That’ll Cost a Kidney: How a Little-Noticed Vote in Congress Could Raise Workers’ Healthcare Costs Even Higher


For the past eight years, three times a week, I've had to go to a clinic for four and a half hours after work to get connected to a kidney dialysis machine to get my blood cleaned.

Like hundreds of thousands of Americans who are dealing with my kind of kidney disease, I rely on dialysis to keep my body functioning.

Thanks to a smart decision Congress made a generation ago, most kidney patients can count on affordable access to dialysis care when the need is most dire.

But now Congress is thinking about undoing that progress. Amazingly, Congress could be on the verge of letting corporate lobbyists change how kidney care is delivered, reducing access to affordable care so two corporations that dominate kidney dialysis can boost their bottom line.

Obviously, this change would affect kidney patients like me directly. But it would also ripple across the healthcare system and drive up costs for ordinary consumers like you. What Congress decides on this issue will say a lot about which way our healthcare system is headed.

Here is what's happening: two companies-DaVita and Fresenius-provide most of the kidney dialysis services in the U.S. They want Congress to force kidney patients to stay on private insurance for a longer period of time before they can qualify for Medicare.

Usually, patients need to be 65 years old before they qualify for Medicare. But in 1972, because the high cost of dialysis put care out of reach for all but the wealthiest patients, Congress made the historic decision to extend Medicare coverage to dialysis patients of all ages. But patients who need dialysis have to stay on private insurance for 30 months before they are eligible for Medicare. DaVita and Fresenius want to make patients wait longer-another year-before they can get access to the program.

It's not hard to figure out why DaVita and Fresenius want to keep kidney patients out of Medicare. These companies can typically charge private insurers-and ultimately employers and workers-nearly three times more than they can charge Medicare for the same services.

It's staggering how much money is at stake with this "small" change. It's estimated that dialysis providers like DaVita and Fresenius would cash in a $2 billion windfall over the next decade if they succeed in persuading Congress to make patients wait longer for affordable care.

Or course, that $2 billion would be paid by American employers and workers. We already know that skyrocketing healthcare costs are a serious headache for many working families. DaVita and Fresenius want Congress to make the problem even worse.

Unlike a lot of families who are struggling to keep up with healthcare and other costs, these companies aren't struggling. Both are profitable. And according to Forbes, Kent Thiry, the CEO of DaVita, was paid $27 million last year, making him the fourth highest compensated executive in the healthcare equipment and services industry.

Our healthcare system is in even worse shape than I imagined if Congress seriously considers making life easier for a multimillionaire like Kent Thiry while making things even harder for patients struggling with kidney disease.

The commercial media has paid little attention to this story, and that also says a lot about American healthcare. This is another example of how corporate special interests-not doctors, researchers, nurses, or patients-quietly use their influence to remake our healthcare system in a way that does not make sense for the vast majority of Americans.

America can and should do better. The good news is that this isn't a done deal: patient advocates like the American Association of Kidney Patients are speaking out. Major employers are on record as opposing this. Personally, I'm a former hospital technician and my union-SEIU Healthcare-is getting involved.

More and more Americans agree that we have got to find a better way to provide quality healthcare that's affordable for ordinary working people. If we keep doing things the old way-letting special interests make money not by improving services but by cutting deals in Washington, D.C.-it's hard to see how we are ever going to fix our broken system.

But who knows? If patients, healthcare workers, employers, and others can stand up to the special interests this time around, maybe we'll win a small but important victory for a new, better way.

Maybe, if we succeed in maintaining access to affordable dialysis care for every kidney patient, we will be able to point to an example of how America can provide quality, cost-effective care in a system that puts patients first.

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