How much is too much?

Or as Anna asks how far is too far? The whole of home hemodialysis operates under this question. In the design of the machine, in the plan for operation, and then how it really works. Can the insurer afford it? (sure as long as it costs no more than conventional dialysis) Can the dialyzor afford it? Can it be priced to operate under Medicare reimbursement rates?

The home dialyzor pays for the privilege to dialyze at home. Payment in our time and effort. We substitute our labor for the labor required for a conventional incenter treatment. This frees up money to pay for additional supplies. With additional supplies the dialyzor can then dialyze more often to live longer, better. The dialyzor gives time, in exchange for time. Time is our currency, it's the whole point.

Anything that adds to the time it takes to complete a treatment is adding to price paid. A new water test increases the price of the treatment. A new paper work requirement increases the price. Going incenter for iron increases the price. Dealing with supplies increases the price. Assuming 20 treatments a month, every hour spent dealing with non-actual-treatment stuff adds three minutes to the per treatment cost. It costs 30 minutes per treatment for every 10 hours spent per month on non-dialysis stuff e.g. going incenter for iron, on the phone, waiting for deliveries, organizing, disposing.

In this case Anna paid the price. What will her partners do? We are a team. The dialyzor is expected and does keep their partner's costs in mind for the good of the program. It's appropriate to acknowledge each other's cost and do what we can to keep all our costs down. Especially avoidable costs. Dialyzors act responsibly as should our partners.

The currency in dialysis is time; dialyzors are as price sensitive as any other group.