Anyone working for FMC annoyed by this?

Mamakellyd · Nov 17, 2009

The only thing I can add (I don't work for FMC) working in a large dialysis corporation is to remember that they are all mostly for profit. I don't like it anymore than anyone else does when I see big annual reports that boast for huge financial success and very little, if any, filters down to me. But when it happens I just remind myself that I chose to work in a for profit dialysis company, and having been an administrator I know exactly what that looks like. I've done everything from being a reuse/patient care tech to staff nurse, PD nurse, charge nurse, administrator, etc. So I've seen every single side of it. As an administrator I hated having to put into place cost saving measures that I didn't necessarily agree with. But a flip side of that is to keep in mind that Medicare reimbursement for most dialysis treatments is only about $125, and then we only get 80% of that. Most of our patients don't have a secondary insurance to make up the difference and we all know they can't afford to pay it either- so we are having to dialyze most of them for very little money. Sad thing is that every other type of medical procedure (even doctor visits) are automatically adjusted upward every year- but not dialysis treatment reimbursement. It literally takes a vote in congress to get it increased, and they typically vote no because our care provided to their loved ones is the biggest drain on Medicare that there is. All the major kidney care providers have joined together to basically lobby Washington, so my suggestion is to find out what your company is doing and join forces with them to help your local US Senator and Representative see what changes need to be made. And if you're ever put in a position that forces you to go outside of the regulations or standard of care to do what has to be done remember that most companies have a compliance hotline that you can always call anonymously to make them aware of what is having to happen.

ccr53 · Nov 18, 2009

I have been working for FMC for 6 years and seems it is the same --- short staffed, small or no raises and central admissions is a waste of money! I was thinking our area manager was the worst one but seems she has company. I am currently looking for change of employment and since I really do love dialysis I regret that FMC has such poor working conditions that this is necessary. Poor staffing and quality of care in outpt units has already put patients at risk! At this point union has been mentioned but I have not been contacted. Our unit would welcome a union at this time.

Ceil

drscepura, BSN, DNP, RN · Jan 4, 2010

In the good old days we had several choices of who to work for. Now the choices are very limited. I do not like how nephrology nursing has become entwined with for profit monopoly companies like FMC and DaVita. It's time for antitrust!

NDXUFan · Jan 9, 2010

In the good old days we had several choices of who to work for. Now the choices are very limited. I do not like how nephrology nursing has become entwined with for profit monopoly companies like FMC and DaVita. It's time for antitrust!

Yes, I would agree, I am a capitalist. The dialysis chains are in need of serious competition. Normally, in the economic process, the more profit, the more competition will appear to make money. You are lucky, at least, you can leave, dialysis patients cannot leave. This is why I left Fresenius and made the switch to home dialysis. I agree with the Nursing staff, I was not impressed with Fresenius, absolutely lousy. The Nursing staff did the best that they could with what they had, which was not much. However, in about the next 5 years, I sincerely doubt dialysis clients will be coming to clinics to run on the machines. Technology is starting to progress to the point that in a number of years, this process is going to be a thing of the past. With the new technology, dialysis consumers will refuse to be institutionalized, as they are in the current situation. In fact, the dialysis industry is going to go thru a cost reduction period, because with the new technology, they will not need as many employees, not even close to what they have now. Yes, Obama is pushing his health care reform. However, the Democrats are going to pay for it, with their political lives, they are going to die in 2010 at the ballot box. If this plan is soooo wonderful, why are Obama, Pelosi, and Reid exempt, why are the rules for us and not for them? Ted Kennedy pushed for Universal Health Care, yet, that is not how he lived his life. Ted had the best health care in the world and while he had the best health care in the world, he believed that we, the common individuals, should wait months or years for our health care. Can we say Hypocrisy?

I do not blame the clinic staff, I blame corporate management. I hear the applause for "Non-profit" status. Yes, the non-profit status does have benefits. Every company, at some point, non or for profit companies must make money at some point in time. Many non-profits and for profit companies have lousy management. How do non-profits stay in business if they lose money, year, after year, after year? Poorly run dialysis clinics regardless of profit status need to go out of business for the sake of the dialysis consumer, the Nursing staff and for society, whose resources they are wasting, day after day.

Onekidneynurse · Jan 9, 2010

Yes, I would agree, I am a capitalist. The dialysis chains are in need of serious competition. Normally, in the economic process, the more profit, the more competition will appear to make money. You are lucky, at least, you can leave, dialysis patients cannot leave. This is why I left Fresenius and made the switch to home dialysis. I agree with the Nursing staff, I was not impressed with Fresenius, absolutely lousy. The Nursing staff did the best that they could with what they had, which was not much. However, in about the next 5 years, I sincerely doubt dialysis clients will be coming to clinics to run on the machines. Technology is starting to progress to the point that in a number of years, this process is going to be a thing of the past. With the new technology, dialysis consumers will refuse to be institutionalized, as they are in the current situation. In fact, the dialysis industry is going to go thru a cost reduction period, because with the new technology, they will not need as many employees, not even close to what they have now. Yes, Obama is pushing his health care reform. However, the Democrats are going to pay for it, with their political lives, they are going to die in 2010 at the ballot box. If this plan is soooo wonderful, why are Obama, Pelosi, and Reid exempt, why are the rules for us and not for them? Ted Kennedy pushed for Universal Health Care, yet, that is not how he lived his life. Ted had the best health care in the world and while he had the best health care in the world, he believed that we, the common individuals, should wait months or years for our health care. Can we say Hypocrisy?
I do not blame the clinic staff, I blame corporate management. I hear the applause for "Non-profit" status. Yes, the non-profit status does have benefits. Every company, at some point, non or for profit companies must make money at some point in time. Many non-profits and for profit companies have lousy management. How do non-profits stay in business if they lose money, year, after year, after year? Poorly run dialysis clinics regardless of profit status need to go out of business for the sake of the dialysis consumer, the Nursing staff and for society, whose resources they are wasting, day after day.

We all have to realize that Fresenius does NOT make money from dialysis treatments. Break it down at $125 per treatment. With salaries, utilities, supplies etc it's probably a break even process. Where Fresenius makes money is with it's manufacturing of dialyzers, lines, and machines among other things. I too believe home hemo is the way to go but I don't see it in the near future. Some Fresenius units are trying to start units in NH's. Seems like a good idea except CMS regs consider NH patients as Home patients and they require each patient to have their own machine. So only one shift a day unless you want to have more machines. Also, a Home/NH patient must have a 1 months supply of lines, NS, dialyzers, needles, gauze available to them. If the patient goes home, say a rehab total hip, in 2 weeks those supplies have to be thrown out. So it's a real stretch to start that type of a program.

Home hemo would be a $$$$ saver. Let the patient pay for electricity,water etc. No daily nursing expenses. Many around here have techs doing HH when the patient doesn't have a partner.

With reform I see family doing much more care for the patient. With MRSA, c-diff, and e-coli pneumonia close to rampant in hospitals now they are becoming as dangerous as they were before practitioners realized hand washing was a good thing. I see home care in all instances blooming but with family doing the bulk of the care. I see hospitals only getting the ICU type patients and then only if there is a high probability of a cure.

Reform in and of itself, as it's being touted now, will not bring down costs. And that is the real problem.. People need to take care of themselves literally and figuratively.

NDXUFan · Jan 9, 2010

We all have to realize that Fresenius does NOT make money from dialysis treatments. Break it down at $125 per treatment. With salaries, utilities, supplies etc it's probably a break even process. Where Fresenius makes money is with it's manufacturing of dialyzers, lines, and machines among other things. I too believe home hemo is the way to go but I don't see it in the near future. Some Fresenius units are trying to start units in NH's. Seems like a good idea except CMS regs consider NH patients as Home patients and they require each patient to have their own machine. So only one shift a day unless you want to have more machines. Also, a Home/NH patient must have a 1 months supply of lines, NS, dialyzers, needles, gauze available to them. If the patient goes home, say a rehab total hip, in 2 weeks those supplies have to be thrown out. So it's a real stretch to start that type of a program.
Home hemo would be a $$$$ saver. Let the patient pay for electricity,water etc. No daily nursing expenses. Many around here have techs doing HH when the patient doesn't have a partner.
With reform I see family doing much more care for the patient. With MRSA, c-diff, and e-coli pneumonia close to rampant in hospitals now they are becoming as dangerous as they were before practitioners realized hand washing was a good thing. I see home care in all instances blooming but with family doing the bulk of the care. I see hospitals only getting the ICU type patients and then only if there is a high probability of a cure.
Reform in and of itself, as it's being touted now, will not bring down costs. And that is the real problem.. People need to take care of themselves literally and figuratively.

Fresenius does not make money on Medicare patients, they make money on private insurance patients. My point is that at some place or at some point, Fresenius must make a profit. In the current form, the "health reform" of Obama, Pelosi, and Reid will not save money, costs are going to explode. Obama, Fancy Nancy Pelosi, and Reid denounce the health care industry as "greedy." I wonder if Obama, Pelosi, and Reid work for free? Home dialysis is much better for the consumer and much cheaper in the realm of costs. To greatly reduce costs, we need a free market medical system, no, the current one is NOT a free market medical system. Insurance companies are protected from competition, this has raised premiums thru the roof. In addition, over 2,000 government mandates and regulations place the health insurance policy out of the price range of individuals with a chronic health condition. In other words, the political elite is buying votes, while stabbing the health consumer in the back. Obama, Pelosi, and Reid pat themselves on the back and think, "How great we are." Yes, they think they are great as long as someone else is paying the bill, we, the people. Yes, compassion to them is when they are reaching into someone else's pocket and they are not paying the bill. Quite honestly, home patients, within reason, do not need a home partner. This is an excellent site by Dr. John Agar, Professor of Nephrology, and Director of the Barwon Clinics, he is considered the patron saint of home dialysis.

http://www.nocturnaldialysis.org

Onekidneynurse · Jan 9, 2010

Fresenius does not make money on Medicare patients, they make money on private insurance patients. My point is that at some place or at some point, Fresenius must make a profit. In the current form, the "health reform" of Obama, Pelosi, and Reid will not save money, costs are going to explode. Obama, Fancy Nancy Pelosi, and Reid denounce the health care industry as "greedy." I wonder if Obama, Pelosi, and Reid work for free? Home dialysis is much better for the consumer and much cheaper in the realm of costs. To greatly reduce costs, we need a free market medical system, no, the current one is NOT a free market medical system. Insurance companies are protected from competition, this has raised premiums thru the roof. In addition, over 2,000 government mandates and regulations place the health insurance policy out of the price range of individuals with a chronic health condition. In other words, the political elite is buying votes, while stabbing the health consumer in the back. Obama, Pelosi, and Reid pat themselves on the back and think, "How great we are." Yes, they think they are great as long as someone else is paying the bill, we, the people. Yes, compassion to them is when they are reaching into someone else's pocket and they are not paying the bill. Quite honestly, home patients, within reason, do not need a home partner. This is an excellent site by Dr. John Agar, Professor of Nephrology, and Director of the Barwon Clinics, he is considered the patron saint of home dialysis.
http://www.nocturnaldialysis.org

There aren't enough private pay patients to cover as much profit as Fresenius makes. Medicare is the bulk of their patient revenues.

How do you figure they don't need someone present when they do HD at home. What happens if they mistakenly enter the wrong goal and crash? Who'd gonna give them saline to revive them? They certainly don't need a paid partner.

Premiums have been raised because costs are up. Is your car insurance cheaper? Is your home insurance cheaper. I just find it weird that people think healthcare will get cheaper. So many seem to think the USA has an unending pot of money somewhere. We don't. I also have problems with people who think their lives and the preservation of that life should come cheap.

Another thing is that many have insurance company stocks in their 403b/401k retirement funds. Now they don't send the money they've made off those profits back to the insurance companies do they?

NDXUFan · Jan 10, 2010

there aren't enough private pay patients to cover as much profit as fresenius makes. medicare is the bulk of their patient revenues.
how do you figure they don't need someone present when they do hd at home. what happens if they mistakenly enter the wrong goal and crash? who'd gonna give them saline to revive them? they certainly don't need a paid partner.
premiums have been raised because costs are up. is your car insurance cheaper? is your home insurance cheaper. i just find it weird that people think healthcare will get cheaper. so many seem to think the usa has an unending pot of money somewhere. we don't. i also have problems with people who think their lives and the preservation of that life should come cheap.
another thing is that many have insurance company stocks in their 403b/401k retirement funds. now they don't send the money they've made off those profits back to the insurance companies do they?

i meant that they make money off of the private insurance consumer, i never said that their entire profit was from the private insurance patient, just that they do make profits from that consumer. my other point is that consumers do not need a partner during nocturnal dialysis.

dr. agar:

in our experience, this is more often an issue of ‘partner burn- out’ when the partner is trained as the dialysis ‘carer’ and thus must take responsibility for the dialysis as well as for most other family tasks. it is not our practice to train the partner as ‘carer’ but to always train the patient to self and sole care. it is of note that nhhd drop-out rates are far higher in the us which requires (carer-led nhhd) than in australia which encourages patient self-care nhhd.

the benefits of nhhd include:

no more of the usual side-effects of chd

no more ‘crashes’ from falling blood pressure

minimal (alternate nights) or no (5-6 nights/wk) fluid or dietary restrictions

no need for phosphate binding medicines if ~4-5 sessions or more are given per week

no need for bp medication for most patients

no need for a dialysis partner (see below) – solo, home, overnight dialysis is not only possible but is practical in un-partnered people.

further benefits include:

stress on the heart is diminished

calcium deposits in blood vessels regress

sleep patterns normalize to generally refreshing rest

sleep apnoea improves or resolves

thinking clears and memory improves

sexual drive/function improves

and … as the biggest benefits of all:

day-time and waking hours are given back

day-time activities return to normal without dialysis interference

energy to work and work capacity is restored

employment opportunity is again equal with people not on dialysis

independence and self-esteem is restored

costs are up, what is the current rate of inflation? how many individuals do you know that are not looking for a deal when they are buying a car, car insurance, a big ticket item, or any other consumer good or commodity? costs in the medical field will be reduced when the health care consumer has some responsibility for paying the medical bill. costs do not increase at infinite pace, forever. "if current trends continue........." the problem is, they do not always continue, they must end at some point. in the past, the medical community has not been questioned about costs, however, now, we are starting to see push back. many parts of the medical community are simply just big business, without a proven health benefit to the health care consumer, such as cholesterol medication, mammograms, exercise programs, etc. in fact, many of the newer medications are not better than older drugs. the vast majority of sectors of the american sector have undergone cost cutting, except for the health care field. costs are up, because it is what health administrators decide to spend resources on x, y, and z. the same kind of games are played at the universities.

in fact, the largest amount of money spent by the drug companies is on marketing, not research and development. the vast majority of drug reps have backgrounds in marketing, not chemistry or biology. the first goal of a drug corporation is to make a profit, not to help the health care consumer. if most patients only knew how the medical community is on the take from the drug industry............. the medical community says, "we cannot be be bought." oh really? why do you think it is that the drug industry spends over $20 billion per year wining and dining the medical establishment, because they love to give out free things? they do because it works! my r.n. sister and r.n. aunt have told me that the drug industry caters free lunches to their offices, 5 days per week. do you believe it is right for the consumer who is struggling to pay their drug bill to be paying for the medical staff's free lunches of cheesesteak subs, pizza, and danish??? the money is coming from that poor patient. the medical establishment should be ashamed. then, the poor patient goes to the appointment only to be lectured about everything under the sun, which many of those things have not been proven, the bmi index, cholesterol theory, exercise, and many other things. i have read many outstanding hard science people, including from m.i.t. and the new england journal of medicine that do not agree with these theories. if cheesesteak subs and pizza are soooooo terrible, why is the medical staff stuffing in their mouth, day after day? many individuals have started to have kidney issues from taking statins.

professor of nephrology and clinical chemistry uffe ravnskov:

"in the may 16 issue (2001) of the journal of the american medical association an expert panel from the national cholesterol education program has published new guidelines for "the detection, evaluation, and treatment of high blood cholesterol"(

read the paper). their writing seems to be an attempt to put most of mankind on cholesterol-lowering diets and drugs. to do that, they have increased the number of risk factors that demands preventive measures, and expanded the limits for the previous ones.

but not only does the panel exaggerate the risk of coronary disease and the relevance of high cholesterol, it also ignores a wealth of contradictory evidence. the panel statements reveal that its members have little clinical experience and lack basic knowledge of the medical literature, or worse, they ignore or misquote all studies that are contrary to their view.

http://www.ravnskov.nu/ncep_guidelines

professor emeritus of organic chemistry joel kauffman, ph.d. m.i.t. 14 drug patents and 100 peer reviewed publications:

relative risk reduction (rrr) is used to magnify results when

the absolute risk reduction is small. if a drug, test, or device cuts

the subjects with the medical condition from 2 in a million to 1 in

a million, the rrr = 50%. but in such a case, why bother?

. many clinical trials study mostly or entirely men, but the results

are applied to women as well.

. subjects in clinical trials may be 40-60 years old to start, but the

results are then applied to those 70-90 years old and children.

. key findings often are not in the abstracts of the articles

reporting on clinical trials.

[color=#a0522d]excerpts:

"cholesterol is always present in our blood, and is necessary for life as an essential component of membranes, of nerve junctions, and of brain function (mauch et al., 2001), and as a source of hormones."

"there was never satisfactory evidence that lowering tc or ldl in most people would be of the slightest benefit. while a correlation does not necessarily prove a cause, a lack of correlation necessarily proves a lack of cause. pretending otherwise is the scam."

dr. jerome kassirer, former head editor of the new england journal of medicine(nephrologist) "statins are worthless." my primary care physician had dr. kassirer in med school said, "he is awesome."

[color=#a0522d]this video is an eye opener:

http://www.youtube.com/watch?v=udzq7tn6dm4

[color=#a0522d]so, when you spend money are you looking to spend the most or the least amount possible? by the way, my auto insurance rates have not increased in a few years. why would you spend an excessive amount of money for no significant benefit or no statistical benefit?

Onekidneynurse · Jan 10, 2010

i meant that they make money off of the private insurance consumer, i never said that their entire profit was from the private insurance patient, just that they do make profits from that consumer. my other point is that consumers do not need a partner during nocturnal dialysis.
dr. agar:
in our experience, this is more often an issue of 'partner burn- out' when the partner is trained as the dialysis 'carer' and thus must take responsibility for the dialysis as well as for most other family tasks. it is not our practice to train the partner as 'carer' but to always train the patient to self and sole care. it is of note that nhhd drop-out rates are far higher in the us which requires (carer-led nhhd) than in australia which encourages patient self-care nhhd.
the benefits of nhhd include:
no more of the usual side-effects of chd
no more 'crashes' from falling blood pressure
minimal (alternate nights) or no (5-6 nights/wk) fluid or dietary restrictions
no need for phosphate binding medicines if ~4-5 sessions or more are given per week
no need for bp medication for most patients
no need for a dialysis partner (see below) - solo, home, overnight dialysis is not only possible but is practical in un-partnered people.
further benefits include:
stress on the heart is diminished
calcium deposits in blood vessels regress
sleep patterns normalize to generally refreshing rest
sleep apnoea improves or resolves
thinking clears and memory improves
sexual drive/function improves
and ... as the biggest benefits of all:
day-time and waking hours are given back
day-time activities return to normal without dialysis interference
energy to work and work capacity is restored
employment opportunity is again equal with people not on dialysis
independence and self-esteem is restored
costs are up, what is the current rate of inflation? how many individuals do you know that are not looking for a deal when they are buying a car, car insurance, a big ticket item, or any other consumer good or commodity? costs in the medical field will be reduced when the health care consumer has some responsibility for paying the medical bill. costs do not increase at infinite pace, forever. "if current trends continue........." the problem is, they do not always continue, they must end at some point. in the past, the medical community has not been questioned about costs, however, now, we are starting to see push back. many parts of the medical community are simply just big business, without a proven health benefit to the health care consumer, such as cholesterol medication, mammograms, exercise programs, etc. in fact, many of the newer medications are not better than older drugs. the vast majority of sectors of the american sector have undergone cost cutting, except for the health care field. costs are up, because it is what health administrators decide to spend resources on x, y, and z. the same kind of games are played at the universities.
in fact, the largest amount of money spent by the drug companies is on marketing, not research and development. the vast majority of drug reps have backgrounds in marketing, not chemistry or biology. the first goal of a drug corporation is to make a profit, not to help the health care consumer. if most patients only knew how the medical community is on the take from the drug industry............. the medical community says, "we cannot be be bought." oh really? why do you think it is that the drug industry spends over $20 billion per year wining and dining the medical establishment, because they love to give out free things? they do because it works! my r.n. sister and r.n. aunt have told me that the drug industry caters free lunches to their offices, 5 days per week. do you believe it is right for the consumer who is struggling to pay their drug bill to be paying for the medical staff's free lunches of cheesesteak subs, pizza, and danish??? the money is coming from that poor patient. the medical establishment should be ashamed. then, the poor patient goes to the appointment only to be lectured about everything under the sun, which many of those things have not been proven, the bmi index, cholesterol theory, exercise, and many other things. i have read many outstanding hard science people, including from m.i.t. and the new england journal of medicine that do not agree with these theories. if cheesesteak subs and pizza are soooooo terrible, why is the medical staff stuffing in their mouth, day after day? many individuals have started to have kidney issues from taking statins.
professor of nephrology and clinical chemistry uffe ravnskov:
"in the may 16 issue (2001) of the journal of the american medical association an expert panel from the national cholesterol education program has published new guidelines for "the detection, evaluation, and treatment of high blood cholesterol"(
read the paper). their writing seems to be an attempt to put most of mankind on cholesterol-lowering diets and drugs. to do that, they have increased the number of risk factors that demands preventive measures, and expanded the limits for the previous ones.
but not only does the panel exaggerate the risk of coronary disease and the relevance of high cholesterol, it also ignores a wealth of contradictory evidence. the panel statements reveal that its members have little clinical experience and lack basic knowledge of the medical literature, or worse, they ignore or misquote all studies that are contrary to their view.
http://www.ravnskov.nu/ncep_guidelines
professor emeritus of organic chemistry joel kauffman, ph.d. m.i.t. 14 drug patents and 100 peer reviewed publications:
relative risk reduction (rrr) is used to magnify results when
the absolute risk reduction is small. if a drug, test, or device cuts
the subjects with the medical condition from 2 in a million to 1 in
a million, the rrr = 50%. but in such a case, why bother?
. many clinical trials study mostly or entirely men, but the results
are applied to women as well.
. subjects in clinical trials may be 40-60 years old to start, but the
results are then applied to those 70-90 years old and children.
. key findings often are not in the abstracts of the articles
reporting on clinical trials.
[color=#a0522d]excerpts:
"cholesterol is always present in our blood, and is necessary for life as an essential component of membranes, of nerve junctions, and of brain function (mauch et al., 2001), and as a source of hormones."
"there was never satisfactory evidence that lowering tc or ldl in most people would be of the slightest benefit. while a correlation does not necessarily prove a cause, a lack of correlation necessarily proves a lack of cause. pretending otherwise is the scam."
dr. jerome kassirer, former head editor of the new england journal of medicine(nephrologist) "statins are worthless." my primary care physician had dr. kassirer in med school said, "he is awesome."
[color=#a0522d]this video is an eye opener:
http://www.youtube.com/watch?v=udzq7tn6dm4
[color=#a0522d]so, when you spend money are you looking to spend the most or the least amount possible? by the way, my auto insurance rates have not increased in a few years. why would you spend an excessive amount of money for no significant benefit or no statistical benefit?

in the 4th month patients can start receiving medicare. so three months isn't gonna change the bottom line. i didn't say private pay don't contribute to the bottom line. i said they are a significant contributor. why wouldn't a nocturnal hd patient not need a partner. we monitor them in the unit at night. again what if they put in the wrong goal?

you are preaching to the choir here about uhc. as for costs why won't they continue to rise? healthcare is the only service people don't even bother to check on the cost before they "buy" it. with more and more technology healthcare will continue to go up. have you purchased a new tv yet? the new hi defs have been out for quite awhile. they haven't gotten much cheaper. because they keep making bigger ones. you can't buy a $200 tv much anymore.

we have no drug reps anymore at fresenius. conflict of interest laws and company ethics prohibit it.

so are you telling me the medical profession should work pro bono? should the car manufacturers work pro bono. should kellog's work pro bono. don't you think food should be a right? what about construction workers building homes. should they work pro bono. we tried having everyone on par in the 60's. we called them communes. they didn't work then they won't work now.

please don't waste my time or yours citing anything form youtube to me.

yes, your car insurance hasn't increased because you bought a vehicle that lost 20% of it's value as soon as you drove it off the lot. buy a new vehicle and see what happens. is your life worth less every year. are you worth less at age 10 than you were at 1. shouldn't you be worth more once you leave home and have a hi paying job, read a taxpayer, shouldn't your government have a vested interest in keeping you working. they do need the money.

Trauma Columnist · Jan 10, 2010

Whew! I'm an APN who is employed by the nephroloy practice (big one) to do HD visits. I am one of 4 mid-levels that does this.

FMC does indeed make a profit - but agree that it is via machines and equipment. All I ever hear about is the cost per treatment must be less. If I want a stat lab, I must order it on a script so that it is charged to the pt, if I want a bigger dialyzer, I must have all the numbers to back it up, if I want a pt to have a specialty referral, I must make the appt because the FMC employees are only there for dialysis-related issues.

Home hemo I think is better too. In my area, MC does have a small home hemo population but Renal Therapies and Davita do too so there is competition.

NDXUFan · Jan 11, 2010

In the 4th month patients can start receiving Medicare. So three months isn't gonna change the bottom line. I didn't say private pay don't contribute to the bottom line. I said they are a significant contributor. Why wouldn't a nocturnal HD patient not need a partner. We monitor them in the unit at night. Again what if they put in the wrong goal?
You are preaching to the choir here about UHC. As for costs why won't they continue to rise? Healthcare is the only service people don't even bother to check on the cost before they "buy" it. With more and more technology healthcare will continue to go up. Have you purchased a new TV yet? The new HI DEFS have been out for quite awhile. They haven't gotten much cheaper. Because they keep making bigger ones. You can't buy a $200 TV much anymore.
We have NO drug reps anymore at Fresenius. Conflict of interest laws and company ethics prohibit it.
So are you telling me the medical profession should work pro bono? Should the car manufacturers work pro bono. Should Kellog's work pro bono. Don't you think food should be a right? What about construction workers building homes. Should they work pro bono. We tried having everyone on par in the 60's. We called them communes. They didn't work then they won't work now.
Please don't waste my time or yours citing anything form YOUTUBE to me.
Yes, your car insurance hasn't increased because you bought a vehicle that LOST 20% of it's value as soon as you drove it off the lot. Buy a new vehicle and see what happens. Is your life worth less every year. Are you worth less at age 10 than you were at 1. Shouldn't you be worth more once you leave home and have a hi paying job, read a taxpayer, shouldn't your government have a vested interest in keeping you working. They do need the money.

I bought a digital television set at Sam's Club for $199.00. Socialized medicine is awful, read the British newspapers online. I would not send my dog to the British National Health Service. Not a fan of the government or insurance companies, cannot stand either one of them. If a dialysis consumer is trained correctly, they will not put in the wrong treatment numbers, it is so easy with the new technology, we are not a bunch of bumbling fools. In fact, more than a few individuals from my home program are engineers. Everyone must work for a profit, the laws of economics will not permit Nurses, physicians, construction workers, or anyone else to consistently lose money and to stay in business. If we look at the American manufacturing sector, despite what you might have heard, is doing quite well. The average American factory worker is producing $234,000 dollars worth of value or goods and services, which is twice the level as in 1990 and three times the level of production of 1980. In other words, they are able to generate more wealth with less workers.

Monitoring dialysis consumers at night, has more to do with legal liability issues than the ability of patients to self monitor their Nocturnal treatments. In fact, Nocturnal patients can be monitored over the Internet, as has been done for years and they can be monitored with web cams, if the patient would so desire.

Laser correction surgery for the eyes has greatly decreased in price, why, very simple, competition. Why do you think that it is when you go to the grocery store that prices have stayed within a reasonable range, competition. I can mention so many consumer products that have decreased in price. The Government decided to stick its nose into the digital television situation, in other words, an unfunded mandate, they do it, morning, noon, and night. So, how has that $13 trillion in social spending been working out in the long term? It is absolute arrogance for a government official to claim that he or she knows more about your health care needs than you do. How can they know about your health care needs when they do not even know you? How does a government official know more about Nursing than you do, they do not. How does Obama, Pelosi, Reid possess the knowledge to make millions upon millions of health care decisions, each and every day??? I worked for President Reagan in 1980 and 1984, I am not a socialist, many of my friends would laugh if they heard you say that to me.

Competition cuts costs, as it has in every sector of the American economy. Profit pushes people to innovate to make our lives much better than they were in the past. Are we still a farm economy as we were in the late 1790's, of course not. In 1790, 90 percent of our labor force was in the farming community. By 1900, only 41 percent of our labor force was in the farming industry and today, only 3 percent of the American labor force is engage in farming as a full-time position. Now, you ask, as that reduction the work force hurt the output of the American farmer? Right now, if necessary, the American farmer could easily feed the entire world. This is how productive and innovative the American farmer has become with the use of advanced farming technology. Now, let us say that I want to build a 5 bedroom house, do you think that the construction workers will build my house for me, because they like me or because they want to make some money? I know they do not give a hoot about me, they want to make some money.

You and I agree that it is worth $100.00 for me to cut your lawn. Yet, the government says, "Mark, you do not have to perform a service for your fellow human being or to serve your fellow human being. "I, the Government will take what your neighbor produces and give it to you, so you can sit on your fanny and watch Oprah in the afternoon." In order to save jobs, would you suggest that we eliminate the use of robots in the factories? Capitalism is the most compassionate economic system on the planet, because it requires you to serve your fellow man or woman. When you are paying an outstanding salary to the physician or nurse, this enables them to perform a higher service or calling, such as taking care of a sick patient in the hospital, or in a dialysis unit, wealth equals compassion. When we create wealth, we give compassion to the sick and the poor, I think that is a great concept. If we cut the physician's salary by 50 percent, this still would not reduce health care costs. The vast majority of the physicians and nursing people that I have encountered, care deeply about the people that come to their office. The main reason that health care costs are out of control is government regulation and mandates. I know that physicians and nurses really hate the business side of medicine. Quite honestly, I do not believe that physicians and nurses are compensated for what they do. I would much rather pay the physician and nurse, than pay for a stupid government regulation. I get tired of the health care industry being sued for every small matter, it is silly. Obama claims to care about the cost of health care, when is he going to rein in the trial lawyers? The answer is never, they contribute millions to his campaign. He wants to talk about special interests............. Talk about favoring the rich???

CocoaGirl · Jan 11, 2010

FMC does make a profit from every medicare pt, the last newsletter put out to all employees boasts about the profit margin & the increase that was made on each tx. Every medicare pt in our clinics has a secondary insurance to pick up the 20% not covered. Believe me when I tell you that before any new patients steps foot in the door they better have insurance or our area mgr will not allow us to accept them. I agree with the above posters about needing competion in the dialysis market, FMC has the entire market in my area.