Renal Dialysis Machines Exploited in US, Used Responsibly Down Under

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Renal Dialysis Machines Exploited in US, Used Responsibly Down Under

The US Federal Reserve Building. / Photo by: Getty Images

 

Earlier this month, US news publications were all abuzz about the new federal money allotted for remote dialysis as one of the few boons for kidney patients in Australia. Renal failure has become so ubiquitous, already being so deadly, that it is now ranked the ninth most prolific killer in the US according to the Centers for Disease Control and Prevention. Back in 2010, ProPublica broke an investigative news report that found the US still having “one of the industrialized world’s highest mortality rates for dialysis care” in lieu of the fact that the US outspends all its peers on renal dialysis. Australia’s historically been following America down the same rabbit hole, but the new commitment on federal spending for renal dialysis follows the one good thing that the US has done to deal with the pandemic: spend more.

Renal failure’s such a leading cause of death worldwide, though, that people come from other developed countries to the US to get treatment. That only exacerbates a preexisting problem with the American healthcare system, and the problem manifests right where the rubber meets the road as opposed to on the insurance side of healthcare where there’s already enough controversy. America spends $25 million on renal failure alone, and there is no other organ in the body that merits this kind of attention. Last Week Tonight’s host, John Oliver, brought up the issue and covered it on his show exactly a year ago. He poked fun at the idea that the kidney is the only organ in the body with universal healthcare.

That much is somewhat true and would likely baffle healthcare professionals and average joes alike in other countries. President Richard Nixon signed a bill in 1972 that established basically universal healthcare only relative to the kidney. Experts at the time could already foresee the current state of affairs in which dialysis is really just a way of life for more and more people in America each year. There were 10,000 patients in need of coverage back then, but the last 40 years have seen massive and consistent upticks in high blood pressure and diabetes, which you see in news articles all the time. Because of the bill that President Nixon made law in the early ‘70s, one percent of the federal budget is now attributable to renal dialysis, which is an incredibly large amount of money for anything smaller than an entire sector like the education system itself.

This has necessitated over time the somewhat gradual emergence of an outpatient dialysis clinic, and a network of such clinics has come to fruition. These dialysis clinics are commonplace today despite being nowhere in sight back when the Nixon Administration was taking stock of the fact that Americans were seeing an increasing need for dialysis in general. About 70 percent of the clinics of the modern healthcare system in America, though, belong to two companies: DaVita and Fresenius Medical Care.

 

These are multi-billion-dollar, for-profit corporations, and there are no federal regulations making physicians’ presence mandatory on site. As such, their patients commonly report feeling as though their dialysis isn’t actually being allowed to fully complete when they come in for their sessions; rather, nurse practitioners on site at these clinics are actually rushing dialysis patients — most of whom are senior citizens — off the machines early because of the immensely high rate of turnover. Nurses are, in fact, encouraged at DaVita to cut corners in order to polish numbers; in other words, get patients in and out as fast as possible regardless of whether or not they’ve completed dialysis in full because money’s the bottom line, which is determined by the patient turnover rate.

These dialysis machines rely on what’s called visking tubing, a semi-permeable membranous tube, for filtration. That filtration is a process of removing small molecules from the blood in such a way that the kidneys would if they were functioning properly. The machines themselves have a lot more accouterments, and it’s clear to see that the technology is somewhat costly. With all the clinics and spending at America’s disposal, there shouldn’t be any trouble dealing with the increase in kidney failure patients in need of dialysis; the only problem is that the companies that own the dialysis clinics shirk medical responsibilities to line their pockets. In Australia, though, there’s no reason to believe the same will happen, so many are celebrating the erection of five new remote renal dialysis clinics in South Australia.

Renal Dialysis machines. / Photo by: Getty Images

 

The new clinics are specifically located in Ernabella, and they’re run by The Purple House, which is a community-owned nonprofit that’s been facilitating renal dialysis since just before Y2K via charity and federal subsidies. That’s a key distinction — the fact that, in Australia, renal dialysis patients will be served by a nonprofit instead of a for-profit, commercial corporation. The Purple House used to collect about $3 million annually, and now the government has committed to $34.8 million to last the program through 2022. That’s intended to be $590 per actual treatment. “It will change our model because in the past philanthropists have been quite reluctant to help as they are concerned we’ll be back on their doorstep asking for more once the money runs out,” according to Purple House CEO Sarah Brown.

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