Editor's note: Talking to the professional nephrologist organizations about harmful effects of their financial incentives is like trying to talk to the NRA about the harmful effects of guns.
They ignore the fact that the largest non-profit dialysis provider has had better mortality and hospitalization data than for-profits for 14 consecutive years. Why is this never discussed at professional meetings? For whom do most U.S. nephrologists work?
Why would virtually no U.S. nephrologists choose, for themselves or their family members, the dialysis treatment regimen that over 85% of their patients receive?
Imagine the legal liabilities and professional consequences of admitting these hypocrisies.
The release of this position paper may be concession to a minority voting bloc within the RPA. The lack of publicity about it likely reflects the preferences of the majority voting bloc.
U.S. nephrology organizations and large for-profit dialysis providers will fully embrace this paper's positions ONLY WHEN significant changes are made to existing financial incentives. The easiest and most productive change, in my opinion, would be to extend the Medicare Secondary Payer period for employed dialysis patients.