How dialysis is monetized in the United States

Knowing that kidneys have unquantifiable benefits to life, academics and researchers have given up on new technologies and treatments to stop kidney deterioration. After booming in search of a palliative option to ensure survival, dialysis is going monetized, at least in the United States. What’s happening in the medical world? Why is this important process primarily about profit?

Tom Mueller is a best-selling author New York Timessuper virginity,” about food fraud, and “A Crisis of Conscience,” about whistleblowers and their enemies. With appropriateness and sensitivity, Mueller delves into the little-known world of kidneys and their fundamental importance in keeping us alive. It’s function, its pain and its disorders.

“There are many causes of kidney failure.. Time wears them down: Between the ages of twenty and seventy, most of us lose half our kidney function as the nephrons (the main functional units of the kidneys, responsible for removing metabolic waste and excess fluid) gradually shrink.water),” wrote Literary Center

Some people are born with genetic disorders and developmental malformations that accelerate kidney deterioration. Inflammatory and autoimmune diseases can also damage our nephrons, as can sudden injuries, heart attacks, or any other accident that cuts off blood flow to the kidneys. Signs of these diseases have been found in the kidneys of Egyptian mummies and later famous people.

From the rise of medicine to the monetization of dialysis

In “How Our Kidneys Keep Us Healthy—and What It Means When They Fail,” Muller noted that Mozart appeared to have died of kidney failure after a severe streptococcal infection.

Buffalo Bill Cody lost a kidney due to long-term use of headache powder. A similar painkiller, Bex Powders, caused a rash of kidney disease in post-World War II Australia. Sir Bernard Shaw died of acute kidney injury after falling from a fruit tree while pruning it.

Recently, Veronica Lake’s kidneys stopped functioning after long-term cirrhosis. Dexter Gordon lost a kidney to cancer, and chess prodigy Bobby Fischer died of kidney failure due to a urinary tract obstruction and refused medication or surgery.

Diabetes, obesity and hypertension have become health epidemics in the West in recent decades. They are the three main causes and accelerating factors of kidney failure. Each condition can damage the kidneys or increase stress on them. In the United States, more than 60% of patients newly diagnosed with kidney failure also have diabetes.

Nephrology and patient hope are born

Certain drugs can damage our kidney units, the most serious of which are NSAIDs such as ibuprofen (a modern alternative to Bex powder). as well as some antibiotics, blood pressure medications, and chemotherapy drugs. “Today, it is estimated that approximately 37 million adults in the United States have some degree of kidney disease, and nearly 800,000 have kidney failure,” he noted.

In 2020, when COVID-19 decimated the dialysis population, these numbers were still increasing. For the first time since the U.S. government began recording kidney failure statistics in 1973, the number of patients receiving dialysis has decreased.

To solve the age-old curse of kidney failure, medicine came up with dialysis. From the end of World War II to the 1960s, doctors in Europe and North America built various devices that could remove waste products from patients’ blood. Additionally, excess fluid is naturally eliminated by healthy kidneys.

A team of doctors and talented loners, many of whom were talented engineers and craftsmen, as well as healers, built a simple blood-purifying device, Muller said. From sewing machine motors, ice cream machines, aircraft parts and sausage casings. Likewise, they invented new ways to connect them to the patient’s circulatory system.

In doing so, they made medical history. Doctors have managed to replace a vital organ with a machine, halting the progression of a hitherto fatal disease. Death can sometimes be delayed for decades. A new branch of medicine was born, “nephrology,” from nephrós, the Greek word for “kidney.”

progress and specialization

Advances in dialysis technology have been accompanied by the development of kidney transplants and related therapies that suppress the immune system. Makes the recipient’s body more receptive to the donor’s organs. In 1954, doctors at Peter Bent Brigham Hospital in Boston performed the first successful major internal organ transplant. Dialysis continues to save lives, but its heroic mission has been obscured by monetization.

One of Ronald Herrick’s healthy kidneys was removed and transferred to his twin brother Richard, a victim of incurable kidney disease. Lung, liver, pancreas and heart transplants followed. «This is the heroic age of medicine. “Revolutionary surgical procedures and novel devices have led to advances in many once-fatal conditions,” he added.

It was a period of intense intellectual enthusiasm. Academic doctors armed with new technology took on humanity’s most formidable foes and seemed to emerge victorious.

international era. Physicians at hospitals in Seattle, Boston, Toronto and Paris, as well as small towns in Sweden and the Netherlands, are creating advanced kidney knowledge centers. Other doctors came to the sanctuary as pilgrims from around the world. They return home having absorbed the wisdom of nephrology and become their own disciples.

In New York, Leonard Stern founded the dialysis program at Columbia University. He remembers his medical school training and residency in the early 1970s, an emerging specialty that was just getting its name.

“I immediately went into nephrology because it fulfilled my need to understand how things work. It was the only specialty at the time that could examine a patient’s metabolic status. Identify the disease and intervene in hopes of correcting it,” Stern said.

At the top

Nephrology and dialysis have no tradition of monetization; they are about serving patients. In nephrology, one might decide, “Well, this is what could happen.” And then the patient senses that, and then we can analyze how they got there. For me, nephrology became a way of thinking about the world and the patient as a whole, not just the kidneys. “

That same year in Melbourne, John Agar, who was awarded an Order of Australia in 2009 for his services to renal medicine, remembered how he and his colleagues viewed nephrology as “a field with great promise” . After completing nephrology training in Melbourne and spending a further year at the University of Massachusetts Medical Center, Agar established a dialysis center in Geelong, southwest of Melbourne. His approach and guiding ideology have helped shape the practice of nephrology in Australia and New Zealand. He also spent a critical period working at the University of Toronto, where he learned the latest technology in home nocturnal dialysis, an innovative treatment method.

technology stop

According to Mueller, “When I began my nephrology training in 1972, it was an exciting and rapidly growing field.” “This seems to be the future of medicine. We are way ahead of gastroenterology and cardiology. We are the only specialty that can replace a vital organ. Not only can we replace it artificially, we can replace it with a new transplanted organ. I Running around Melbourne with an Esky cooler filled with donated kidneys! “We’re also on the cusp of xenotransplantation, or so we think. “

“We’ll be able to transplant pig organs, monkey organs,” Agar explained. “Even breeding special animals to give us an unlimited number and variety of kidneys for transplantation without the need for human donors at all.”

He continued, “Dialysis is about empowering patients. Not only does it save their lives, it gives them the skills to take care of themselves. This all happened when I started practicing nephrology.” But, “Since Across the world since 1972, the original promise of dialysis has disappeared,” and monetization has something to do with it.

New technologies for treating kidney failure patients excited young doctors like Leonard Stern and John Agar in the 1970s, but no significant progress has been made in half a century, Mueller said.

“What was once boundless hope has now turned into boundless disappointment,” said John Agar. “Dialysis is at a standstill around the world. The United States is in crisis, with high rates of infections, heart attacks, and other dialysis disasters. Patients are forced to undergo a round of harsh treatments that are more than painful and debilitating , and often results in medical harm.”

Profits arise to save lives

“About 22% of patients in the United States die each year, and survival rates are among the lowest in the industrialized world,” said Leonard Stern. “The mortality rate in Japan is only 5 to 6 percent per year. In Western Europe, it’s between 9 and 12 percent per year. So what’s the difference? First, most dialysis in the United States is for profit. And for profit Sexual businesses always have lower survival rates than nonprofits.”

After decades of the rise of for-profit dialysis and the deterioration of care in the United States, many veteran nephrologists, such as John Agar and Leonard Stern, had seen enough. “I’ve been telling my American colleagues for years: You have to stop killing your patients,” Agar said.

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