Alwin Hawkins is a critical care nurse and therefore is on the front lines of the health care battles. He offered some interesting pushback on the article I published recently on the proposed Medicare bill that would increase the level of payment to dialysis centers at the expense of home dialysis.
I didn’t suggest that the reimbursement rates should be cut, just that they shouldn’t be increased, and not at the expense of home dialysis. The corporation that owns the dialysis center I use is looking at an annualized profit (based on Q1 financials) on the order of US$160 million this year.
Here’s how I would support an increased reimbursement rate (subject to change after the Philadelphia subpoena of DaVita records runs its course):
Normalize the Medicare and private insurance payments to the providers. This would stop the private insurance gouging and lower customer premium rates.
Increase the RN compensation by 20% (in the Twin Cities the current median RN salary is U$50,000 per year; this would bump it to US$60,000 for dialysis RNs). No offense to the critical care RNs, but I think they already get a pretty good “hazardous duty” bump and have manageable case loads.
Increase the compensation of dialysis techs with five years experience by 40% over the next five years. This would bring the pay rate for dialysis techs with five years experience to just under US$30,000 per year in five years. At that rate, the field to pick from would be of significantly higher quality.
Mandate adequate dialysis center staffing and manageable case loads for doctors, nurses, and technicians.
Of course the real solution is to take the profit motive out of health care altogether and pay everyone in the field a decent living wage. I mean, how did we ever allow ourselves to get in the situation where corporations are making enormous profits on the misfortune of others? The solution is to implement the solutons proposed by Marjorie Kelly and David Korten with regard to financial reporting and corporate aristocracies. More on that later.
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