Kathy Fairbanks, Medicare, Dave Ragan discussed on Forum
Ten mile radius each with its own medical director. I don't know how much they're paid. But I think it's a significant amount in the hundred thousand dollar a year range that could be reduced. You could have one medical director for four units within a ten mile range. And there would be no issue there. And they're quite a savings of money. There's a lot of look savings that can be done. Nurse managers are fearful that they would lose their job because apparently they're not supposed to work on the floor. If these units they could easily work some few hours a week on the floor. And I think that would be a good thing, and it would then allow their fees and salaries to fall under the guidelines of this proposition. So good you're on record here. Kathy is being in favor of the preposition. I'll let that stand and get another caller on right away in the two Rick. Join us. Yeah. Hi, I wanted to ask about the impact Medicare because I thought Medicare kicked in about eighteen months of dialysis. So I don't think there's really saves people money as much as. Insurance companies money. Will this impact of this would be mostly on commercial payers of dialysis because they they pay the highest rate, you know, Medicare does have a fixed rate, but there is a lot of movement of dialysis patients between different pairs, depending on their life circumstances, depending enough if they become disabled during the time, they're dialysis and what we're talking about is the overall revenue of a clinic, which is dependent on this mix of pairs. So in a sense, we have the commercial insurers paying much more than Medicare and Medicaid, and that sort of where this is being fought. But as long as we're talking about that go back to you, Dave Ragan microage. This is a misuse of union dues of the costs are too high the insurance companies and Medicare should negotiate better whose to judge what profit margins are, right or not. Well, it is too high because a Medicare patient is charged two hundred and fifty dollars for a treatment, and a commercially insured person is charged twelve hundred and fifty that's because of the lack of regulation and davita and for Sunday's have monopoly. Pricing power because they've cornered the market, and they figured out a very lucrative way to extract a hundred and fifty thousand dollars in charges from somebody. That's commercially insured over the course of a year. It is a predatory business model. They really are the payday lenders of the healthcare industry has Fairbanks responded. Yeah. You know, a lot of what Dave is saying is it really borne out by proposition eight, and I think, you know, keep in mind, your organization could have written a very different initiative if this were really about patient care. They would have drafted an initiative that mandated more training that in instituted quality controls were issue. Mansard. Something from a listener says outright were any clinicians involved in drafting, no, yes. Was there? A third party review. What the economic? Yes. This is the whole problem could be, you know, this is this is this really motive, you know, this were driven by pure motives, this could be something taken up in the legislature. If patient quality care is really such a problem introduced a Bill in the legislature on that. Your clients have spent more money against this one hundred and eleven million dollars setting a national record for spending in a ballot. Cam. Through defend four billion dollars a year in profits. That's what this is about. That's why is your your resume for dialysis patients and how we're going to get this sorted out by our health editor here. There was a third party. Look by the legislative analyst's office was introduced you can't make changes to lead an initiative, and they essentially often through the legislature, which is part of the fun. I mean, if I had to summarize this is such a new thing that they didn't have a lot to compare it to in the past. And they said on the one hand if it's interpreted this way, local governments will have to pay more because patients if the clinics close patients will go to local emergencies room rooms on the other hand, this could save local governments money or the state money and medic- Medicare payments. So it's really unclear would be a radical experiment. So it's important to note. And I think, you know, Kathy continues to say the clinics will close, and that's just a fabrication last week, the two largest insurers and California. Kaiser. Permanent an anthem in a report to the Los Angeles city, employees retirement system said that passing proposition eight would have no effect on access. This is fear mongering of the first degree. It's let's shoot the messenger. Let's scare everybody. Let's spend one hundred and ten million dollars. But the people who are responsible for making sure dialysis patients get their services are saying passing proposition eight does nothing to access, but we will stipulate it does a lot to reduce windfall profits. Very simple question here. Mcafee, but let me go back to carry to the legislative analyst's office say the clinics we close, well, they don't that's not how they do the reports. They just look at what's the impact on local government. And they basically had to say this. This could be interpreted through regulations if it does pass in a couple of ways if it's interpreted very strictly clinics, Mike close, but we can't predict what these companies will do if it's interpreted this other way, that's more. You know? Helpful to you know, how they define what direct patient care is them clinics might not close, and we might look at some savings for government. So they basically kind of said we can only look at this limited scope thing. We're not sure we've got seconds left. I want to give them to you Kathy Fairbanks because we started with Dave go ahead. The legislative analysts use the phrase unclear uncertain difficult to understand difficult to interpret ten times in its analysis which underscores the sloppy drafting how difficult this is to do. Right. The need for oversight, maybe through the legislative process. If that's the way you wanna go as it relates to Kaiser anthem Dave misstated, what was said in that.