{"id":291,"date":"2012-02-29T15:47:14","date_gmt":"2012-02-29T22:47:14","guid":{"rendered":"http:\/\/danschmidtforsenate.com\/blog\/?p=291"},"modified":"2012-02-29T15:48:32","modified_gmt":"2012-02-29T22:48:32","slug":"difficult-choice","status":"publish","type":"post","link":"https:\/\/danschmidtforsenate.com\/blog\/?p=291","title":{"rendered":"Difficult Choice"},"content":{"rendered":"<div id=\"attachment_292\" style=\"width: 410px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/goro-fritz-artificial-kidney-dialysis-machine-purifying-blood-flow-into-patient.jpg\"><img aria-describedby=\"caption-attachment-292\" decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-292\" title=\"goro-fritz-artificial-kidney-dialysis-machine-purifying-blood-flow-into-patient\" src=\"https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/goro-fritz-artificial-kidney-dialysis-machine-purifying-blood-flow-into-patient.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/goro-fritz-artificial-kidney-dialysis-machine-purifying-blood-flow-into-patient.jpg 400w, https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/goro-fritz-artificial-kidney-dialysis-machine-purifying-blood-flow-into-patient-300x225.jpg 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/a><p id=\"caption-attachment-292\" class=\"wp-caption-text\">Early Dialysis Machine<\/p><\/div>\n<p>Yesterday afternoon we heard a proposal to phase out <a href=\"http:\/\/legislature.idaho.gov\/ope\/publications\/reports\/r1107.pdf\">this<\/a> state program. It\u2019s pretty rare to eliminate a government program. It seems easy to get them started, but they never seem to go away. I think it\u2019s time this one did.<\/p>\n<p>The Idaho State End Stage Renal Disease program was started in 1970 by a legislator with a family member who needed dialysis. This was a tragic fatal condition ( \u201curemic poisoning\u201d) that was just being solved. <a href=\"http:\/\/www.kidneydialysis.org.uk\/inventor-of-dialysis.htm\">A man<\/a> had invented a machine for dialysis but they were not in wide use, nor widely available. Nobody could afford them and there was no mechanism for payment. An <a href=\"http:\/\/kidneytimes.com\/article.php?id=20110304143111\">engineer in Seattle<\/a> built a few of the machines of the unpatented design for a friend who was dying of kidney failure. But how do you decide who gets treatment? Indeed, there was even a \u201c<a href=\"http:\/\/www.aei.org\/article\/health\/the-god-committee\/\">God Committee<\/a>\u201d that decided who got access.<\/p>\n<p><a href=\"https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/LifeDeathCommitteeB_cropped.jpg\"><img decoding=\"async\" loading=\"lazy\" class=\"alignleft size-medium wp-image-293\" title=\"LifeDeathCommitteeB_cropped\" src=\"https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/LifeDeathCommitteeB_cropped-300x216.jpg\" alt=\"\" width=\"300\" height=\"216\" srcset=\"https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/LifeDeathCommitteeB_cropped-300x216.jpg 300w, https:\/\/danschmidtforsenate.com\/blog\/wp-content\/uploads\/2012\/02\/LifeDeathCommitteeB_cropped.jpg 768w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>I\u2019m sure the legislator here in Idaho knew if we just directed more money the way of dialysis, there would be more machines. We influence markets all the time with taxpayer dollars. I don\u2019t know if he declared his conflict of interest, but Idaho established this program in the Department of Vocational Rehabilitation. It is still funded to this day to the tune of about $500,000.<\/p>\n<p>The trick is that in 1972 the Federal Government decided that people with End Stage Renal Disease (ESRD) would be eligible for Medicare coverage. We now have many <a href=\"http:\/\/www.economist.com\/node\/15911962\">for-profit dialysis companies<\/a> around the country. And the Idaho program mostly pays for travel expenses to and from dialysis as well as some medications. The money is flowing.<\/p>\n<p>Let us not ignore the tragedy of kidney failure. It is a chronic debilitating disease. I believe it is just and proper for there to be support for these people. We should support their care, their needs. But this program no longer fits the intended role of support nor is it fair or efficient. We need to do better.<\/p>\n<p>There are about 100 people in Idaho receiving these benefits. The very <a href=\"http:\/\/legislature.idaho.gov\/ope\/publications\/reports\/r1107.pdf\">first link<\/a> in this piece gives more details. We heard testimony from the Department of Voc Rehab and the sponsor supporting the phase out of this program. But there were others in opposition. One man on dialysis spoke passionately that we would be removing support for these patients. On questioning it came out that he was not receiving these benefits, but was considering applying. Two social workers for the for-profit dialysis companies also asked us to not remove these necessary benefits. We pointed out that this program mostly paid folks for travel expenses ($290\/ month average), not for dialysis. \u201cBut if they can\u2019t get to the center they can\u2019t get treatment.\u201d<\/p>\n<p>It was compelling testimony. There is always a reluctance to take away benefits from unfortunate victims but it was made even more painful knowing we had a committee member whose family had just been through a kidney transplant.<\/p>\n<p>Still, we voted to phase out the program. I believe we can still support these folks. It will need our attention. These are the infinite details we must address in health care reform.<\/p>\n<p><strong>All comments read but not posted<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Yesterday afternoon we heard a proposal to phase out this state program. It\u2019s pretty rare to eliminate a government program. It seems easy to get them started, but they never seem to go away. I think it\u2019s time this one &hellip; <a href=\"https:\/\/danschmidtforsenate.com\/blog\/?p=291\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/291"}],"collection":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=291"}],"version-history":[{"count":3,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/291\/revisions"}],"predecessor-version":[{"id":296,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/291\/revisions\/296"}],"wp:attachment":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=291"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=291"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=291"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}