hi folks
I don’t want to pop anyone bubble , but this is what the medical world, the consumers that are in medical world will face with the new congress. Even if congress gives more $$ to every part of the medical ,(which will never happen). Those in good dialysis companines or center will still be in good places. Those of us home might still be able to stay home. But I don’t see the bad centers getting better.
I’m not not upset or any other words you may want to fix to me. I’m a realist. I know that unless you fight for what is right and are well organized. The system will spit you. I have not given in yet I still have a few cards that I will play out over the next couple of months.
I know dialysis consumers are not organize plus our #'s are way to small.
As for the groups that are there to help, have they made home dialysis easy for people to try and to even know about?I’ve talked to doctor ,nurses that don’t know home dialysis is out there. How long has home dialysis been around?
I don’t see the cause for concern. Of course the ADA takes corporate funds, just as many renal non-profits take Amgen money, I don’t see this as a pressing issue.
The idea of negotiating Part D appeals to me. It’d be great if we could tear down the artificial accounting wall between between Parts A B & D. Then the Part D savings could be used to fund additional Part B spending. My slogan for 2007: Part B spending is the solution to the rising problem of Part A & D spending (Part C spending is also in the sites of Dem budget cutters).
I’m optimistic Bob. I think we could have 12 months when merit will count.
[QUOTE=Bill Peckham;11289]I don’t see the cause for concern. Of course the ADA takes corporate funds, just as many renal non-profits take Amgen money, I don’t see this as a pressing issue.
The idea of negotiating Part D appeals to me. It’d be great if we could tear down the artificial accounting wall between between Parts A B & D. Then the Part D savings could be used to fund additional Part B spending. My slogan for 2007: Part B spending is the solution to the rising problem of Part A & D spending (Part C spending is also in the sites of Dem budget cutters).
I’m optimistic Bob. I think we could have 12 months when merit will count.[/QUOTE]
Hey Bill
I’m glad your opptimistic, a person must be to keep going when faced with chronic illness.
The point behind the NYT things was for any one to see that the battles are always there and will be there . The one ADA was about image, it is not that lobbying or giving $ to this group or this person. But the ADA is looking at how it sells it logo. Company A has one item that is good for people but 100 items that cause people to have health issues.I know that it still boils downs to each person but if you company A with ADA logo could mean to some that company A cares?
bobeleanor
HI y’all,
Home dialysis has been around for just about as long as chronic hemodialysis has–since the mid-1960s. It started in Seattle–with not enough machines and dialyzers to go around (and insurance not paying because it was considered experimental), several test sites were set up across the US with temporary government funding. One way to keep costs down was to have people treat themselves at home, so they wouldn’t be using as much staff time. Treatments were done overnight for 8-10 hours 3x/week. Seattle eventually moved away from nocturnal home hemo–and is, in fact, just now getting back into it. But Dr. Bernared Charra, in Tassin, France, has been doing nocturnal hemo (at home and in-center) for more than 30 years, with the best patient outcomes in the world. The shortest in-center treatment they permit in Tassin is 5 hours.
Nocturnal home hemo was resurrected by Dr. Robert Ulldall and Dr. Andreas Pierratos in Toronto in 1995. Dr. Uldall died, but Dr. Pierratos is still running this program. I will never forget going to the American Society of Nephrology meeting in Toronto in 2000, and seeing the huge room packed with people to listen to Dr. Pierratos telling about his patients. They ate better! They slept better! Their sex lives were better! They went back to work! They needed phosphate supplements instead of binders! It was amazing–and for me, at least, the start of a realization that it was not ESRD itself that made people feel so wretched, and need such limited diet and fluids, but rather the way we treat it with short, high UF in-center HD.
Short daily home hemo came later, with the advent of the Aksys PHD and then the NxStage System One.
As far as doctors and nurses not knowing about home dialysis, that’s a matter of PR. At every kidney meeting, there are sessions on it, more dialyzors know about it, and there are even articles in the general press. But every year there is vastly more new medical information than doctors can possibly see, let alone learn. So, it’s not going to happen overnight, but each day more folks find out about home treatments.
[QUOTE=Dori Schatell;11297]HI y’all,
Home dialysis has been around for just about as long as chronic hemodialysis has–since the mid-1960s. It started in Seattle–with not enough machines and dialyzers to go around (and insurance not paying because it was considered experimental), several test sites were set up across the US with temporary government funding. One way to keep costs down was to have people treat themselves at home, so they wouldn’t be using as much staff time. Treatments were done overnight for 8-10 hours 3x/week. Seattle eventually moved away from nocturnal home hemo–and is, in fact, just now getting back into it. But Dr. Bernared Charra, in Tassin, France, has been doing nocturnal hemo (at home and in-center) for more than 30 years, with the best patient outcomes in the world. The shortest in-center treatment they permit in Tassin is 5 hours.
As far as doctors and nurses not knowing about home dialysis, that’s a matter of PR. At every kidney meeting, there are sessions on it, more dialyzors know about it, and there are even articles in the general press. But every year there is vastly more new medical information than doctors can possibly see, let alone learn. So, it’s not going to happen overnight, but each day more folks find out about home treatments.[/QUOTE]
Hi DORI
Two things you bring up
“Home dialysis has been around for just about as long as chronic hemodialysis has–since the mid-1960s.”
So, it’s not going to happen overnight, but each day more folks find out about home treatments.[/QUOTE]
We are now in 2006, most people on dialysis don’t mind waiting. AS a group people who are on dialysis are very good at waiting. WE are the best at waiting.
Things I wanted to bring out is that there is big $$ on the table which is good. But for the dialysis folks we just don’t have the ##'s or the money. We have time
bobeleanor