WASHINGTON – Dialysis patients got a six-month reprieve in December when both the Senate and the House approved the Medicare, Medicaid and SCHIP Act of 2007. However, many groups are still worried because there will be more legislation to fight over next year.
Some issues are still unresolved: Kidney patients are going to have to fight to maintain the period of time before Medicare kicks in as a secondary payment (MSP) again next year.
“Originally this was a proposal for a 12-month MSP extension which the Congressional Budget Office (CBO) scored at $1.2 billion in saving to Medicare over 10 years,” said Virginia Rodin of the Service Employees International Union (SEIU).
Medicare can cover a patient on dialysis for $67,000 per year, compared to the estimated $180,000 a private employer pays.
With the proposed bill, the dialysis industry, including top guns DaVita and Fresenius, would cash in a $3 billion windfall over the next decade if they succeed in persuading Congress to make patients wait longer for affordable care. American employers and their workers would pay the large figure.
Congress lengthened the waiting time from 12 months to 30 months as part of the Balanced Budget act in 1997.
The average survival rate for people on dialysis machines is four years, and much of that time is spent waiting for Medicare to kick in as a primary payer for treatments, according to Kris Robinson, CEO of The American Association of Kidney Patients (AAKP).
“We want patients to have the benefit of the Medicare coverage,” she said.
According to the SEIU, the Medicare as a Secondary Payment (MSP) extension will drive up costs for employers and is a perfect example of what is wrong with the U.S. healthcare system.
Union officials say the proposed bill would make healthcare costs more problematic. They note that patients’ families face hardships because insurance companies, already faced with the high cost of dialysis, aren’t affording them any coverage.
“Some [dialysis patients] can work part-time, but after treatments your muscles ache, joints ache, you can have low calcium, low blood pressure,” said Juan Basile, a dialysis patient since 2006. “I am one of the people that can work full time, but many are afraid to leave their comfort zone, where they know they can receive treatments. It makes life tough.”