This Dialysis Photo Archive (DPA) photo is of a 1969 Tacoma News Tribune article (PDF) about Donald Melquist who was dialyzing at home before the ESRD program under Medicare was launched. A 1968 article while he was in training mentions his hope that going home from incenter will allow him to get back to his job at Boeing. This article indicates that he instead of getting back to the Lazy B Melquist went into business for himself selling Amway. I hope he was a success.
What really caught my eye was the mention of some cost of dialysis information. The article indicates that he has gone into business for himself to meet the $4,000 a year annual cost of his home hemodialysis. The article also mentions that:
Melquist had had a kidney removed and had become dependent on an artificial kidney machine in Seattle three times a week at $150 each time.
$150 was the cost of dialysis in 1968. Or about $23,400 year. Compared to $4,000 to dialyze at home or about $25 a treatment.
The really astounding thing is that the nominal coat of dialysis is about the same today! Medicare's allowed charge for dialysis is about $160 (which Medicare pays 80% until this will completely change stating in 2011 because of bundling). And the cost of supplies for one conventional or nocturnal home treatment today using a standard machine and RO would be about $25 excluding the cost of equipment. The variable cost of both home and incenter dialysis in nominal dollars is the same in 2008 as it was in 1968!
Of course nominal dollars hide the real truth. You have to adjust the dollars for inflation to make a real comparison, $150 went a lot further in 1968 than it did last year. According to an inflation calculator what cost $150 in 1968 would cost $922.03 in 2007. When you consider the degree dialysis has clinically stagnated over the last 40 years these numbers suggest reimbursement culpability.