Beth-I am Curious?

Beth, please state your position is to why competition among dialysis providers would not benefit dialysis patients? Currently Davita and Fresenius control 71 percent of the dialysis provider market, resulting in numerous abuses of dialysis patients…

Please tell me why economically competition would not reduce dialysis and patient costs, as it has done in every other industry, cable television, cell phones, airlines, etc?

Read The All Nurses Message board in dialysis under Nursing specialities, it will tell you everything you need to know. :slight_smile:

If individuals in the medical field and dialysis providers are not being paid enough, why do I see luxury cars in their parking spaces???

I’m sorry, I can’t resist. Sure, if a good clinic moves into town a lousy clinic might try to do better. But I also see problems if there are too many clinics, problems I’ve read about when hospitals try to compete - doctors don’t get enough practice at their various procedures and quality of care goes down at both places. I could see that happening with dialysis clinics.

Also say clinic A has whiz-bang care and is taking workers and patients from clinic B. How might clinic B respond with it’s too few, new, and inept techs? Possibly work harder to get new patients who don’t know any better, possibly cut a deal with the local nursing home - prey on the most vulnerable? I could see that happening.

Now excuse me while I go back to living the conservative dream as an older tech worker: watching the boom and bust, working without benefits, watching my co-workers get laid off when jobs go to China, and now watching our conservative friends in congress try to kill any hope of my being able to afford health insurance for my wife. And no, I’m not in a good mood today.

From (previous) Obamacare lover: “I actually made it through this morning at 8:00 A.M. I have a preexisting condition (Type 1 Diabetes) and my income base was 45K-55K annually I chose tier 2 “Silver Plan” and my monthly premiums came out to $597.00 with $13,988 yearly deductible!!! There is NO POSSIBLE way that I can afford this so I “opt-out” and chose to continue along with no insurance. I received an email tonight at 5:00 P.M. informing me that my fine would be $4,037 and could be attached to my yearly income tax return. Then you make it to the “REPERCUSSIONS PORTION” for “non-payment” of yearly fine. First, your drivers license will be suspended until paid, and if you go 24 consecutive months with “Non-Payment” and you happen to be a home owner, you will have a federal tax lien placed on your home. You can agree to give your bank information so that they can easy “Automatically withdraw” your “penalties” weekly, bi-weekly or monthly! This by no means is “Free” or even “Affordable.””

I’m sorry but somehow I missed this thread.

Regarding the first post, I agree that competition among dialysis providers is a good thing especially if there are more than a few providers that are competing. In fact, I hate to see the mega-providers acquiring all the small and medium sized providers because I fear that patients will be more vulnerable especially if they have lower income, fewer resources, are more debilitated, and believe in-center dialysis is their only choice. I’ve known patients to travel across country to get the treatment they want at a high quality dialysis facility, but sadly everyone doesn’t have that option.

Regarding the last post, it appears that this was originally posted on Facebook by someone named Will Sheehan who may have misunderstood or may have been purposely trying to mislead people. A screen shot of the whole Facebook post and comments was re-posted to a Ron Paul Forum. Not surprising, those commenting bought the story hook, line, and sinker.

I knew the claim about the tax penalty was false since in 2014 it’s going to be the higher of $95 or 1% of 2014 income reported in 2015. However, I had never heard such crazy claims as loss of driver’s license and lien on a home. Both Snopes and Politifact have dispelled the “facts” of this Facebook post. Too bad so many people have probably accepted what was written as fact and not checked these sites.



People can lose their professional licenses if they are not current on child support, in the State of Ohio.

This isn’t related to the ACA, but it looks like people that don’t pay at least 50% of their court-ordered child support payments can not only have their professional license suspended, but their driver’s license as well. I have known parents who had to support their kids on their own without court-ordered child support because the divorced parent chose not to pay it. Having a child is a responsibility and child support should be paid when it’s due. It would be interesting to see if this approach has worked better than throwing the person in jail where there is no way they can make the money to pay the child support they owe.

In some cases, the support ordered is extreme and the father or the individual paying the support does not have anything to live on, while the custody parent is lazy and will not get a job. The custody parent should be forced to accept the burden of raising the child by working, as well as the other parent. If they will not find a job, they would have to work on a work detail, do not care if it is picking up trash, as is done in Germany. Taking care of the child is not a one way street, both parties need to support the child, not just one individual. Deadbeat Dads would be on the work detail as well, not going to let them be lazy, they will be working.

This appears to be a topic about which you have strong feelings. Both parents are responsible for rearing their child and assuring that their child has basic needs met. Each parent has a responsibility for assuring that their child gets an education and gains the life skills that will make him/her a good citizen. However, this is off topic for home dialysis and I’ll stop there.