Overview
This investigation examines the dialysis industry in the U.S., highlighting its transformation from a lifesaving medical breakthrough to a highly profitable and criticized business sector dominated by a few large corporations, amidst concerns over patient care, systemic issues, and recent related criminal events.
Dialysis: Medical Necessity and Patient Experience
- Dialysis is essential for patients with kidney failure, replacing lost kidney function by filtering blood.
- Home dialysis allows some patients, like LaQuayia Goldring, to survive with greater flexibility, though most receive clinic-based care.
- Life expectancy for dialysis patients is around five years, with quality of life and survival worsening the longer treatment continues.
- Many patients face long transplant waiting periods, with over 100,000 Americans awaiting kidney transplants.
Industry Structure and Criticisms
- Most U.S. dialysis clinics are run by for-profit corporations, particularly Davita and Fresenius, who control about 80% of the market.
- Critics argue that clinics prioritize profits over patient care, allegedly offering shorter treatments and higher flow rates to increase patient throughput.
- The current model reportedly results in higher mortality rates and substandard patient experiences compared to other developed nations.
- A third of clinics failed to meet federal standards this year, with numerous deficiencies and unsanitary conditions reported.
- Since 2015, Davita and Fresenius have paid over $1.13 billion to settle civil lawsuits related to care quality.
Financial and Regulatory Context
- Medicare covers dialysis costs for most patients, totaling over $40 billion annually (1% of the federal budget).
- The high costs are blamed on lack of competition and the corporate-dominated market.
- Congressional intent in 1972 was to ensure fair access to dialysis, in contrast to earlier periods of equipment scarcity and rationed care.
Criminal and Legal Developments
- In Indiana, Dr. Andre Obua was charged with attempted murder after shooting another doctor, allegedly motivated by claims of a multi-million-dollar scam involving dialysis medications.
- Dr. Obua referenced recent high-profile violence and claimed he sought to expose industry harms, but legal authorities condemn violence as a means of protest.
- Obua's trial is scheduled for August.
Reform Proposals and Patient Advocacy
- Suggested reforms include increased competition, patient choice, and advocacy for home dialysis.
- Despite lawsuits and settlements, critics see little improvement in patient care.
- Patients like Goldring campaign for broader changes and increased transplant opportunities, facing grim daily realities as they await new kidneys.