End State Renal Disease (ESRD) is the only disease condition that is covered by Medicare regardless of patients’ age. This benefit was passed in 1972. One result of Section 299I of Public Law 92-603 is that Medicare pays for two-third of dialysis patients, down from 87% in 2004. When your kidney function falls by 85% to 90% your kidneys can no longer keep you alive. According to the National Kidney Foundation, the average life expectancy on dialysis is 5 to 10 years, but many people live much longer when their dialysis is tailored to their needs. This often does not happen due to the United States’ mostly one-size-fits-all approach to dialysis, which is not ideal.
Category: Single-Payer/Medicare-for-All
How Medicare Advantage Saves Taxpayers Money
Here is one example:
The Medicare Advantage plans know that 90 percent of the amputations are caused by foot ulcers and that you can reduce foot ulcers by over 40 percent with clean socks and dry feet. Medicare Advantage plans have staff working on dry feet and clean socks, [while] the fee-for-service providers who make more than $100,000 for each amputation in their fees actually had an increase in cases during covid because it’s so profitable.
The [MA] special-needs plans had almost no amputations.
How Medicare Encourages Hospitals to Monopolize the Medical Marketplace
In 2016, the first hour of chemotherapy infusion — one of the most common services billed by oncology practices — was reimbursed at $136 for physician’s offices, while payment for hospital outpatient departments was 106% higher, at $280…. This year, this payment disparity has jumped to 158%, with physician reimbursement declining to $129 and the outpatient department rate increasing to $333….
Saturday Links
- Reprint of a Uwe Reinhart classic: how Republican administrations gave us health care price controls and Keynesian economics fiscal policy.
- OxyContin and the Sacklers return to TV in a Netflix series fact checked by Slate.
- Blue Shield of California tears up the prescription drug playbook and partners with Mark Cuban Cost Plus Drug Company. (WSJ)
- Did you know the US government is stockpiling cheese ….. and raisins?
- What happens to the roughly 20 million people slated to lose Medicaid coverage? The vast majority have other insurance and apparently didn’t need to be on Medicaid in the first place. (WSJ)
- COVID experts calling for masks again — even at home!