Federal policy should move beyond fee-for-service and prioritize prevention
Nearly half a million Americans suffering from kidney failure depend for their survival on dialysis. For many of them, life is nasty, brutish, and short.
One in four dialysis patients will die within the first year of treatment, and six in 10 will die within five years. Patients typically spend four hours a day, three days a week, tethered to the machines that draw out their blood, filter it, and return it to them. Chills, fever, and crippling fatigue are common – as are heart attacks, due to the stress of pumping patients’ blood through the machines at the rate of a pint per minute. Infections are commonplace too, particularly for patients outfitted with chest catheters, nicknamed the “great white tubes of death” because of their ability to send pathogens straight into a patient’s heart and bloodstream.