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Blog #26 A Medievel Hero versus A Modern part-time Villain (giving the villain the benefit of the doubt - maybe he just doesn't know any better)

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Written by: Super User
Category: Blog
Published: 04 August 2024
Hits: 1483
  • Tag: BillionaireRedemptionOrNot Blog

Update: And it gets worse:  KIDS!!!!

Petition (and see our visit to DC and DC Press Conference + Rally)

For a short time, something has had this nearly 25 year kidney dialysis advocate smiling - the face hurt since it hasn't found itself in that position much over this long span.  But before the joy is revealed, it is worth mentioning one major problem in kidney dialysis is nephrologists have been kept in jobs at clinics they may have hated.  Hated because these doctors have seen what is under the hood of the clinics run by monopolistic corporations and bean-counting top-management.  Why don't they just leave you ask?  Unfortunately, noncompete contracts have kept them locked down in a loathsome job - other employers aren't a consideration and innovation is stifled.

But then out of the blue comes a Joan of Arc from an unlikely place, DC!  FTC Commissioner Lina Khan and her crew shot down these ridiculous contracts that should never have existed in the first place!  A short read will tell you what it has done for kidney dialysis.  But every story has a villain doesn't it?  So we have coming from the dark, dank, and cobwebbed basements of modern academia where good ideas go to die, a sinister figure. A sinister figure who has the ability to overcome brilliance and blind opponents with bull shit.  Someone looking like the Penguin from a Batman movie.

Billionaire Reid Hoffman has made a name for himself, and recently a lot of names have been hurled his way!  This after he appeared on CNN which brought up his multi-million dollar to-me-sure-looks-like-a-bribe to Kamala Harris. And what is Reid looking for with his money?  Only to get rid of the best FTC Commissioner since the New Deal, Lina Khan!  From Reid's book Blitzscaling apparently this guy really loves monopolies!  Monopolies have worked for Robber Barrons like Andrew Carnegie, Cornelius Vanderbilt, and John D. Rockefeller - why can't they be allowed to work for him?  Us indentured servants are lucky to get the crumbs we do, so be grateful!  His nerdy rear-end wants to get higher in the stratosphere, away from us bothersome earthlings.  Hey, maybe he can catch a ride on SpaceX for a few more bucks.

Reading a bit of his bio it can be seen he has faced some tough choices in his life - where does he go, Stanford or Berkeley?  If there is one fellow who CAN'T relate to people who face food or rent choices each month, this would be the one.  But I know, he got to where he is by himself, like Homer.

I've only gotten to know Mr. Hoffman recently.  I don't know how I've missed him since  he seems like a fellow who doesn't know how to shut up.  In his latest word salad I've seen, he goes on a long spiel on X.  It looks like he is doing the Distract Dance until all the mean people go away, another good example of "if you can't dazzle them with brilliance, blind them with bull shit".  But out of the verbal mess, one item stood out, quote: "I think her (Lina Khan's) ongoing efforts to dismantle companies weakens America's innovation economy".  I would wonder what companies he would be talking about that have been "dismantled" and weakened?  I mean beyond taking a few bucks out of a billionaire's pocket.  Were there mass layoffs? Did product quality suffer? Or did costs rise?  Oh wait, we have seen that - but usually when it has gone in the other direction: Mergers and Acquisitions.  And a few of us have seen the worst of what duopolies and monopolies can do when left to be free: free to take advantage.

What could be at the root of Hoffman's problem?  He seems like an intelligent fellow (wise might another story).  He is well-educated.  Possibly he has been hanging around too many brainwashed MBA holders, like this one. If anybody see's former DaVita ceo Kent Thiry, tell him I still have a few questions for him.

But getting back to Hoffman, how could we deprogram this misguided soul.  Apparently he likes to read books!  He likes to write books!  I hope his books are better than his mish-mash of an X reply!

Possibly he would appreciate a reading list, all the writers are impressive with impressive credentials:

Reading List

 

Update: And it gets worse:  KIDS!!!!

Petition (and see our visit to DC and DC Press Conference + Rally)

 

 

 

 

    

Blog #25 Imagine just a Couple of Restaurants in Town

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Written by: Super User
Category: Blog
Published: 23 June 2024
Hits: 784
  • Tag: BillionaireRedemptionOrNot Blog

Update: And it gets worse:  KIDS!!!!

Petition (and see our visit to DC and DC Press Conference + Rally)

Suppose a person is wandering the country and winds up in an area where there are only a couple of restaurants: 'Marvelous Mike's Michelin-starred' restaurant and 'Salmonella Sam's Toxic Waste Dump' restaurant where the chef has graduated from "Typhoid Mary's School of Culinary Delights!".  Being hungry, but not knowing the area, it is decided to ask a local wandering by where a person might partake of a good meal and refreshments.  The local assures the traveler he knows the lay of the land very well - but recommends the traveler dine at 'Salmonella Sam's'!  Why?  It isn't because the local hates tourists, turns out the local is co-owner of 'Salmonella Sam's'!  Hey, the local might otherwise be an upstanding member of the community, but good intentions don't feed the bulldog!

The local restaurant owner could tell themselves: "It is only one meal!  The out-of-towner will probably survive?  It isn't like a steady diet of crap!".  Now imagine a steady diet of crap served up by your local doctor!  A local doctor who may not be part-owner of a restaurant, but a dialysis clinic.  Let's call this clinic 'Fred's Discount Dialysis', motto: "Discount Care, at High, High Prices!", catchy huh?  Instead of clientele who are free to leave and get out of town, the doctor's "customers" are force-fed a steady diet that is eventually going to kill them sooner than when their time would normally be up.  Traveling out of town isn't an option for most of them.  A 'Marvelous Mike's' of dialysis could show up in town, something like 'Community Dialysis Houses', a wonderful innovation where dialysis patients don't so much as 'cook' for themselves, but control their own treatments!  Between the two dialysis options, you may have already guessed which place the local doctor maybe very tempted to recommend - the one he has a financial interest in, 'Fred's Discount Dialysis'!  (aka the huge for-profit dialysis companies DaVita and Fresenius)

(You may wonder where the oversight for dialysis clinics is at, much like the health department for restaurants.  Can you say 'Captured Regulation'?  But that is more a story for another day)

There is good news that there is a tool in the arsenal to keep doctors from recommending things like a 'Fred's Discount Dialysis', that they have a financial interest in!  It is called the 'Stark Law'!  It is named after federal Rep. Pete Stark who was a main force in getting it passed in 1989 and 1993.  It was supposed to stop physician self-referrals.  It was supposed to stop co-owner doctors from referring things like a 'Fred's Discount Dialysis' clinic.  But the bad news is kidney doctors (nephrologists) got an exemption to the Stark Law!  Oh, what big money, corporations, and lobbyists can buy under the guise of the need for rapid expansion!  (uh, why couldn't places like small care co-ops just get loans?  But maybe I'm naive, but I like to think I know crap when I see it)

An excellent article about physician self-referrals and joint ventures was done by Scientific American and Undark in a series of articles about dialysis.

Here are a few quotes from the article:

----------------------------------------

Dr. Berns who has serious qualms about joint ventures: the arrangement leaves many nephrologists with a financial incentive to steer patients to their co-owned clinics for dialysis, even when other, perhaps even better or more appropriate interventions like medication and lifestyle changes are available.

Dr. Moss, who could play the devil's advocate: acknowledged that these same financial incentives could also cause a physician to subconsciously steer patients towards their own clinic and away from options that might be more beneficial.

Dr. Meyer of Tufts Medical Center: if you have the stock market sucking away resources (epitomized by the for-profits DaVita and Fresenius), you just have a mess left over to take care of the patient, even though the people on the ground at the bedside may all have the best intentions and be very, very devoted.

----------------------------------------

But getting back to comparing restaurants to dialysis clinics, it seemed more apt to compare DaVita's and Fresenius clinics to 'Salmonella Sam's' restaurants than what former ceo of DaVita Kent Thiry compared them to, Taco Bells.  Comedian John Oliver felt compelled to apologize to Taco Bell on behalf of Kent Thiry starting at 21:50 of this video.  Quote: "You are actually more likely to find a doctor in one of our restaurants (Taco Bell) than a dialysis clinic". 

 

*Carrie Arnold, a lead reporter for the series of articles mentioned, also did an article about what happens to patients who make the mistake of questioning their care - terminations!

*For a deeper dive, NYT's best-selling author Tom Mueller last year put out the book 'How To Make a Killing; Blood, Death and Dollars in American Medicine'.  He is also mentioned attending a press conference in DC in January 2024 along with a 'Rally to Congress' in February of 2024 (same article).

Update: And it gets worse:  KIDS!!!!

Petition (and see our visit to DC and DC Press Conference + Rally)

 

 

     

Blog #24 June 2024 Update - Back to writing Federal Reps etc...

Details
Written by: Super User
Category: Blog
Published: 11 June 2024
Hits: 697
  • Tag: BillionaireRedemptionOrNot Blog

Update: And it gets worse:  KIDS!!!!

Petition (and see our visit to DC and DC Press Conference + Rally)

Since Warren Buffett (major stockholder in DaVita) so far refuses to wave his magic money wand to fix the the problems in kidney dialysis - even after a trip to Omaha last month - and even after being whaled on by the ghost of Charlie Munger. (Ok, I may have made up that last part)  This writer has gone back to doing things like handing out flyers at the Auraria campus here in Denver.  And also writing my federal reps, they tend to wander off if not nudged often enough.  Having watched my state legislators at work I do notice legislators bounce around like ping pong balls.  So I'm putting out the following examples of what could be written to your legislators.  The first is a simple example of what anybody could write, the 2nd is what I recently wrote:

--------------------------

From a previous email:
 

"There are a lot of reasons DaVita (the huge kidney dialysis company) should be broken up (the numbers, scandals), are there any reasons left indicating DaVita SHOULDN'T be broken up into something like small care co-ops?"   (text example that can be copied and pasted into a contact webpage)

Federal contact links

--------------------------

Recent email:

Rep. (Jason) Crow,
 
Besides having not even kids being spared in kidney dialysis, I thought I ought to mention another God-awful problem that has been around for decades: dialysis patient terminations.  I came close to almost seeing this firsthand years ago when my daughter was in a clinic and I made the mistake of asking too many questions - and not liking the answers.  The charge nurse threatened to kick my daughter out of the clinic, though she and the doctor relented later.
 
The article I linked to had this to say about terminations:
"This profit motive makes involuntary discharge a very American problem. In countries such as Australia, Canada, and New Zealand, the vast majority of clinics must accept everyone. Involuntary discharge “would not be tolerated in the Canadian health care system,” Bear says. “There would be outrage beyond description.”"
 
And:
"In his nephrology practice in Alberta, Bear saw plenty of patients prone to outbursts and disruptive behavior. What he didn’t see over his four-decade career, he told me, was a single involuntary discharge. He attributes this to lower patient-to-staff ratios. The bulk of care in Canadian dialysis clinics is performed by highly paid and well-trained nurses, Bear says. Technicians are responsible for maintaining the machines, not attending patients. This, and the absence of profiteering, he says, has rendered involuntary discharge nearly nonexistent." (all of this for higher costs here in the US of course)
 
Journalist Carrie Arnold wrote much of the article I quoted, she and others were also responsible for a series of articles put out by Scientific American and Undark.
 
So what are the solutions?  They are mentioned in the 2nd half of the article I'm linking to.  The first half of the article summarizes the press conference NYT's best-selling author Tom Mueller had with the labor union SEIU with DC earlier in the year, Tom Mueller has the book 'How to Make a Killing' out.  A book we left with your staff in DC on February 29th.  A book we hope you and your staff had time to look over!
 
Federal contact links
 
--------------------------
 
P.S. There is audio and video of the May 2024 Kidney Dialysis Walk in Omaha, but coming from the age of smoke signals and the pony express it is taking time to put together.  
 
This is the worst abuse of monopoly power many of us have seen!  Today we go after for-profit dialysis!  Tomorrow it could be for-profit nursing homes and for-profit hospitals!  Think BOEING on steroids when it comes to dialysis! 
 
Petition (and see our visit to DC and DC Press Conference + Rally)
 

Blog #23 Spring has Sprung! Time to visit Warren Buffett again!

Details
Written by: Super User
Category: Blog
Published: 24 March 2024
Hits: 5463
  • Tag: BillionaireRedemptionOrNot Blog

Update: And it gets worse:  KIDS!!!!

 

Petition (and see our visit to DC and DC Press Conference + Rally)

------------------------------------------------

There is a good chance Tom Mueller, NYT's best-selling author, will make an appearance in Omaha!  His book 'How To Make a Killing' shown quite an unfavorable light on the dialysis industry (to put it mildly)

Update: Tom Mueller sends his regrets, but he won't be able to make this Saturday's May 4th Walk in Omaha. However he did give an endorsement.

The snow has melted, the flowers are awakening, and the grass is starting to green - and my wife is trying to tackle me before I get out the door again!  Yes, it is spring in this household.  My wanderlust has taken hold and a far off land is beckoning - a land I visited last year  (more on the new May 4th,2024 event at the bottom of the page)  Some guys go on golf trips, some guys go on fishing trips - this guy likes to hand out flyers, listen to some tunes if he can, and talk to people - lowers my blood pressure.  My wife worries about my heart, I've had problems in that area.  Me, I worry about my heart if I don't do this!  What do we want in Omaha?  The breakup of DaVita, the huge kidney dialysis company, and better care for kidney dialysis patients!

In Omaha, I liked talking to people about a little old man - Warren Buffett [1] - who is hiding behind a wall of money and a mighty, mighty PR machine.    What is he hiding from?  These facts and scandals about his DaVita dialysis investment might give you an idea!  I hear the cries of this little old man looking for the road to redemption!  A fellow who has been trying to buy his way into heaven - some might call it generosity - some hard, cynical people (like myself) might say it is a way to alleviate guilt and rack up points on the positive side of the ledger before he winds up in the complaint department in the basement of hell.  The message I'm getting is a fleet of semis full of loot from places like the huge dialysis company DaVita doesn't get a person past Saint Peter's toll booth.  The message I'm getting is it might take a person admitting his mistakes, like admitting when choice is taken out of healthcare, holding the victims hostage isn't such a great idea!  Admitting throwing them crumbs while he runs off with the cake isn't such a great idea.  Rumor has it (rumor I started) the Ghost of Charlie Munger has been visiting Buffett, and whispering in his ear (that's my story and I'm sticking to it).  What isn't a rumor is my friends and I payed a visit to our federal reps in DC this last January 31st and February 29th.  A good chance those reps won't be whispering in Buffett's ear - they could be shouting!

But am I being too cynical?  Aren't there some patients out there loving their in-center care?  Patients just full of sunshine and lollipops?  I'll get to that later.  But I'll tell you about some of the patients I've run into.  I'll start with one who might almost qualify as a happy in-center patient.  Back in 2007 he was part of team of a clinic manager and patient care technician, that testified for davita and against our kidney technician certification bill at a Colorado State Capitol hearing.  Yes, he described a beautiful, shiny clinic on a hill.  A land of peace, love, and harmony where staff and patient joined hands for wonderful medical treatment.  Then when he was done testifying I saw him blinking out S-O-S!  Ok, it just happened in my mind.  I went down memory lane looking for more possibilities.  How about Frank Brown (R.I.P)?  When he was a 47 year old man he had been on dialysis half his life - at the time he was claimed he had been on dialysis the longest of anybody in the country!  Surely he would have some good things to say.: uh, not too many.  How about the 2000 US Senate hearings?  Nope, nothing there!  Then how about our own hearings here in Colorado?  I'll let you listen, maybe I missed something.  All old news?  Then how about the January 31st, 2024 Press Conference and February 29th, 2024 events in DC?  Patients weren't exactly singing the praises of their care there either.

So where might be the Camelots of kidney dialysis in-center care?  The answer might surprise you, it surprised me after I googled it just recently- the LDOs (Large Dialysis Organizations) like DaVita and Fresenius!  They sometimes offer in-center slow nocturnal hemodialysis - what I've been told for years is the Cadillac of treatments!  I don't know how many are out there - are they few and far in-between?  I felt obligated to say something.  Since so many DaVita and Fresenius clinics are out there maybe a person could push for nightly slow nocturnal dialysis in their current clinic?  But now the hard, cynical side kicks in.  Even if some patients managed to get great dialysis at night, what would it be like for patients during the day?  Still the short, violent bazooka treatments these for-profit clinics are known for?  I don't know.  Surely the doctors could step in and make sure bazooka treatments didn't happen - not when they are trapped in their gilded cages.  This leads to something previously mentioned, another big need in this field of medicine - the elimination of the nephrologists' exemption to the 'Stark Law' which stops doctors from profiting off their patients with their financial interest in specific clinics!  Neprologists need to see people as deserving the best treatment possible for their situation! 

The other potential Camelot centers might be something I just learned about!  Community Dialysis Houses aren't here in the US yet as far as I can tell. But not only do they offer self-care, but potential savings!  The person I learned about the houses from is a prolific poster on X (twitter): @DailyHemo "Started dialysis in 1978, tried standard incenter 3x weekly, Daily Short, Every Other Day and currently on Nocturnal Hemodialysis incenter"  I couldn't imagine a more knowledgeable resource!  I've provided the good (just above), the bad (further up), and the ugly of dialysis - a lot of ugly going on!

And I would be amiss if I didn't mention what has impressed this 20+ year kidney dialysis advocate for years and years - home dialysis.  Someone who I talked to often on the phone and was like an uncle to me claimed home dialysis saved his life!  Dr. Kenneth Bays - his 2000 US Senate testimony.  Not enough has changed since then!

But getting back to the May 4th, 2024 event where we will be handing out flyers (and more?), details can be found here.  Again, what happened last year is linked to here.  It is hoped this year's event will be more than a one-man "scouting" mission!  A good chance there will be more blogs before the May 4th event, so stay tuned!  -- Also again there is a good chance NYT's best-selling author Tom Mueller may show up in Omaha!  Author of: 'How To Make a Killing' which shines a light on the dialysis industry.

 

Petition (and see our visit to DC and DC Press Conference + Rally)

[1]  Buffett's Berkshire Hathaway owns 40% of DaVita, the huge kidney dialysis company.  The huge for-profits, DaVita and Fresenius, have been linked to inferior care

     

Blog #22 POST 'Rally To Congress' Washington D.C.

Details
Written by: Super User
Category: Blog
Published: 05 March 2024
Hits: 5003
  • Tag: BillionaireRedemptionOrNot Blog

Update: And it gets worse:  KIDS!!!!

Petition (and see our visit to DC and DC Press Conference + Rally)

There were 'Winds of Change' in D.C.'s hallways of Congress this last February 29th, 2024 - both figuratively and literally!  It was quite blustery both inside and out - but that is pretty much a constant on the inside.  But we added something not always seen - we spoke the truth!  We spoke the truth with our stories outside the Capitol building!  We spoke the truth inside the hallways and rooms of Congress at both @RepMaxineWaters' conference room and outside @RepJasonCrow's office! We thank you both for helping to lead this effort!  And thanks to so many of our Congress people, the huge labor union SEIU, NYT's best-selling author Tom Mueller, and Dr. Rhonda Hamilton for their efforts at the January 31st Press Conference in front of so many of our Congressional leaders!  It was an excellent Press Conference from all indications.  Dr. Hamilton also led us this February 29th!    

I'll ask, could this be an issue that could unite the parties? (bear with me)  The old-school Dems over the years have been perceived by some as caring about quality of care and workers' rights - and have recognized we all need a little help now and then.  The old-school Republicans on the other hand were at one time thought to be in favor of local control, picking themselves up by the bootstraps, and fiscal conservatism - all qualities that have been severely lacking in kidney dialysis!

How so?  This writer could see many old-school Republicans in favor of things like local small clinics which would be much more manageable than the current Goliath big two scandal-ridden dialysis companies who fight any type of reform at every turn - and have the big bucks to shout down any opposition! 

Old-school Republicans are also known to preach about picking-yourself-up-by-the-bootstraps. (haven't always practiced what they preached)  What is more 'picking yourself up' than home dialysis where self-care is emphasized?  Which leads to fiscal conservatism.  At home, patients don't need a clinic's building surrounding them or staff helping them out - a big cost savings! 

The old-school Dems on the other hand might point out there are going to be people who are in too bad of shape to ever qualify for home dialysis and clinics are always going to be needed - and there are people who just don't want the hassle for one reason or another.  Choice needs to be a factor in all this!  And those in clinics deserve staff that is well-trained and not worked to death with improper staff to patient ratios!

So what is the holdup if this is a bipartisan issue?  As mentioned the dialysis companies will fight tooth and nail any attempt they see as a threat to their assembly-line treatments - get them in and out as fast as you can and get paid (out the wazoo).  A big wall of money is going to try to stop things like innovations that would threaten management's big bonuses!  Innovations like 'Community Dialysis Houses' where many dialysis patients who are perfectly capable of self-care, but for whatever reason can't do home dialysis, can do their own treatments with minimal help.  This also saves the system money.  However the big dialysis companies would lose "customers" so it shouldn't be surprising they just might be against it.  And nephrologists, kidney doctors, might not be inclined to recommend such places.  They might not have a financial interest in 'Community Dialysis Houses' and would have less of an incentive to recommend them.  Which leads to another big need in this field of medicine - the elimination of the nephrologists' exemption to the 'Stark Law' which stops doctors from profiting off their patients!  Neprologists need to stop seeing their patients as cash cows, they need to see them as people who deserve the best treatment possible!

It is time to "Undo Big Dialysis"!!!

Petition (and see our visit to DC and DC Press Conference + Rally)

 

 

  1. Blog #21 A Knife Point into the Heart of Monopoly Power - Kidney Dialysis
  2. Blog #20 Washington D.C.'s M.I. Mother's Keeper - Press Release
  3. Blog #19 Just a Couple of Guys from the Neighborhood - Can They Make a Deal?
  4. Blog #18 A Christmas Carol, starring Warren Buffett with Charlie Munger in the Role of a modern Jacob Marley

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