Blog #10: Damn to Heck Best-Selling Book Author Tom Mueller
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Some of us associated with DialysisEthics were interviewed by author Tom Mueller. There was hope the author would find we were a bunch of misled people. We could just slink off to the shadows with egg on our faces and never be heard from again! Some of us have spent over twenty years staring at some God-Awful stories. Not to mention articles and media we've had to endure and the horrifying numbers we have dug up. Surely someone would come along and convince us kidney dialysis is a land of great medical care - freeing us from a twenty-some year prison we have been in! We were hoping to hear "you people are full of it and currently things are great, and here is why!"
But no! Tom Mueller came out with this book due in August: "How to make a Killing: Blood, Death, and Dollars in American Medicine". That's not what we were hoping for! And it gets worse! The author goes on to say:
"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."
So I guess it is back to putting the shackles back on and being glad we have three hots and a cot. Maybe the duopoly dialysis companies will convince Mr. Mueller they are made of sunshine and lollipops (like Warren Buffett's castle) - they sure haven't been able to convince us! We were hoping for a savior, but all we got was another instigator and troublemaker! (like we have been labeled) But seriously, welcome to the club Tom! We are glad to have you!
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Blog #9: A Major Problem with this Country (US)
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What is a major problem with this country? The interns have broken out of the accounting department!!! (one bean for you, two beans for me - one bean for you, three beans for me -one bean for you, four beans for me, etc...)
Bob Lutz, President of Chrysler Corp. etc... is the author of ''Car Guys' vs. Bean Counters: The Battle for the Soul of American Business'. He was a car guy who saw the results when the bean counters hold sway:
"But then GM's leadership began to put their faith in analysis, determined to eliminate the "waste" and "personality worship" of the bygone creative leaders. Management got too smart for its own good. With the bean counters firmly in charge, carmakers (and much of American industry) lost their single-minded focus on product excellence. Decline followed."
"A common theme in the book - and as eluded to in the title - is the role of the over-analytical wave of thinking (primarily driven by MBA's) which was a contributing factor to the demise of GM. Bob also covers the other factors, that led to the eventual Chapter-11 filing, including rising fuel prices, staggering health insurance costs etc."
At least the auto industry had some choice. But my recollection was the cars seemed the same (while breaking down). Management would be on one board then on the board of a different auto company - until companies like Toyota came in and blew their doors off!
So what would one area of medicine look like if the "accounting interns" (aka MBAs) came in and gathered up all the dialysis clinics? Dialysis clinics by themselves are small monopolies, like utilities, and many times are the only option in a geographical area. Factor into that a kidney dialysis patient only really has two choices: get dialysis or die!!! Sounds like an monopolistic accounting intern's dream! Customer service, who needs that crap! Take all those little monopolies and make one big monopoly! I'll reiterate, what would this look like? Here is a picture. Someone needs to write a 'Medical Guys vs. Bean Counters' book (maybe someone has, but we will see).
Blog #8: A fourth Way to Participate in the 'Save the Billionaires (or not)' Walk
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Jim Cramer, the stock guru, is famous for having had to sleep in his car at one point in his life. He knows a little of what it is like to come up the hard way. After having listened to his show for years (I do have one bad habit -stock investing - keeps me away from the racetrack) he is someone who has impressed me as a person who is sympathetic to the underdog. So I wrote the following redacted email to him! Why not! Sometimes long shots do come in:
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Blog #7: A Message and Question for Becky Quick at CNBC and Warren Buffett - Join In!
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(Questions for Warren Buffett and Becky Quick of CNBC can be sent to
This was emailed off to Becky Quick of CNBC who will be interviewing Warren Buffett and Charlie Munger at the Berkshire Hathaway meeting on May 6th, 2023:
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Quote:
Arundhati Roy
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