| A hospital system that provides affordable | | | | through payroll deductions before they can |
| healthcare or complimentary medical services to | | | | receive coverage. |
| the poor and uninsured in Miami-Dade County has | | | | So far, all but about 40 of Jackson’s dialysis |
| announced it will cut dialysis treatments for nearly | | | | patients have successfully located alternative |
| 200 patients with progressive kidney diseases and | | | | sources of care for dialysis treatments. In |
| renal failure. | | | | addition, nearby Baptist Health South Florida (a |
| Jackson Health System, a quasi-government and | | | | private, for-profit healthcare company) has called |
| privately funded consortium of primary care | | | | for a charitable medical partnership to create a |
| clinics, mental health facilities hospitals in the region | | | | new, ongoing safety net for the patients who |
| made the decision as a direct result of rising | | | | require dialysis. |
| medical costs and funding cuts from local and | | | | ``These people are going to seek treatment,'' |
| federal governments. Jackson estimates it will | | | | Keeley tells the Herald. ``They're going to migrate |
| save about $4 million per year by eliminating the | | | | to the nearest emergency room,'' after they |
| dialysis program. | | | | become sick, meaning care will be more |
| ``This decision was not taken lightly,'' Eneida | | | | expensive. Such a scenario is “very |
| Roldan, chief executive of Jackson, tells the Miami | | | | inappropriate'' when they could be kept well at |
| Herald. Roldan explained that Jackson is trying to | | | | outpatient dialysis centers, he said. |
| reduce a projected loss of $168 million for fiscal | | | | Under the healthcare reform proposals now |
| 2010. She said patients can still get treated in the | | | | before Congress, the emphasis is on getting |
| emergency room. | | | | cheaper basic care for an additional 30 million |
| According to the National Kidney Foundation, | | | | Americans to reduce emergency room care for |
| some 26 million Americans are living with kidney | | | | those people without a primary care physician or |
| disease. About 300,000 of them suffer from End | | | | health insurance. |
| Stage Renal Failure (ESRF), a non-reversible | | | | Gerard Kaiser, Jackson's chief medical officer, |
| disorder that eliminates the body’s ability to | | | | justifies the decision to end dialysis treatment at |
| filter waste products from the blood. Without | | | | its facilities because various government programs |
| dialysis --- a mechanical process whereby a | | | | pay for inpatient dialysis but don't pay for |
| machine essentially “washes” the | | | | outpatient treatment. He also explains that the |
| patient’s blood three times per week for | | | | savings Jackson will receive will come at the cost |
| about three hours on an outpatient basis --- the | | | | of shifting care to other facilities in the |
| patient requires a kidney transplant in order to | | | | community, since they may end up at ERs other |
| survive. | | | | than Jackson's. |
| Other medical facilities in the Miami area have | | | | The National Kidney Foundation counters such an |
| offered to come to Jackson’s aid in an effort | | | | argument on its Web site, where the organization |
| to provide care for its indigent dialysis patients. | | | | is calling for higher reimbursement rates for |
| Jackson estimates about a third of them are | | | | dialysis from Medicare. The NKF also fears that |
| undocumented immigrants. Although the federal | | | | healthcare reforms under consideration by |
| government does provide guaranteed Medicaid | | | | Congress could unintentionally threaten patient |
| coverage for dialysis treatment, the process for | | | | access to dialysis facilities, since they depend on |
| applying for benefits takes about a year and does | | | | the cross-subsidization of private insurance plans |
| not pay claims for illegal citizens. What’s | | | | to allow them to continue operating. |
| more, the federal government requires that | | | | Medicare currently requires patients who receive |
| beneficiaries must have “paid into” the | | | | dialysis benefits must terminate their existing |
| Medicare program for a certain period of time | | | | health insurance coverage, if they have any. |