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Freakonomics Radio

457. Is Dialysis a Test Case of Medicare for All?

Freakonomics Radio

Freakonomics Radio + Stitcher

Documentary, Society & Culture

4.632K Ratings

🗓️ 8 April 2021

⏱️ 53 minutes

🧾️ Download transcript

Summary

Kidney failure is such a catastrophic (and expensive) disease that Medicare covers treatment for anyone, regardless of age. Since Medicare reimbursement rates are fairly low, the dialysis industry had to find a way to tweak the system if they wanted to make big profits. They succeeded.

Transcript

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0:00.0

On last week's episode, we asked whether the US healthcare system is really as messed up

0:08.7

as people think.

0:09.7

Oh, I think absolutely the US health system is as messed up as people think it is probably

0:14.2

more so.

0:15.4

In the US, we spend 17% of our GDP on healthcare, around $3.5 trillion a year.

0:22.8

The big players are doing extremely well.

0:25.6

The stakeholders are making a ton of money except for one stakeholder, which is the patient.

0:31.7

As we were interviewing doctors and healthcare economists and policymakers, there was one

0:37.1

story that kept coming up as a cautionary tale.

0:41.0

Here's Zach Cooper.

0:42.0

He's a healthcare economist at Yale.

0:44.6

You want to know why the US healthcare system is messed up?

0:46.6

But look at how we treat folks with end-stage renal disease.

0:50.0

End-stage renal disease, or ESRD, is the final and permanent stage of chronic kidney disease.

0:56.5

It's also known as kidney failure.

0:58.6

By this point, the kidneys are no longer able to perform the vital function of filtering

1:03.9

your blood.

1:05.1

Left untreated, the condition is fatal.

1:08.2

What are the treatment options?

1:10.0

Here's Ryan McDevitt, an economist at Duke.

1:13.3

Transplant is the most preferred option.

1:14.9

It's the only way to cure this condition long-term.

...

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