(see John Oliver and friends' take on kidney dialysis after the following)

!!!!!!!Out Now!!!!!!!

By Author Tom Mueller

How to Make a Killing: Blood, Death and Dollars in American Medicine

***See author's interview with NorthWest Passages on YouTube***

(from the author's website)

How did a lifesaving medical breakthrough become a for-profit enterprise that threatens the people it’s meant to save?

Six decades ago, researchers achieved the impossible: a treatment that made kidney failure a manageable condition instead of a death sentence. And yet, in the hands of a predatory medical industry, this triumph led to skyrocketing costs and worsening care.

A gripping microcosm of American health care gone wrong, How to Make a Killing recounts how the optimism of the 1950s and 1960s—when transplants and early dialysis machines offered hope—gave way to anguished debates about the ethics of rationing (and profiting from) life-saving care. After Congress made renal disease the only “Medicare for All” condition, Big Dialysis proliferated, and the Hippocratic oath gave way to the profit motive.

A triumph of investigative research, Tom Mueller’s book features an unforgettable cast of characters: CEOs who dress as Musketeers to exhort more aggressive profit-seeking, nephrologist insiders who reveal the substandard care this causes, and heroic patients who risk their lives to reveal the truth.

Tom Mueller's books and articles


(updated 2023)

(Click the image for information on finding a living donor, home dialysis, and other info)

The following video and articles highlight what happens when a CEO can't tell the difference between a Taco Bell and a dialysis clinic (that observation was made by the comedian John Oliver):


Profit and Loss: America on Dialysis

This December 2020 Scientific American series of articles points out many of the multitude of problems affecting kidney dialysis:  

*When large corporations come in hospitalizations will go up and treatment quality will go down.

*The dialysis companies have figured out how to game the system and increase their already outrageous profits by getting dialysis patients off Medicare and into private insurance where private insurance can be gouged!  This results in higher insurance premiums for the rest of us.

*Also pointed out are the downsides of having nephrologists have a financial stake in dialysis clinics.  There is also some discussion of the other side of the argument.

*Another article points out the racial disparities in dialysis.  However one doctor does provide a bright spot.

*An uplifting article discusses how the pool of available kidneys has been increased with the use of things like hepatitis C infected kidneys.

*An article discusses how dialysis patients have a hard time accessing palliative and hospice care.

Summary of Articles


Dialysis: Last Week Tonight with John Oliver

The link provided below brings up a quick 24 minute video which provides an excellent introduction to the goings-on and history of kidney dialysis through the anesthesia of humor.  Kent Thiry and Davita play a prominent role in this clip about an area of healthcare that has been on the forefront of bad medicine.  It led one commentator to state: "We are paying the most to get the least." That seems to be American healthcare in a nutshell.":

                                                                                             Credit: John Oliver on Youtube

John Oliver and dialysis on Youtube


Bonus - Click for Diabetes Care
(a bit more encouraging - sort of)


The Strangest Show on Earth!

Former CEO Kent Thiry liked to call Davita a "Village" where he was the mayor.  But was it as Dr. Peter Laird of Lancaster CA called it: “the Village of the Damned”?  This hard-hitting article by Luc Hatlestad might help you decide:

                                                                                                                        credit: Eddie Guy and 5280 magazine

The Strangest Show on Earth!



From paying doctors kickbacks to endangering patients' lives with the drug epogen, Davita has spent quite a bit of time in court justifying their unethical pursuit of profit - and paying out some good sized settlements:

                                                                                   credit: unsplash.com



Questions for Kent Thiry

Here are 12 questions many would like to see former Davita CEO Kent Thiry answer.  They were put together in 2017 - they haven't been answered in all this time.  I'm sure he has just been busy.

                                                                                                                              Credit: freepik.com

12 Questions for Kent Thiry


These Pictures Should be Worth 2000+ Words

(plus a bonus)

If a picture is worth a 1000 words the link below should take you to a couple of graphs that will tell you a WHOLE lot about how our for-profit dialysis companies not only stack up against a country like Italy, but also a nonprofit dialysis company like DCI Inc..  Maybe it is just something about the water in Italy (or wine) - harder to explain DCI. 

It's notable to mention these graphs were handed to Colorado Governor Jared Polis during a bill signing ceremony for the renewal of a state bill for the certification of kidney dialysis technicians.


For-Profit Dialysis vs Italy and a Nonprofit
Bonus: Colorado state bill


Rivals wary of dialysis giant DaVita's aggressive business style

This article highlights the difficulties some doctors and staff had in dealing with DaVita. Just a couple of quotes:

""There were numerous reasons we didn't want to continue our relationship with DaVita — one was that we didn't care for the way they cared for patients," said Dr. Michael Anger, one of the Western Nephrology physicians."

"Pikes Peak doctors say DaVita's "cost-cutting measures and administrative bureaucracy" were taking precedence over patient care. The doctors say they were concerned about the centers' staff's overuse of the anti-anemia drug Epogen, plus poor wages and working conditions for nurses."

With the complications of non-compete and no-poach agreements DaVita has tried to enforce (mentioned in this story), it is no wonder the Stark Law was passed in 1988 (it would have barred a doctor from referring a clinic the doctor has a financial interest in).  Unfortunately kidney dialysis got an exemption to this law and the results are seen here.

                                                                                       Credit: Denver Post

Davita's Aggressive Business Style


Dialysis Treatment - A Punch in the Kidneys

The anti-anemia drug Epogen has been mentioned a couple of times on this webpage.  Why is there such concern about it's overuse?  Part of what the article linked to here mentions is why so many people were up in arms about it, quote:

"Unlike not-for-profit dialysis centers, which reduced doses of the anemia drug Epogen after they reached recommended hematocrit levels, for-profit centers continued to increase doses, sometimes to three times that of non-profit centers."  "Why is this important? High doses of Epogen and similar drugs can lead to increased risk for death, strokes and heart attacks in kidney dialysis patients, which is why the FDA following the study issued a black box warning to advise doctors that they should use only the lowest dose necessary."

                                credit: whatifpost.com

A Punch to the Kidneys


Kent Thiry Meets The Judge (February - April 2022)

In February of 2022 Kent Thiry and DaVita went to court to face three counts of conspiracy charges concerning restraint of trade to allocate employees (labor market collusion).

                                                                                                                      Credit: Getty Images

Articles covering the Hearings and Trial



High Costs and Hidden Perils of a Treatment Guaranteed to All

This series of articles by the online news organization ProPublica goes in-depth into the workings (or non-workings) of kidney dialysis. 

Propublica became the first online news source to win a Pulitzer Prize in 2010. Since then ProPublica has partnered with more than 90 different news organizations and has won six more Pulitzer Prizes.

                                                                                                                                              Credit: ProPublica

ProPublica Exposé


Link to information on finding a living donor, home dialysis, and other info