The new federal government initiative for kidney care that was signed this week by President Trump was long overdue. More than 20% of the Medicare and Medicaid money goes towards care for patients with kidney diseases: $114 billions (with a B) is spent on an annual basis for patients with kidney diseases. This number does not include patients with private insurance.
The main goal of this initiative is obviously to decrease healthcare cost. Dialysis is very expensive if you look how much the main 2 national providers made in 2018. Fresenius and Davita grossed $24 billions in dialysis care in one year alone. These two companies swallow about 4% of the public money available for healthcare.
The measure has some very interesting features like shifting dialysis from institution to home dialysis which would save a lot of money. Many start up companies are entering the market at this time like CVS Health and other private insurance companies. Competition should help improve quality and improve cost.
The other measure is to promote kidney transplantation much earlier in the process of end stage kidney disease. The ultimate goal is to increase the number of kidney transplant by making it ever easier for living donor to donate. By example the government could pay for child care during recovery from the donation surgery.
“25% of the Medicare/Medicaid budget is for kidney diseases care on an annual basis”
The least talked about and most underrated measure is to decrease the number of patients with kidney disease. It is the least favorite measure for all the companies who makes a profit with sick patients but in the long run would be very cost effective and guess what… save lives. Did you know that the cause of end stage kidney disease for more than half of the patients is preventable??? Diabetes and hypertension (high blood pressure) are the main two causes of kidney problems. These two conditions are silent killers because it is already too late when symptoms start showing. Most diabetes and hypertension complications are irreversible.
So how do we prevent that?? As you might say it is easier said than done but it is doable. It is called preventative care or prevention. Americans will need to lay off the sugar and sweet and start moving a little more. Eating less could also help as obesity is a risk factor for hypertension and diabetes. I am more of a freedom of choice kind of guy so I hate to tell other people what to do but having so many unhealthy people affects all of us. In order to make people do more prevention, they need to be informed and have access to healthcare. Most people don’t know (or don’t care) what diabetes can do to them. Having more aggressive information campaign will not save all but could help the government reach its goal of decreasing the number of people with kidney disease by 25%. That will be real money saved and real lives saved.