By Peter Laird, MD
Davita continues to encounter more allegations of improper business dealings in civil, state and Federal investigations. (here, here and here) The allegations are augmented by whistle-blower civil lawsuits recently filed against the dialysis giant. The main thrust of the alleged illegal business arrangements focusses on the issue of improving Davita's bottom line at all costs but doing nothing to improve patient outcomes:
"The complaint makes clear that for years, DaVita has used different sets of rules to game the Medicare system and illegally inflate their government reimbursements at taxpayer and patient expense," said L. Lin Wood, attorney for the whistleblowers. "Taxpayers and patients should feel a sense of outrage when they read the complaint and learn how DaVita has become a multi-billion dollar business due in large part to corporate strategies and protocols focused on extracting every dollar possible from the government rather than on improving the care of chronically ill patients."
The allegations against the dialysis industry as a whole of placing greed and profits above patient outcomes is not new. Belding Scribner, the inspiration behind chronic hemodialysis spoke out against the for-profit dialysis practices that have resulted in the developed world's worst patient outcomes . Dr Scribner spent his last remaining years critizing the emphasis on profits instead of saving lives with this unique technology. Dr. Scribner ironically gave up the riches of his shunt invention and instead focussed on simply saving lives when he gave his shunt freely to the world lending his criticism more relevance:
A less known aspect of Scribner's world-view was his abhorrence for the contaminating effects of the profit motive on medical care. He felt strongly that a physician's commitment to a patient should not be tainted by profits. “He was disturbed that what had been a ‘noble experiment’ was degenerating into a rush for profits,” says Dr Christopher Blagg, professor emeritus of medicine at the University of Washington. “In 1960 it wasn't usual for academic physicians to patent inventions. They sort of gave them away. He joked that if he'd patented the shunt he could have bought an island,” said Dr Blagg. “He was upset that academia was becoming more and more involved with commercial entities.”
Today, many aspects of the American dialysis experience of rapid patient turnover, short treatment times compared to other nations and overly aggressive ultrafiltration are directly attributable to the for-profit dialysis industry which has worse outcomes than the non-profit dialysis providers as noted in a recent study.
Newswise — If you need dialysis for advanced kidney disease, where you get it could make a big difference. A large study found that patients in certain large chain facilities are significantly more likely to die than those treated elsewhere. Mortality was also higher in for-profit than non-profit dialysis centers.
“The differences were not minor,” said Yi Zhang, Ph.D., lead study author. “We need to find out what caused them.”
Whatever the outcomes of all of the DaVita investigations is, America is already under an indictment of the love of money more than the love of man in many aspects of health care. In my opinion, the love of money is most noted especially in the American dialysis industry that continues to reap the benefits of huge profits while delivering the highest mortality and worst outcomes of all the developed nations. It is time to place saving lives as the highest goal of dialysis treatment. Americans are not getting their money's worth out of delivering huge profits to these large dialysis organizations that dominate the provision of dialysis today. Many note that where there is smoke there is fire. If so, DaVita certainly may be on fire today.