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September 13, 2009

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Zach

A good example of poor journalism.

Did this woman approach the American Kidney Fund for assistance regarding her rejection medication?

Did she attempt to receive "samples" from her transplant team or from the makers of the immunosuppressive drugs?

Of course the 36 months should be extended to a lifetime.
But lets get more facts New York Times!

Bill Peckham

I commented to the article - saying about what I said in this post - and the author replied:

There is no inconsistency. Ms. Whitaker’s actual monthly cost for dialysis before her second transplant was $9,300 a month. The government’s most recent figures for the average cost of dialysis, covered by Medicare, is about $71,000 a year, or about $5,900 a month. But that’s an average, and the actual cost for any individual may be significantly higher or lower depending on geography, type of dialysis, and numerous other factors.

At least the number came from somewhere but still that $9,300/month figure is presented as the cost of dialysis when it could only be her total Medicare charges (Part A, Part B and Part D). Even with the geographic wage index, and case mix adjustments, the cost of DIALYSIS or even Part B out patient dialysis charges are not $9,300/month.

Or if her Part B charges were that high then she is such an outlier that her case isn't relevant. The article used average transplant costs, it should have used the relevant average dialysis costs.

I appreciated the article - it is a hugely complex issue. Left unsaid is the House's "pay for" - extending the MSP to 42 months. Which I think is misguided.

Or what coverage is being extended specifically. I believe the language in the House bill extends immunosuppression coverage but not full Medicare coverage - it would be very helpful if the NYT clarified the coverage. If it is just the Part D coverage for immunosuppression drugs she'll still be locked out of the insurance market for routine followup care and the inevitable hospitalizations.

Zach you're right that it would have been edifying to hear if she reached out at all when faced with the cost of her meds. I don't understand why her transplant program didn't follow up as the 36 month period loomed. Where was her doc?

Zach

"Left unsaid is the House's "pay for" - extending the MSP to 42 months. Which I think is misguided."

And once again, the "caring kidney folks" are pushing for that extended MSP as well.

Which may lead to more "out of network" dialysis patients reaching their life time insurance caps sooner.

That is unless health Insurance reform comes soon.

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