Dialysis: Last Week Tonight with John Oliver (HBO)

last week tonight dialysisjohn oliver dialysisdavitafresenius

For-profit dialysis companies often maximize their profits at the expense of their patients. John Oliver explores why a medical clinic is nothing like a Taco Bell.

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Davin Deptuck
Argh... I'm actually getting sick listening to this and my heart feels really uncomfortable. AARG I feel like I'm going to die. I'm serious. Help
1% of the federal budget for dialysis? NASA only only gets 0.5% of the federal budget!!!
Michael King
Dialysis is already expensive as hell so let's force them to have an attending physician at all times and raise costs even more
Michael King
All of these problems come back to one thing: government single payer for dialysis. There's no competition, no incentives. And no surprise that it is abused and costs run wild. To think that John Oliver and his simpleton fans want to make our whole medical system like this. You think it costs a lot now? Just wait until the government pays for everything.
Patricia Carlson
This is how pharmacy is becoming. Walgreens, CVS, Etc are all about numbers, not about patients and safety.
Just Goldd For Now
What if i "donate" some one else's kidneys
British guy knows more about my country than I do.
Leslie Taylor
I worked for Davita for eight years. The first clinic I worked, everyone got promotions because of sleeping together. This was reported to DaVita; nothing was done. The dietitian didn't know patient's names, charted on deceased patients as if they were still alive, and had an....unusual relationship with the boss. She's now a boss herself.
I am also a kidney patient. I have had ESRD since 1989 (10 years old), and am waiting for kidney #4. I lost my last transplant when Davita put me to part time via text and I lost their (crappy, but still) insurance coverage. This means my medicine was $4k out of pocket per month.
They ruined me....and a whole lot of other patients and employees.
Nichole Perkins
As a dialysis nurse I must respond to this comedian's view on a medical topic and the economy that surrounds it. First, I will say that I agree with a few of the points made.
1. Dialysis centers are understaffed. All medical facilities are understaffed. The great news is that most of us are in healthcare because we have a heart for patients. We work long hours, not sacrificing patient care, because people matter to us. The hard truth is that insurance companies, specifically Medicare, dictate what care we get, how long we get it, and what is and isn't necessary. Every year Medicare decreases payment for services, increases rules and regulations that have nothing to do with care or improving the health of our patients and "bundles" services. Bundling, simply put, means that if two patients are receiving care and one requires much more time, medication and/or supplies...the healthcare provider gets paid the exact same. When I worked in Home Health we actually lost money on many of the patients we admitted. Medical facilities are forced to pay for numerous employees to code, audit, appeal and manage the insurance company's requirements. Try calling for an authorization for your patient. I have been on hold longer than this segment, Mr. Oliver. I do it because I care what happens to my patient. Insurance companies can deny or retract (and they do frequently) payment because a coder hit the wrong button, a provider didn't include the exact verbage in their documentation or because their decision tree says my patient doesn't need what the physician ordered. I'm not saying there shouldn't be oversight. I AM saying that perhaps we should stop criticizing healthcare providers and the issues of care and look at the root of the problem. My company, Davita, pays for 12 weeks of training for its employees. That's thousands per teammate to ensure a thorough knowledge and expertise so that our patients get the best care. And, yes, our patients enjoy being part of our village. It takes a village to provide the quality of care we provide. We staff social workers to help with financial restraints, home situations, and transportation issues. We have a dietician to educate and encourage healthy life choices. We have nurses and technicians and so on. No, we don't have a doctor on site. Patients who dialyze at home don't have a physician sitting in the recliner next to them either. We are highly trained professionals. If we need a physician's input we discuss issues when he makes rounds or call him.
2. Patients are moved quickly after their treatments. Yep. When is the last time you saw a doctor at his office or in the hospital and he sat to have a cup of joe with you? Not once have we (speaking for my facility) asked a patient to end treatment early. Frequently patients arrive late, on the wrong day, etc. We work them in. The biggest issue for our patients is that they depend on transportation. If the transportation brings them an hour late and picks them up at the usual time, they are forced to end treatment early. We have several patients right now struggling to get to the clinic. They have "capped" out and MCR/MCD won't pay the 4 dollars each way for them to come to the center. These patients end up in the hospital. Medicare will pay for that. That's bundled too. Hospitals are encouraged to discharge patients quickly. Home Health may admit these patients. Discharged too soon and sent back to the hospital? The hospital and Home Health agency is penalized because they should have kept the patient out of the hospital. Makes a heck of a lot of sense, doesn't it? Maybe the insurance company could have just paid the 4 bucks to prevent all of it? Oh, and Mr. Oliver, "one for all and all for one" is a pretty good sentiment when working as a team to help people.
3. Okay, I have to disagree about dialysis center's education on kidney transplant. First of all, I think it is the physician's responsibility to discuss options with the patient and determine if they are a candidate. However, we do educate our patients on options. Some patients do not want to go through the transplant process or the risk for failure. It's kind of a big deal. In addition, one of my Davita "teammates" actually donated one of her kidneys.
Dialysis becomes a lifestyle for patients with ESRD. It is so unfortunate that they are forced to spend a good portion of their life in a chair, away from home, tied to this machine. This machine prolongs their life. Patients can live a long time on dialysis and they adapt. Today, at my clinic, patients were laughing and saying hello to one another. They were exchanging recipes and wishing each other "happy birthday" (a huge blessing to them). Our technicians were visiting with the patients-not because they have time to but because it's a significant part of our care. As far as Mr. Thiry's reference to the importance of his employees, here's the deal:
1. Employees who have job satisfaction perform better and stay with the company. They don't grumble about their jobs. They have passion and commitment. They feel supported and valued.
2. Employees who are passionate about their jobs will stay late, go the extra mile, and perform better than those who are unappreciated, untrained, and simply "punching a clock".
Perhaps your next comedic chat could be about the issues surrounding insurance oversight and efficiency. I'd give you a standing ovation :)
Noor Goossens
Garage versus need go useful phone casual victory theater gesture.
Can I represent my fellow Canadians and say that that joke at the beginning was actually really funny?🇨🇦😂
Carol Owens
Learn How To Cure Kidney Disease & Improve Kidney Function Naturally in 6 - 8 Weeks Without Dialysis. 100% Guaranteed By Thousands People From Worldwide. And Approved by Doctors and Nephrologists. CLICK HERE ►►https://plus.google.com/u/0/113729580869698703236/posts/XRZRQjPwpGQ
Dave Hobbs
As a Canadian may I say, fuck the US health system.
"Who would possibly refuse a transplant?"
Old people. Old people would. And yes, the whole "community" thing would definitely be a factor. If you're a shut-in besides the days when you go out to get dialysis treatments, you may be very hesitant to let that go. Also transplants can be very risky, moreso for some people than others.
Laura Rodriguez
- Richard Nixon...
- Really?!! 😂
Matthew Harris-Levesque
Hey. My pet also loves me because i bathe it and give it a sense of security.
And it's closer to 80% of babies....
moist faucet
Morality and profit never get along.
Kevin Criswell
holy crap, I wonder if the bigger problem is why are so many people on dialysis.
Ritu Patel
Thank you for bringing light to the lack of preventative care for chronic kidney disease. With the rise of more people developing high blood pressure and diabetes from poor diet and a sedentary lifestyle, there are more people developing chronic kidney disease and end stage renal disease. There is only so much we can do to manage kidney disease medically and thankfully it’s one of the organs that we are able to artificially support. That being said, it does come with its challenges. When a first shift patient comes in late for his or her treatment, that then creates a problem for all the patients that come subsequently afterwards. Many units do try to make things work but imagine, for whatever reasons, if 5 of 25 pts show up late first shift Monday morning. What will it do to the next 2 shifts after that? Most units open at 6 am and doing 3 shifts a day means a 12 hour day with time needed to clean the machine after every shift. It’s just not easy running a unit. I agree with the medication waste and the gross negligence of exploited health care dollars. Yes, dialysis is hard on the heart and all other organs, but let’s put one fact out there, the renal failure in most dialysis pts isn’t something that happened independently of other medical problems. Most people in a unit have a history of high cholesterol, cardiac disease, diabetes and/or high blood pressure. Those are probably factors that put them at increased risk of mortality while in dialysis. Yes transplant is a great option but the demand for the organ surpasses, by miles, the supply that is available. And even a successful transplant does not guarantee life without dialysis.

I could speak on this topic for days but I agree with a few things. Getting screened and monitored for renal disease is very IMPORTANT. Preventative medication can keep people off dialysis for longer leading to a healthier life and less healthcare costs overall. Transplants are a good alternative to hemodialysis but they come with their own sets of risks.
LMAO! He licks the shells!
Michael Kohler
Just wanted to write and say that I first saw this segment as I was recovering from a hemodialysis session at a DaVita clinic.

A: They're every bit as awful as John Oliver portrays them. By far the worst health care I've ever had to deal with in my life.
B: Thank you for this segment. It made me angry but at the same time grateful that someone was paying attention. I only had to do hemo for a few months before I got a transplant (my wife was a match, if you can believe it), but the look of the people who were doing it for years... just incredibly depressing stuff. Nor can I imagine thinking of DaVita as a "community." Nobody at my clinic talked to each other. Nobody. After my last session, even though everyone knew that I was getting a transplant the next day (it changed which medications they gave me) not a single member of the staff so much as said "good luck" or even "goodbye" to me at any point. They did not care.

And there is no way that they were doing the right amount of cleaning. I was often in the chair only 10 minutes or so after the previous patient left. With my little bag where I'd have to carry in my own blanket and pillow, since DaVita doesn't have them, because they don't care. In the hospital they knew that in dialysis you can get super-cold (since your blood is out of your body), so they had heated blankets and you spent the session on a motorized hospital bed, so you could rest if you wanted. The staff worked in lower light so patients could feel more comfortable and rest. DaVita: bright lights in your face and nothing but a chair, since DaVita is to cheap to pay for laundry. I have absolutely nothing good to say about them. The one nurse I knew who actually gave a damn quit because of how the company treated patients.
Kadambari H.A
Watched this and realised how do people not know what dialysis is? I studied that in 10th grade.
Man I’m
Here on dialsis and it’s so true about what he says!! It’s scary and I’m doing bad!! When I get home I can’t even get up I pass out in seconds when I stand up. I don’t have hunger or thirst anymore.
Sameer Sajid
I want Taco Bell now....
Tim O'Neill
Man my grandfather had to go through dialysis. He suffered alot with his kidneys. I will give no quarter to those who takes it for granted or believes it a waste of time can say hello to the ghost of my grandfather who was lucky to get dialysis so he didn't die of kidney failure, before cancer could take his life. Fitting he was born on Halloween.
But seriously we need more organized transplant opportunities I'm an organ doner and honestly lot of people could use it so if your willing to do something good with your lives before you die, please do children and adults can really use your squishy bits.
Nxstage is a thousand times better.
when taco bell and nixon are on the good guys side of the story you know this shit is messed up...
my country health care system is nuts
but i prefer it over usa s
Mr OutLaw
Richard Nixon
Really? 😂😂😂
John Morgan
I am so glad this is getting attention.

My wife is on dialysis. I am 100% sure that her nephrologist, the dialysis center (he is part owner), and the transplant hospital are in collusion to keep my wife on dialysis for as long as possible. She has medicare and the system doesn't appear to have oversight. So they charge thousands. The bills arrive and I cannot believe how much money they make off medicare.

I don't know how to prove this collusion. At first we tried going to a second hospital to throw them off their game. But that hospital experience was a nightmare. So we quit it.

Now we have figured out that we need to quit the dialysis center she is at and go to another one. Hoping this will keep them more honest.

Here is my question. Who can I contact who will be on our side and evaluate all of this for us....someone who is unbiased...someone who is not benefiting from her dialysis? I have tried getting a second opinion but this nephrologist seemed very hesistant to go against what was already on paper.

Why would Medicare spend this kind of money without better oversight?
I work for a medical transport company in Ohio. 50% of our clients are dialysis patients. Breaks my heart seeing folks spend 4+ hours sitting in those cold, and I mean COLD clinics. They spend 4+ hours with needles in them and they are not quiet places. These places are understaffed and overworked. I go out of my way to cheer the clients up when taking them back home to their already shitty nursing homes. I'd rather just die out than deal with dialysis. I am, however, an organ donor for reasons just like this.
Thirty percent? Seems a little low.
I've watched a lot of these over the last few days and I reckon John's favourite number is 4 as it comes up in pretty much every video at least once. Hand gesture included without fail.
little harmonizer
I love Oliver's face after the whoot from the crowd when he said Nixon did an amazing thing lol
The Rustbelt Blacksmith
if you find this video disturbing, just imagine if you could see the law makers portfolio's, the people who have any power of changing any of this, will never do so.

i'm between laughing and crying atm
Aven Preston
No need to say sorry
Uzayr Haider
I'm actually on pd dialysis. I was on hemo dialysis for 3 years and then I got a transplant. It was alright for 4 years then It started failing and now I'm on PD dialysis.
Justin Nehls
Kidney tronsplonts
Jessica Galvin
Man, I really want some Taco Bell right now.
Oh, my god, he made a Martin Scorcese joke.
Honestly Tax payer wouldn't work. We are very anti-consumer and Don't care to take down companies coexisting in monopolies.
nick willemsen
i am sorry but shouldnt doctors mention tranpslants before sending them to dialysis. Feels rather strange a companie with incentive to give bad advice should give patients advice.
Razar Campbell
Damnit, John! Stop glorifying cocaine! Cocaine wrecks lives! Heroin is the king of drugs! Heroin BUILDS lives. Start pushing heroin instead, please and when the money starts rolling in, please send me my cut in bricks of heroin. :D
František Zet
In my country everyone is automatically an organ donor, unless you register on the list of complete assholes :D
So much product placement. I'm pretty sure a diet of nothing of taco bell will lead someone needing dialysis eventually
Cheo Pitchford
the pigeon flying in cocaine is what gave the idea for spring time with Hitler
My phone doesn't have that Button......
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