Dear ESRD community, ie patients and staff,
For those who are not aware of it, dialysis facilities are being paid the same amount of money that they were receiving back in 1983. Imagine if you had to run a household, today, with the same money you earned 21 years ago? I would imagine that most of us would be filing for bankruptcy and eating government cheese.

Keith Mentz, the president of the National Renal Administrators Association, is fighting a valiant battle for all of us in Washington D.C. He recently sent me an 82 page document produced by the Centers for Medicare and Medicaid Services. This document outlines what Medicare has in store for ESRD providers, beginning in January of 2005. It doesn't look good, folks, especially for small independent providers. And, for small rural providers, it could be the kiss of death.

I know that there are many patients under the assumption that dialysis facilities are making money hand over fist. Well, it isn't true. Chains are surviving, simply due to volume purchase of drugs and supplies, otherwise, they would be in the same boat as the independents. Remember that we are all receiving the same amounts that we received in 1983. To prove this, I am going to provide a link at the bottom of this positing. If you go to D&T City, you will see a section called "Documents". I will post the 82 page monstrosity there and you will be able to download it and read it.

My patient representatives have read the document and the are appaulled by it. It's been a heck of an education for them, as it has been for me and my staff. Since we are a small rural facility, we are very concerned.

The upside of the document states that in January, all dialysis facilities will receive a 1.6% increase in what we are paid for the dialysis treatment. The down side is that the Director of Health and Human Services has the option of doing whatever he wants to reach a "neutral balanced budget". Neurtral balanced budgeting is clearly explained on page 67, where this document shows that it is possible, through complex math a rocket scientist would be hard pressed to understand, to receive less money than we are getting, today. Furthermore, this document says that we will be getting less money on our drugs, particularly, EPO, which is the second largest budget item in dialysis.

This government document does not make me feel hopeful about the future of dialysis and it makes me fearful for rural dialysis patients and providers. The fact is that we have the largest deficit this government has seen in decades. The piggybank is going empty and dollars must be cut. I'm saddened and disgusted that ESRD has been earmarked to be the fiscal scapegoat and sacrificial lamb of a goverment that is spending out of control.

Our government is paying private security guards $200,000+ a year to pull guard duty that a $16,000 a year soldier could do. When I was in the service, we had mess halls with sergents overseeing army privates who cooked the meals. Everything has been outsourced to private industry. All of that money being spent, which has driven our deficit up, is going in the pockets of private companies. Organizations who are doing jobs that could be done at less than a quarter of the price by government workers or our military.

I know that we are at war with terrorist, but ESRD patients must receive care and providers must have the money to carry out this important and vital mission. Every person reading this posting needs to contact their Congressperson and Senator, as well as President Bush. You need to let them know how important our ESRD system is and why we need to provide that system with enough money to carry out its mission.

If you have ever considered becoming politically involved and were looking for a reason to become motivated, this should be your motivation. It's time for patients, staff, physicians and dialysis providers to get on the same page. If we don't, we are all going to lose and lose big. Our failure to act will make us complicit in our own destruction. We must remember that we are free Americans and being such, we have a right and a responsibility to speak up when we see that our government is not operating in our best interests.

The document also provides the reader with an ecellent history of the U.S. ESRD system. It will open your eyes.

People, it's time to get involved.

Respectfully,

Joe Atkins

please go to: http://groups.msn.com/DialysisTransplantCity

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