StatCounter


DSEN twitter feed

    follow me on Twitter
    Blog powered by Typepad

    « Drug And Device Companies Will Now Have To Report Payments | Main | NKF notes passage of Affordable Care Act, says it "will benefit Americans with kidney disease" »

    March 25, 2010

    Comments

    Feed You can follow this conversation by subscribing to the comment feed for this post.

    somerville

    I can imagine four reasons why people have been hesistant to comment on the impact of the new legislation on the endstage renal disease community. First, the law is 2200 pages long, and few will have the patience to read through the whole statute to ensure that some loophole does not trump the apparent rights it formulates. Second, provisions for insuring adults with pre-existing conditions only become effective in 2014, so there is no rush to consider the impact on most dialysis patients. Third, the fines for non-compliant insurers refusing to cover people with pre-existing conditions are ludicrously small, so many insurers may well decide that it is more cost-effective not to comply. Finally, I anticipate that as soon as the Republicans regain power they will undermine or destroy Obama's innovation. As you will remember, after the extension of funding to cover dialysis was introduced in the early 1970s, within a year or two, after costs turned out to be higher than expected, there was a serious effort in Congress to halt the program.

    Bill Peckham

    One: the KCP and KCC as well as many of their individual components have highly paid people at K Street Lobby shops that are paid to tell them what is in legislation. The Senate Bill passed three months ago and if the 2,400 pages were conventionally laid out it would be less than 400 pages.

    Two: the high risk pools go into effect in 2011. If there is a potential gap in coverage between 2011 and 2014 right now would be a good time to start crafting legislation to address those gaps rather than banging on about extending immunosuppressant coverage as if the Affordable Care Act never passed.

    Of apparent greater importance to the CKD advocacy community is the possibility that CMS in the next few months will release the final PPS rule and it will include oral drugs. The new legislation provides some great talking points to avert that outcome. If I can read the relevant sections in my free time and realize this, the paid, full time leadership of the CKD advocacy community can figure it out too. When tIme is of the essence, being nimble is required.

    Three, I don't think you understand the legislation.

    Four, that's farcical. I don't think you understand the American political system.

    Fred

    What wonderful communications skills.

    somerville

    I am not sure where all this hostility comes from; I was just trying to suggest reasons to help explain the phenomenon which you yourself had noticed, and so was simply supporting your observation.

    The bill just passed states that insurance companies which reject applicants with pre-existing medical conditions must pay a fine of $100 a day per customer rejected. For extremely expensive conditions like endstage renal disease, which might involve costs of $60,000 a year for dialysis, $260,000 for transplant, $25,000 a year for immunosuppression, plus payments for other co-morbidities, potential insurers might find $36,500 in fines per year less costly than providing insurance.

    I don't find the prospect of future Republican efforts to roll back the new healthcare benefits in the future under the slogan of 'cost control' or 'decificit reduction,' both now nearly universal mantras, to be in the least implausible. This is especially true, as you can read for yourself if you check an index of New York Times stories on dialysis in the 1970s, since it has already happened once, when Congress reacted in panic over the 'unexpectedly high' costs of Medicare covering hemodialysis after 1973 and thus moved to end the program.

    Bill Peckham

    The insurers have to comply to be in the exchanges but either way the role is for the professionals who are suppose to track this stuff to explain it to we hobbyists.

    If there is hostility it is towards the continued pursuit of obsolete advocacy objectives when there are tremendous advocacy opportunities that demand new tactics. Time is being wasted.

    Verify your Comment

    Previewing your Comment

    This is only a preview. Your comment has not yet been posted.

    Working...
    Your comment could not be posted. Error type:
    Your comment has been saved. Comments are moderated and will not appear until approved by the author. Post another comment

    The letters and numbers you entered did not match the image. Please try again.

    As a final step before posting your comment, enter the letters and numbers you see in the image below. This prevents automated programs from posting comments.

    Having trouble reading this image? View an alternate.

    Working...

    Post a comment

    Comments are moderated, and will not appear until the author has approved them.

    Your Information

    (Name is required. Email address will not be displayed with the comment.)

    Gala (2)
    Supporting Kidney Research at Northwest Kidney Centers 2017 Gala - Give 'til It Feels Good -

    Fix Dialysis

    • www.fixdialysis.com

      DSEN in the Press

      "... not evil ...""
      Kent Thiry, 5280 Magazine

    Search DSEN


    • WWW
      WWW.BILLPECKHAM.COM

    Rate DSEN

    November 2017

    Sun Mon Tue Wed Thu Fri Sat
          1 2 3 4
    5 6 7 8 9 10 11
    12 13 14 15 16 17 18
    19 20 21 22 23 24 25
    26 27 28 29 30