Keeping New York Safe From Big Dialysis

Kerry Howley | December 28, 2006

New York has some of the worst kidney dialysis care in the country, and diabetic New Yorkers are dying of complications in relatively high numbers. Analysts blame understaffed mom-and-pop dialysis operations. Big national chains provide better care, and their patients are simply less likely to die. There aren't many national chains in New York. And that's because the state has banned them:

The ownership restriction...was intended to ensure that hospitals are responsive to local concerns, not to far-flung shareholders. Though the Health Department talks of changing the law, no one has made it a priority, and not even the large chains have pushed the issue in Albany.

Better dead than Wal-Martized! Ron Bailey cast a wary eye on New York's compulsory diabetic surveillance program back in July.

Comments

|12.28.06 @ 12:03PM|#

The ownership restriction...was intended to ensure that hospitals are responsive to local concerns, not to far-flung shareholders.

Bullshit. The ownership restrictions are intended to insulate local constituents from national competitors. The public be damned.

Sam Franklin|12.28.06 @ 12:04PM|#

In 1980, fewer than 50,000 people in the United States needed dialysis to do the work of their kidneys; today, there are more than 350,000, including roughly 24,000 in New York. In 1980, diabetes was the primary cause of kidney failure for fewer than 6,000 dialysis patients; today, the figure is about 150,000.

Anybody want to guess what I, Sammy Franklin, make of this data.

This paragraph seems a lot bigger and more important than either the rest of the article Ms. Howley linked and Ms. Howley's reaction to the article.

dhex|12.28.06 @ 12:20PM|#

what's it like being a monomaniacal bore? is it awesome? IS IT SUPER COOL?

|12.28.06 @ 12:23PM|#

"Better dead than Wal-Martized."

Yeah, cuz nobody get's that big box feeling in a hospital, and I hear they underpay their doctors. If you're going to make fun of us rabid anti-Walmartites, at least grab a clue. You make it sound like "development" or "chain of stores" are the evil concepts, and anything "mom & pop" is liberal heavan. Mom and Pop dialysis? C'mon. I'd rather eat shit and die...quite literally in this case.

|12.28.06 @ 12:39PM|#

I'd like to seem some good ol' capitalistic competition come to the dialysis field. Dialysis will prolong your life, in exchange for a life of hell on earth. Anything like $$$ that will motivate someone to make radical changes to upgrade the technology is OK by me.

Miggs|12.28.06 @ 12:41PM|#

Lamar,

werd yo.

|12.28.06 @ 1:33PM|#

Bullshit. The ownership restrictions are intended to insulate local constituents from national competitors. The public be damned.

Bingo.

|12.28.06 @ 2:01PM|#

Anybody want to guess what I, Sammy Franklin, make of this data.

I'm going to guess that it's not that medicine has advanced to the point where people with severe kidney problems can survive long enough that they can use dialysis. Or that with an increased life expectancy, people are more likely to have organ failure, and diseases like diabetes than if they'd died in their fifties.

No, I'd expect the real cause is a conspiracy between government and huge corporations and the use of a dangerous substance in the food supply.

Thomas Paine\'s Goiter|12.28.06 @ 2:03PM|#

And to think, all those lazy, fat New Yorkers have to do is get up off of their ass and burn some of the massive amounts of calories that they consume daily.

Sam Franklin|12.28.06 @ 2:03PM|#

David:

what was the average life span in 1980 compared to now? Have we seen a seven fold increase in that? Two fold? Any fold?

Thomas Paine\'s Goiter|12.28.06 @ 2:04PM|#

I'm going to guess that it's not that medicine has advanced to the point where people with severe kidney problems can survive long enough that they can use dialysis. Or that with an increased life expectancy, people are more likely to have organ failure, and diseases like diabetes than if they'd died in their fifties.

Or that a sedentary lifestyle, combined with access to extremely inexpensive food has caused people's asses to grow twenty-fold.

Sam Franklin|12.28.06 @ 2:13PM|#

lots of wishful thinking here, but a small marginal increase in either life exteptancy or weight should not be leading to a seven fold increase in diabetes. What is that? An 800% increase?!?!?!?

The 30-fold increase (6000 to 150,000) in dialysis related deaths may indeed be due somewhat advances in other technologies. it may be due to big dialysis manipulating the statistics, but whatever -- a 30 fold increse in fatalities over a 26 year period is a major screw-up, and it is difficult not to see the diabetes explosion as a huge part of the reason, moreso even than big asses.

|12.28.06 @ 2:25PM|#

Why not start with life expectancy for people diagnosed with kidney disease? You wouldn't need even a huge increase in years for the number of people using to skyrocket.

I think the 6000 to 150,000 deaths is probably due more to a change in how the deaths were diagnosed than a real increase of that size.

Thomas Paine\'s Goiter|12.28.06 @ 2:28PM|#

lots of wishful thinking here, but a small marginal increase in weight should not be leading to a seven fold increase in diabetes.

Which study are you referring to?

Sam Franklin|12.28.06 @ 2:37PM|#

on life expectancy this one:

http://www.cdc.gov/nchs/data/hus/hus05.pdf#027

i think the most relevant part of the table, for present purposes would be the life expectancy at 65 portion.

From this portion of the table we see that life expectancy went up 2 years from 1980 to 2003 (most recent year).

Saying that a 2 year increase in life expectancy leads to a 7 fold increase in diabetes incidence is ridiculous. I know why the people who believe that continue to believe that. It is what they want to believe. there is nothing about diabetes such that a person living a couple years longer is 7 times as likely to get the disease. that just doesn't make sense.

|12.28.06 @ 2:39PM|#

Anybody want to guess what I, Sammy Franklin, make of this data.

No.

|12.28.06 @ 2:41PM|#

Did you guys see the line in the article that points out that 90 percent of kidney dialysis is paid for by the theft of our money (aka Medicare)?

Thomas Paine\'s Goiter|12.28.06 @ 3:05PM|#

on life expectancy this one:

Which completely evades my question. Good job.

Thomas Paine\'s Goiter|12.28.06 @ 3:07PM|#

Did you guys see the line in the article that points out that 90 percent of kidney dialysis is paid for by the theft of our money (aka Medicare)?


http://finance.yahoo.com/q/bc?s=FMS&t=5y&l=on&z=m&q=l&c=

Sam Franklin|12.28.06 @ 3:23PM|#

Which completely evades my question. Good job.

Okay, if big fat asses and two extra years of life expectancy cause a seven fold increase in diabetes, then why don't they also cause a corresponding increase in, say heart attacks? heart attacks are related to ass size, right? older people get heart attacks more than young people? wouldn't the heart attacks increase seven fold for these reasons just like diabetes does?

There is more to this horrific diabetes increase than simple life expectancy and fatter asses.

|12.28.06 @ 4:06PM|#

Oh, you mean Kerry Howley's attempt to latch this issue onto "Walmart" was a total dodge of the real issue? Figures.

Miggs: "werd" is not in my vocabulary. Please restate.

Thomas Paine\'s Goiter|12.28.06 @ 5:04PM|#

Okay, if big fat asses and two extra years of life expectancy cause a seven fold increase in diabetes, then why don't they also cause a corresponding increase in, say heart attacks? heart attacks are related to ass size, right?

"The leading therapeutic classes in 2003 sales were cholesterol-lowering agents, with $13.9 billion in US sales, up 10.9% from 2002;"

http://www.medscape.com/viewarticle/479951

"The first agent isolated was mevastatin (ML-236B), a molecule produced by Penicillium citrinum. The pharmaceutical company Merck & Co. showed an interest in the Japanese research in 1976, and isolated lovastatin (mevinolin, MK803), the first commercially marketed statin,"

So statins were used to treat high cholesterol, which leads to coronary heart diseas and which causes heart attacks. This would diminish the number of heart attacks and slow any linear relationship with weight.


older people get heart attacks more than young people? wouldn't the heart attacks increase seven fold for these reasons just like diabetes does?

In your fantasy world, yes. In reality, no.

There is more to this horrific diabetes increase than simple life expectancy and fatter asses.

Yeah, keep digging. Ignore those giant nuggets of truth along the way.

|12.28.06 @ 5:07PM|#

What about incidences of goiter, hmmm?

Sam Franklin|12.28.06 @ 5:08PM|#

Kerry knows what she is doing. I mean, if she had wanted to a blog post that said "700% Increse in Diabetes Over last 25 years" do you think they would really let her?

So she does a little strategic misdirection so she can slip us some info we actually need to hear. End justifies the means. She is smart enough to understand that no one is going to care about a few extra deaths due to sub-standard, small entity dialysis when there are hundreds of thousands extra untimely deaths due to the diabetes spike itself.

Sam Franklin|12.28.06 @ 5:22PM|#

What about incidences of goiter, hmmm?

Well, let's see. There was a defect in certain food supplies, so they studied the food, identified the defect, figured out a way to modify the food to correct the problem, enacted government regulations requiring (in over 100 countries) that the food be modified in the way that prevents goiter, and wiped out the problem, at least in the part of the world with money.

Now I wasn't suggesting that the government regulate the manufacture of HFCS the way it regulates the manufacture of table salt. However, your analogy is pretty thought-provoking there . . .

Gen. Jack D Ripper|12.28.06 @ 5:28PM|#

Mandrake, do you realize that in addition to fluoridating water, why, there are studies underway to fluoridate salt, flour, fruit juices, soup, sugar, milk... ice cream. Ice cream, Mandrake, children's ice cream.

|12.28.06 @ 5:33PM|#

I find the diabetes spike disturbing, though I don't think it is news to anyone. I am also troubled by the fact that New York is actively preventing diabetics from getting the best care available. I didn't realize that I had to pick one, or that to post about one problem is to deny the existence of another.

|12.28.06 @ 5:34PM|#

This kind of protectionist measure is insignificant compared to the general legal protections the medical lobby has managed. Dialysis is just one of hundreds of bread and butter procedures doctors have managed to keep for themselves. Butt scopes, laser eye surgery, botox; I think that most states require a dermatologist staffed for any spa that does strong chemical peels. There are countless trivial and routine procedures like these that cost far more than they could. I feel a bit ambivalent just saying this. My wife aspires to be a Nephrologist and this sort of thing will money in the bank.

|12.28.06 @ 5:35PM|#

That's because you don't live in conspiracyland, as "Sam" does.

|12.28.06 @ 5:39PM|#

What Kerry isn't telling you is that she didn't post those numbers because at every staff meeting an ADM executive announces the agenda for the blog. His bodyguards carry dart guns, and every dart injects a lethal dose of corn syrup. If you don't follow the rules, you sleep with the corn husks.

And for anybody who thinks I was serious, you might want to ask the Secret Designers to tweak the microchip implanted in your brain.

Sam Franklin|12.28.06 @ 5:45PM|#

I find the diabetes spike disturbing, though I don't think it is news to anyone. I am also troubled by the fact that New York is actively preventing diabetics from getting the best care available. I didn't realize that I had to pick one, or that to post about one problem is to deny the existence of another.

I didn't accuse you of denying the existence of the diabetes spike. What I "accused" you of playing a little trick on your paymasters to get a timely reminder of the diabetes spike into an HnR post without management coming down on you. The only thing you are denying is the (excellent) stealth publicity you did today.

Robert|12.29.06 @ 1:41AM|#

30+ years ago the way we got around this was operating Biomedical Applications of the Bronx, Inc. (the Bronx Dialysis Center) as a franchise of National Medical Care, Inc. Years later I worked in R & D at NMC, and then Fresenius AG acquired them.

dhex|12.29.06 @ 9:54AM|#

LONG LIVE THE CORNFITADA!

Sam Franklin Responds To dhex|12.29.06 @ 10:14AM|#

what's it like being a monomaniacal bore? is it awesome? IS IT SUPER COOL?

http://www.reason.com/blog/show/117479.html
(1.22p entry)

dhex|12.29.06 @ 10:54AM|#

so it's like a tedious cry for help?

Sam Franklin|12.29.06 @ 11:02AM|#

I didn't come here for help. I came to this thd to discuss why New York State is providing its welfare (Medicaid) funded recipients of dialysis less than the best dialysis that money can buy.

dhex|12.29.06 @ 11:18AM|#

no, you came to beat on your dead horse, like a starving mother nursing a dead child she cannot bear to bury.

"What I "accused" you of playing a little trick on your paymasters to get a timely reminder of the diabetes spike into an HnR post without management coming down on you."

normally, i would accuse you of being a tremendous comedian. however, with so much evidence leaning towards your seriousness on this issue, i can only accuse you of being somewhat legendary. not really a troll, and not really a jerk, but some sort of fusion of the two. jertoll? trollerk?

neologisms can be tricky sometimes.

|12.29.06 @ 8:23PM|#

PKD wrote a little about mental illness. In one book he wrote about the sufferer getting stuck on a single note, so to speak, and ceasing to be a human being, but becoming a reflex arc.

That's your random PKD thought of the day.
Happy New Year!
Now drink your HFCS.

|12.31.06 @ 8:10PM|#

"I came to this th[rea]d to discuss why New York State is providing its welfare (Medicaid) funded recipients of dialysis less than the best dialysis that money can buy."

Perhaps because they aren't buying anything. While I support free or reduced-cost medical care for many poor families, it is a handout. We can't just fly every poor diabetic to Massachusetts General for personalized care.