Wednesday, July 27, 2005

GOVERNMENT MEDICAL CARE FAILS KIDNEY PATIENTS

The nation's largest kidney-care provider has closed five dialysis centers in the greater Washington area, which has one of the highest rates of kidney disease in the country. In addition, the dialysis provider -- Fresenius Medical Care North America -- says more closures can be expected because of a lack of reliable government funding. "When the patients are on Medicare and Medicaid, we can't survive," company Vice President Robert Ward said. "We're losing money every treatment."

Fresenius Medical, based in Lexington, Mass., has closed one dialysis center in Prince George's County, two in the District and two in the Baltimore area. The closures affect about 5,000 local patients who have end-stage renal disease and rely on dialysis to survive. Of the nearly 20 million kidney patients nationwide, more than 375,000 live between Baltimore and Fredericksburg, Va., according to the National Kidney Foundation of the National Capital Area. "Based on our population, we're right at the top," said Dr. Andy Howard, a former kidney foundation chairman.

Mr. Ward said the number of kidney patients in the region has more than doubled since 1990 and is expected to rise further. Health care providers said dialysis centers are closing because Medicare reimbursements have not kept pace with the increase in kidney patients and treatment costs over the past two decades. "The funding [for dialysis] comes straight out of Medicare," said Nancy J. Sharp, a registered nurse with the American College of Nurse Practitioners. "Medicare pays approximately $130 [per treatment]. It hasn't raised from that since about 1983. The rest of the world keeps getting more money from inflation, but the dialysis rate has just kept the same." ....

Kathleen Smith, a vice president of government affairs for Fresenius Medical, said most kidney-dialysis centers are independent and not represented by such groups as the Centers for Medicare and Medicaid Services. "We don't have that, so we have to go to Congress on our own every year," she said. "We're trying to close centers in D.C. where the impact won't be as severe. We used to never think about that. We've started down a road we never expected to be on."

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SURGICAL AFTERCARE FOR THE ELDERLY GETTING WORSE IN BRITAIN

The more the British goverrnment spends on its NHS, the worse it gets. But there is plenty of money for more and more bureaucrats

A woman aged 75, just discharged from hospital after hip surgery, was dumped on her doorstep by welfare workers with a bag containing some tea bags and margarine. The shocking case of Maureen Hayes sums up what charities say is serious neglect over care for the elderly. Old folk released from hospital are being given little or no support at home, campaigners claim. And many others are forced into residential care because of lack of help with washing and cooking. The number receiving home help has fallen by 21 per cent since Labour came to power eight years ago, says a report by a coalition of charities including Age Concern and Help the Aged.

Mrs Hayes, from Bournemouth, told of her struggle for help after her hospital stay. She could not wash because of her sore hip and back, was unable to get help to bathe, and developed a serious infection. Mrs Hayes said: "I have had to fight tooth and nail for the little help I have got from social services. I've needed to involve my MP. "What on earth do people do if they are less feisty and less eloquent than I am? I will fight this bureaucracy all the way, but it shouldn't have to be like that. Social services have a very patronising attitude and treat elderly people like children."

Another dissatisfied pensioner, Margaret Cracknell, 72, from Norfolk, said: "I have been told that it's down to the money. There's not enough to go round so they keep you waiting in the system, hoping you'll go away."

The charity report says that, while the Government has increased funding for social care, the sums have been outpaced by rising costs. It points out that old people make up 62 per cent of social services "clients", but receive just four per cent of funding. A consultation process on the Government's Green Paper on Adult Social Care ends this week - and campaigners warn that any new legislation is doomed to failure unless extra funding is guaranteed. Charities' spokeswoman Annie Stevenson said: "Older people everywhere are paying for inadequate social care funding with their own mental health, physical health and dignity. "Rationing social care funding for older people is making later life a misery for thousands." Aid with washing, housework, transport and mobility would increase independence and save the taxpayer millions, the charities argue.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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