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Listen and learn from experts in the field as they discuss the current status of dialysis in America.

John Oliver examines the state of dialysis treatment in America in this 24-minute segment. May 15, 2017.

By New York Times bestselling author Tom Mueller.

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"How did a lifesaving medical breakthrough become a for-profit enterprise that threatens many of the people it’s meant to save?
 

Six decades ago, visionary doctors achieved the impossible: the humble kidney, acknowledged since ancient times to be as essential to life as the heart, became the first human organ to be successfully replaced with a machine. Yet huge dialysis corporations, ambitious doctor-entrepreneurs and Beltway lobbyists soon turned this medical miracle into an early experiment in for-profit medicine—and one of the nation’s worst healthcare catastrophes."

Fresenius in its own words:

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"In the U.S., a portion of the dialysis treatments is reimbursed by private insurers...; these reimbursements are in general higher than the reimbursements of the public health care systems. As a result, the payments we receive from private payors contribute a substantial portion of our profit. In 2022, approximately 43% of our consolidated Health Care services revenue were attributable to private payors in the North America Segment. If these payors succeeded in lowering reimbursement rates in the USA...this could result in a significant reduction in our revenue and operating profit."

"Is Dialysis a Test Case of Medicare for All?"

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"Since Medicare reimbursement rates are fairly low, the dialysis industry had to find a way to tweak the system if they wanted to make big profits. They succeeded."

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53 minutes. April 7, 2021.

DaVita explains its revenue in its own words:

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"When Medicare becomes the primary payor, the payment rates we receive for that patient shift from the commercial insurance plan rates to Medicare payment rates, which are on average significantly lower than commercial insurance rates."

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"The payments we receive from commercial payors generate nearly all of our profits..."

In 2017, commercial insurance paid DaVita an average of $1,041 per dialysis treatment, compared to $248 for government insurance, totaling $148,722 each year for a privately insured patient versus $35,424 for one on Medicare or Medicaid. May 13, 2019.

"A new California law aims to curb what sponsors say is profiteering by dialysis centers. But are there any easy answers?" December 14, 2020.

Data on diabetic patients and costs from the National Institutes of Health, Bethesda, MD, 2022.