Dialysis Patients are Wall Street Commodities
I pray to God that I never go into End Stage Renal Disease.
When I read in the Bangor Daily News that Eastern Maine Medical Center was going to sell their Dialysis services (patients at average $70,000 annually each in 2008) to DaVita Dialysis Corporation, I was shocked. http://bangordailynews.com/2012/04/24/health/eastern-maine-medical-center-to-sell-dialysis-clinics-to-national-chain/ It is my understanding that EMMC offers a fine service already, just as they have promised their charitable donors they would. Charitable donors have given money toward a beautiful 4 year old facility on the West Side of Bangor, ME, and I have never heard anyone complain about their treatment. Information about bad care often trickles down to me because I am a patient safety activist and advocate.
The BDN news article went on to describe 3 concurrent investigations into Davita by regulatory agencies. One is for fraud in overcharging for a common medication given to dialysis patients, Epogen. These investigations were fluffed over by EMMC and we, the BDN readership were assured that these investigations are no big deal…..really? Apparently the investigations are not as big a deal as a check for over $10.000,000 for the purchase of EMMC dialysis. A fellow activist from California contacted me about Davita. She warned that Northern Maine does not want or need them here. She in turn connected me with Arlene Mullin Tinker. Arlene and her team of legal advisors have advocated for thousands of harmed dialysis patients. Many of them have been Davita patients. Her experience is that Davita is #1 for dismissals. During my 42 years as an RN, I had never heard of dismissing dialysis patients. Wouldn’t that be a death sentence?? A death sentence usually involves a judge and a jury of our peers. Not so for dialysis patients.
As it turns out, Davita clinics nationwide have repeatedly dismissed dialysis patients without cause or notice. These patients have generally been patients who were vocal. They complained about unsafe care, complications of their care, poorly trained staff or poor infection prevention techniques. All of these complaints sound reasonable to me. I would certainly complain if I was on the receiving end of poor care. Dialysis patients are captive to their illness and to the treatment for it, dialysis. Without regular high quality treatments, they will die. So, even if their care is substandard, they generally have no choice about where to get their treatments. Their only option is to continue care, often times from the same people who may have harmed them. My research revealed that the only reason to “dismiss” or fire a dialysis patient is violence.
At EMMC Dialysis services, the hierarchy beyond the director of the clinic, is EMMC management, and then Eastern Maine Health Services management, and finally we have 2 local Boards of Directors. Managers and Board members are Bangor and EMMC service area residents. They live, shop, go to church and social functions in the same places that the patients do. Our local Hospital hierarchy coexists in the same community as the patients and they are accountable to them.
Davita, now that is a different story. They are a Fortune 500, for profit company headquartered in Colorado. They are buying up Dialysis clinics all over the World. Davita people ”from away” came to Bangor on May 25 to do a slick sales pitch at a State of Maine DHHS Certificate of Need hearing. They presented an almost religious mission and presentation. They explained their trilogy of care. 1. We care for the World 2. We care for each other. Last and finally, 3. We care for patients. I immediately figured it out. Patients are last on the list. But, the money that patients bring in, mostly from taxpayers in the form of Medicare/Medicaid dollars, is really #1. The “world” is their stockholders. ”Each other” are the so called citizens of the Governors community(will explain in a moment). And finally at the bottom of the pit are the patients…..who get the dribs and drabs of whatever remains of the healthcare dollars after the coffers are filled. I looked into Davita leadership. Their CEO, Kent Thiry is quite a guy. He likes to be called “Governor”, which seems kind of egomaniacal. Employees are called “citizens” of his community. He runs RAH RAH rallies for his cult like “followers’ and dresses up like a Muskateer. He leads loud Nazi like rants/chants. He does somersaults on the stage. He hired a bull for a ritzy Las Vegas meeting to prove that he can ride one. What does any of this have to do with Patient Safety and high quality of care. Dialysis funding (through Medicare patients) pays for all of these Davita variety shows! http://www.youtube.com/watch?v=JowmBdx4nFw
Davita is a perfect example of everything that is wrong with Healthcare today. Taxpayers pay into Medicare and Medicaid services. Coverage for dialysis treatment in guaranteed to every US citizen regardless of income. Around $70,000 to $100,000 is paid annually for every medicare dialysis patient. EMMC was offered over $10,000,000 by Davita for their dialysis services. Kent Thiry ‘s 6 year average yearly compensation was over $22,000,000, http://www.forbes.com/lists/2012/12/ceo-compensation-12_Kent-J-Thiry_IPFN.html, more than all of the dialysis services of EMMC is worth. All of these figures prove that there is HUGE money in corporate dialysis services. My concern is …How much is spent on safe, high quality dialysis care? If the profits in this for profit ”business” are any indication, not much actually goes to patient care.
The slick sales people at this CON meeting also bragged about Walmart-like “one stop shopping” for patients. They are proud that they offer their own mail order pharmaceuticals for their patients. Most dialysis patients are on at least 8 prescription drugs. Staff are trained to be sales people and to encourage their patients to purchase their medications through Davita mail order services. Then they will deliver them directly to the patient, at the bedside. WOW, it’s a miracle. Bill Miller of Miller Drug on State St in Bangor has been doing that for free for years…same day, home delivery for free. And Bill’s profits stay in Bangor, and help the local economy. Bills neighbors and friends can also borrow certain medical equipment for free. I borrowed a wheelchair from Bill a few years back to help my father get around at the American Folk Festival….no charge! What does Davita do for free? What else will Davita sell their patients? They are starting to buy up employee health clinics, nursing homes and other practices. This is a company with outside policies and controls, and with inside sales. This is a company that will profit off our local dialysis patients, and bring nothing to our local or State economy. The money will go to the corporation/stockholders. Living, breathing, suffering and captive Patients become cash cows for Wall Street Commodities.
Where do patients fit into the Davita scheme? Good question. If they are harmed or have issues with their care or safety, the complaint process is complex, and my understanding is that complaints often go into a black hole. The End Stage Renal Disease Network fields these complaints. Davita has representation on that network, so complaints essentially go to the people who are being complained about. If a complaint somehow reaches a state health department, they might do an investigation, but generally the investigators are nursing home inspectors, and they do not know the specialty of dialysis. If CMS (Centers for Medicare Services) is brought in and they make recommendations, Davita may or may not comply. Since there are no sanctions, there is no accountability and no incentive for Davita to fix problems. Then if a Davita clinic does not like the patient, because they have asserted themselves about substandard care or complications, Davita may just dismiss them. Some patients that have been both harmed and dismissed by Davita clinics were also blackballed from other dialysis services. Since Davita will purchase 3 dialysis clinics business, in Bangor, Ellsworth and Lincoln, ME, all inpatient EMMC services and home dialysis services, this leaves local dismissed pateints out on a limb….facing either death or horrible long commutes to distant clinics. None of this bodes well for patients.
Davita answers to their stock holders, not to their patients and as importantly, not to our community or service area. It is very clear what this company’s priorities are. Patients bring money to the company, and by cheapening dialysis care, they make their stockholders happy. Ask Warren Buffett.
Maine does not need Davita. They are exactly what is wrong with Healthcare today. Davita is a prime example of why healthcare is bankrupting this country and our States. The fact that EMMC service area patients may recieve cheaper and lower quality care is reason enough to escort them out of State. We need to tell them “Thanks anyway, but we value our citizens too much to invite you in.” Maine welcomes business..there is a sign near the New Hampshire border saying “Maine is open for Business”. If that business has potential to harm our citizens or suck money out of our economy, we do not welcome them. I look forward to seeing the back side of Davita going over the NH border….headed back to Colorado.
Addendum http://bangordailynews.com/2012/05/27/business/who-makes-the-most-50-highest-paid-ceos/
check out who is #46 on the list of the highest paid CEOs in the US…all made on some of the sickest patients in our country, and on Taxpayer dollars to care for them.
