insurers were not calculated in. The first three years I'm on dialysis my insurance company pays over 12k a month!!! All that money and still FMC wanted extra money for me to do home hemo. Home hemo would help me, but it would also help them. I guess they don't see it like you do Ridgerunner, or they would be chomping at the bit to get pts. out of center.<
>As for selfcare, it's a good thing for pts. to know how to take care of themselves, but on the other hand why should staff and the companies be paid exhorbitant fees for doing almost nothing? If a pt. does selfcare the companies should get paid less; it would save them in staffing fees. Lin.
*****************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Wed Apr 23, 2003 11:57 pm Post subject: figures
--------------------------------------------------------------------------------
I believe that $67,000 a year comes from Drs. Lockridge and Blagg (backers of HR1004). It includes hospital stays, meds, etc.<
><
>sky.prohosting.com/cschwa...pport.html <
><
>I think you want to multiply it by 275,000 though. It is true that there are 380,000 ESRD patients, but of that number I believe 275,000 are on dialysis (USRDS 2002 ADR pg. 1 . Still a big chunk of change. I had to painfully verify some facts in the editorial I wrote, I might as well get some more use out of that sucker.
*****************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Thu Apr 24, 2003 12:01 am Post subject: USRDS
--------------------------------------------------------------------------------
That was USRDS 2002 pg. 18 (#!>@ emoticons! - actually they do come in handy now and then)
*****************************************************************
Coil
Joined: 14 Jan 2003
Posts: 27
Posted: Thu Apr 24, 2003 1:08 am Post subject: Costs
--------------------------------------------------------------------------------
Plugger,<
>The number's you're quoting from USRDS, do they take into account the cost of nurse's salaries, building expenses etc.? Because when we calculate cost savings of home hemo, we take into account everything, air conditioning cost, water etc. That might account for some of the difference between the two figures quoted on this discussion.
*****************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Thu Apr 24, 2003 3:01 am Post subject: figure
--------------------------------------------------------------------------------
Coil,<
><
>If I recall correctly, that $67,000 figure from Drs. Blagg and Lockridge would be the average bill for a dialysis patient and would include salaries etc.. But this figure looks to be at least a couple of years old. I see it also with the document support for the 2001 bill that didn't go through. I imagine medicare and the insurance companies could save themselves a bundle if home hemo became more available.
*****************************************************************
Me again
Joined: 24 Apr 2003
Posts: 1
Posted: Thu Apr 24, 2003 4:59 am Post subject: That sounds as the Federal Composite rate figure
--------------------------------------------------------------------------------
Could that be just the composite rate. That is what the clinics receive before they add all the other charges. I will try and locate where you can find what is on the composite rate. It is buried in archives.
*****************************************************************
Coil
Joined: 14 Jan 2003
Posts: 27
Posted: Thu Apr 24, 2003 5:38 am Post subject: Gomen Nasai
--------------------------------------------------------------------------------
Sorry Plugger,<
>I had an attack of fingers typing before I finished reading. Things make more sense if you read the whole thing <
>
*****************************************************************
ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Thu Apr 24, 2003 11:44 am Post subject: costs
--------------------------------------------------------------------------------
i am glad to see some discussion on the subject. i failed to add the costs of ssi and early drawing of social security. but the major thing we the govt. have a bear by the tail and do not know how to turn it loose. i use the term we because we are the govt. and we pay the bills. paying the corps more is not going to do it. we must have reform and standards. if we do not i think the thing will get out of control like the welfare system. come on lets have some more discussion i think that this is most important issue facing ESRD.
*****************************************************************
Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Fri Apr 25, 2003 12:01 am Post subject: Reform
--------------------------------------------------------------------------------
One thing that appeals to me about home hemo, and even in center nocturnal, or even home hemo, is that younger pts. who still want to work would be able to arrange their txs. so that they could work perhaps even full time again. They would again be paying into benefits and Medicare. That would benefit everyone. The bottom line is there is no one right answer when it comes to dialysis. We need choices! Each of us has different limitations and we each need a modality that is suitable to our personal condition. Lin.
*****************************************************************
CHOICE
Joined: 25 Apr 2003
Posts: 1
Posted: Fri Apr 25, 2003 4:13 am Post subject: CHOICE CHOICE CHOICE CHOICE CHOICE CHOICE CHOICE CHOICE
--------------------------------------------------------------------------------
CHOICE OF MODALITY AND CHOICE OF MACHINE-- WHETHER ANYONE BELIEVES IT OR NOT THERE IS A BIG DIFFERENCE IN THE MACHINES!
*****************************************************************
ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Fri Apr 25, 2003 4:35 am Post subject: costs
--------------------------------------------------------------------------------
i am glad i have got some people thinking. the problem is ours and it is up to us to find the solutions and fight for them. as far as the machines that is something that has to be left to the clinic because of the maintance factor but there should be standards for them. no time limit on run no reuse. no waiting time between runs. this a few and i am sure there are more. lets stop thinking what the govt can do for us but what we can do for our selves. the helpless should be taken care of. but the ones that are capable should be forced to do for themselves or do without. i know this a harsh statement but someone has to work. everyone cannot have a free ride. i wish i did not have ESRD but that is the way things happen.
*****************************************************************
realdialysisethics
Joined: 06 Jan 2003
Posts: 41
Posted: Fri Apr 25, 2003 4:49 am Post subject: Re: costs
--------------------------------------------------------------------------------
The composite rate dept of CMS under Mr. Richter is the dept to find out what is in the composite rate.<
>His email hrichter@cms.hhh.gov<
>Phone number is 410-786-4562
*****************************************************************
