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Wednesday, February 02, 2011


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Miriam Lippel Blum

They should be picketed outside their building and media attention should be brought to their abysmal policy.

Bruce Carter

Peter, count your blessings that you are one of the fortunate few with access to a relatively efficient non-profit HMO, unlike the majority of Americans. In any other industry, these practices would be grounds for class action lawsuits--but until the law changes (and last year's healthcare "reform" failed in this regard) giving consumers the ability to hold insurance companies legally accountable for their practices, little will change. The issues you address in your blog are part of a larger picture:

Good luck though--sometimes bad PR and exposure leads insurers to do the right thing.

roberta mikles

This is outrageous. To recall, in WA state there are limited insurance plans available to anyone. The entire insurance industry might be changing besides rising prices.
Roberta Mikles


In the area I work in - upstate New York, I am not aware of any insurances that cover more than thrice weekly dialysis. The facility has always had to absorb the additional cost (and lose money on the option).

Peter Laird, MD

Dear LS,

Unfortunately, the payment structure for dialysis has not supported daily dialysis options even though many studies show it is MORE cost effective in total than the usual care in-center schedule and it has signficantly improved outcomes. Although individual dialysis units cannot see all of the cost savings themselves, that is not true for an integrated medical group such as Kaiser or in this instance Group Health, yet Group Health chooses to not fund and support these modalites despite the benefit to patients and reduced secondary costs such as hospitalizations.

Kaiser on the other hand does support these programs which is truly a "win-win" for both patient and medical group. Perhaps someday, all insurance groups will place both goals into practice.

home owners insurance company

This is a controversial restrictions. What if the patient is no longer mobile and needs a home dialysis done as prescribed by the doctor?

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