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Take'em at their word.

In case you've been living in a cave somewhere, 2012 is an election year. Candidates from Congress to President to Road Superintendent are all saying the same thing: Cut Government Spending!

And most candidates' favorite way to do that is to: Cut Waste in the Cost of Medical Care!

OK. Let's take'm at their word and show how they can actually do both. Let's offer government a Billion Dollars. That might get their attention.

We in the transplant community have proven non-controversial ways to reduce Medical costs and cut government spending. And it's a lot of money. Let's make sure political candidates hear what we have to say and let's ask them to take a position on it. They can get the credit and our patients will get the help.

We know government is influential in health care in this country. But, do we know just how big a player it is. Some health economist will have to run these numbers, but think of all health care government buys. Government pays for health care through Medicare and Medicaid, the big ones. But, there are others. Health care for military, veterans, prisoners, government workers at all levels and even Members of Congress.

And some of those costs are going to be for failure of vital organs. The Medicare ESRD Program makes kidney failure a big issue. It's not the only one; but, since it's so big, let's base our argument on that. It is after all, $26,000,000,000 for Medicare alone.

Let's say, just for argument's sake that a kidney transplant costs $120,00 the first year and $20,000 every year after that. And, dialysis costs $75,000 every year. Someone with kidney failure needs one or the other in order to stay alive. (I'm basing these numbers on what government pays. Private insurance pays much more for dialysis. And, private insurance is the primary payer for the first three years.)

Let's say that we can take just 10 people in every state off dialysis and get them a transplant by:

* Pre-emptively transplanting them before they are put on dialysis. That saves more than $225,000,000 over 10 years.

* Providing them with an ECD or DCD kidney and getting them off dialysis. That saves $225,000,000 over 10 years.

* Preventing the discard of a kidney for them and getting them off dialysis. That saves $225,000,000.

That represents cutting government spending by $675,000,000 for only 10 people in each state. Could we do 20 or 30, or 1,000? Add that to the reduced spending we would have by paying for immunosuppressive drug coverage for all who've had a Medicare transplant, thus preventing a return to dialysis and removing another kidney from the pool. And because of private insurance, the numbers are actually higher.

We're talking Billions! How's that for cutting government spending and reducing waste in Medicare?

I don't know how many people can be helped by these steps. but it has to be at least 10 in every state, doesn't it? We know how to do this and it is in everyone's interest to just do it.

Transplantation is an answer to our health care crisis, not a problem. These things can be done and should be done. Candidates should help us and government should act. No one loses and patients win. So do taxpayers.

By John Davis, Former CEO, National Kidney Foundation

Occassional Contributor
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Author:Davis, John
Publication:Transplant News
Date:Mar 1, 2012
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