From Forbes:
Compared to the baseline wave (conducted in June 2009), medical directors report a significantly higher awareness of the ESRD bundle and have become decidedly more negative about the impact to patient outcomes. Close to three-quarters of the respondents now expect bundling to have a “negative” impact on patient outcomes, compared to 43% in June. An area of particular concern for the research participants is the inclusion of oral medications (phosphate binders and cinacalcet) in the proposed rule, which was released in September.
Almost half of the respondents indicated active or planned pilot programs to evaluate the impact of various clinical strategies under the new payment system. A majority of respondents anticipate a decrease in the use of ESAs through a shift to subcutaneous dosing, potentially lower hemoglobin targets and dose limitations in select patients. In bone and mineral metabolism, more than half of the medical directors suggest that a shift to calcitriol (from Abbott’s Zemplar and Genzyme’s Hectorol) is likely and a major offset to Amgen’s Sensipar is projected. And although an increase in the use of calcium based phosphate binders was deemed to be “not in the best interest of the patient” by a majority of medical directors, future market share projections indicate increased use of these agents in place of more expensive, non-calcium agents such as Genzyme’s Renagel/Renvela and Shire’s Fosrenol.
The third wave of this research will be fielded following the release of the final rule which is expected in the next few months.
Commentary from somebody who has a loved one on dialysis:
Did you get that? What the doctors have established as the best care for ESRD? They can’t give you that under Obamacare and they have been figuring out the minimum they can do on what they will have now that will keep you alive – barely. This is important for you to understand. This is real. It is happening right now under Obamacare. Am I reaching you yet?
What this is, is people who have been forced into Medicare by machinations designed to help the poor and unless they can pay for the treatment on their own without the assistance of insurance, because private insurers won’t cover it, because the government covers it … they are now subject to rationing. Was that clear enough? I can never tell. This is your future.
I don’t expect you to give a rat’s ass about people with a disease you’ve never heard of, getting ‘free” treatments when – if poor – they would probably be dead, so beggars can’t be choosers. I expect you to understand that the way this works is the way Obamacare will work and while it’s admirable to care for the poor, the people who are average, middle class workers are sucked under and their options are stripped from them. And. At the whim of the government. They are looking at a modern zombieland with no way to save themselves from the budget cuts. Their treatments will be cut from the more expensive drugs and care that keeps them active and productive, to just barely enough to keep them breathing and there is not a damned thing they can do about it unless they are rich.
This, my friends, is YOU in five years. Never has a Medicare cut demonstrated more clearly that the government, when given the power of life and death over people, will begin by allowing you to live – and thanks a lot for that, btw – and then when money is tight or priorities are different, they drop you into the abyss. You’re ability to find your own way – all avenues you might have used to save yourself are cut away because the private sector cannot compete, and WILL not complete with the US Government.
Starting in 2011, your life will be in danger from the Federal Government if you require dialysis.
A1A South 
Negative Impact of Obamacare Continues … at Bride of Rove said,
March 29, 2010 @ 7:01 am
[…] South is also on it Blog Post Below: Over at Carol’s place she has a post on the first wave of obvious […]
Jenn Oates said,
March 30, 2010 @ 5:59 pm
The older I get, the more this sort of thing terrifies me, and I’m not even on dialysis.
swampie said,
March 30, 2010 @ 8:26 pm
Yeah, me too! I don’t like the idea that some grumpy government hack that can’t read or understand the medical records will just decide to deny treatment because they can’t get laid. And, of course, can’t be sued by the denyee or their survivors.
RebeccaH said,
March 31, 2010 @ 10:13 am
When black people start screaming “racism” at opponents of Obamacare, they should be reminded of the high rates of hypertension and diabetes among black folks… which often lead to a need for dialysis.
john said,
January 19, 2011 @ 2:25 pm
I’m 24 and on dialysis, at least until I can get a transplant, and the idea that I might not be getting the most effective treatment, even covered by my patents’ insurance, scares me.
Ted said,
January 10, 2013 @ 6:34 pm
Inform yourselves. Im on dialysis and you can do a lot of things yourself because a lot of what happens to you on dialysis depend on YOU. Keep to your Diet as if you life depends on it, because it does. Keep all you old and d/c medicines: Dialysis is a rollercoast ride; where you once was, you will soon be back. While they have trended down on medication, Doctors, Nurses, Techs are still people; make your case to keep you at the upper end of the scale if they dial down. Always know your labs, study them, know how they affect you, question you nurses, doctors, techs about your labs ( piece , by piece ), find out what foods on your diet actually help your labs – stop cheating Peroid.
But most importantly – you have to have a POSITIVE ATTITUDE. Get in touch with yourself, forgive youselft, be kind to yourself, sleep good (take all the naps you can stand), wear clean clothes, get rid of people who everytime they see you think you are dying, get an answering machine and put your phone on mute, dont tolerate any more stress or stressfull peopl . —-LOVE yourself.
Tim said,
October 7, 2013 @ 2:08 pm
So big dick obamashit have you estimated how many people with ESRD you plann to to KILL. you murdering BASTARD …..ROT IN HELL. why doesn’t he slash his med benefits to match ours? I am also on dialysis and also agree with Ted toI, I already do these things Our fight to live will never end. I always stay very faithful and positive. And your right, diet and fluid intake are of utmost importance.. Life is a gift and the Gov may not care but I SURELY do. I will NOT let their stupidity take me down. God Bless all my ESRD teamates. We can do this.
Shazz said,
May 10, 2014 @ 7:28 pm
I am currently dying because I can’t afford renvela and no one cares.
but I am at peace with it because dialysis is a living nightmare