WTF? Is that Odo cosplaying as nixon?
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Oddly enough the order seems basically sound, but I’ll be honest his track record doesn’t fill me with confidence that some of the more open ended sections will be handled well. Section 8 , about expanding the allowable expenses for living donors, particularly worries me because, while that policy needs to be revamped, if it isn’t handled correctly we’ll basically be creating a kidney marketplace, rather than simply making living donation more feasible. Section 4 is worrying in another way, allowing “flexible advance payments for nephrologists” needs to be handled with more thoughtful policy than anything I’ve seen out of this administration.
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We’ll find out within a week, but your gut reaction is likely correct.
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Yes, this really happened.
For tRump, like everyday.
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Hmmm. . . tastes kinda like. . . warm, flat Budweiser.
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I have a dear friend in dialysis. It’s no coincidence that he is also a vocal Trump-hater (and isn’t that something that nearly the entire world has in common now?). This news will fill him with more than the allotted daily dose of confusion.
People worrying about a kidney marketplace should know that, under the status quo, wealthy people may acquire a kidney when needed. They can also acquire preventative dialysis that can prevent kidney failure. Poor people must divest themselves of all signs of diabetes before they will be considered for such projects.
Dialysis has become a racket. Our government, by providing better-than-average insurance to its employees is paying for this. Health insurance reform, in any form, is in the government’s best interest and it was literally their idea in the first place. Enter lobbyists and profound dysfunction and here we are. Trump can’t fix it, but he could stumble into improving things simply by doing something, anything, anything at all for God’s sake.
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Can’t remember who it was, but some SNL cast member that was on one of the episodes w/ Drumpf was asked what his takeaway of the latter was. His response was that Cheeto is a rare man that has no sense of humor whatsoever.
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Twain and Berra were quite consistent in the quality and humorous whimsy of their quotes. Trump’s kidney comment is akin to a stopped clock being right twice per day.
TWITTER: President Trump is directing government to revamp the nation’s care for kidney disease; aims to allow more people whose kidneys fail to have a chance at early transplants and home dialysis. https://nbcnews.to/2O0CeGD
Early transplant? Is he promising that he wants to make it legal for the rich to pay for quicker access to donated kidneys?
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I’m on dialysis, paid for through the ACA. God help me.
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I’m curious what the bill actually does. From what I understand the problem with transplants is that supply is too limited, and I’m not sure what the government can do to make this better. Paying for people to donate one kidney? Harvesting organs from prisoners? Advertisement campaign to extoll the virtues of checking that “organ donor” box on their license and another campaign about how cool motorcycles are and how uncool helmets are?
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I spent about a year working on two different renal (kidney) function projects. The first was an artificial kidney which was so bad it never got beyond a paper study. But I learned a lot about dialysis. Some key take aways:
- Dialysis works rather well. Not perfect (the middle molecule problem), but it gets the job done.
- Dialysis is miserable. Both hemo and peritoneal dialysis result in lost time, recurring serious infections (hospitalization!), and not feeling that great.
- Because of Medicare / Medicaid, the USA covers the elderly pretty well. Better than many countries with socialized medicine.
- Reimbursement for hemodialysis had been, at the time, capped for several decades. Dialysis clinics got a fixed payment, but had to continue to cut costs to stay in business. This has led to very efficient clinics that do this on an industrial scale. Home dialysis is more expensive and carries more risk.
So then comes project number 2. I had an epiphany one day on a way to use the intestine to do dialysis. Good blood flow, osmotic membrane, large surface area. Check, Check, Check. As a bonus, it could be done non-sterile (no infections!). But I assumed it couldn’t work because it would be used if it were.
I was wrong! There is literature about it pre-WW2. The breakthrough of hemodialysis killed intestinal dialysis research. And peritoneal too. But peritoneal came back.
So we did research and got it working on animals. Then came the problem: no way to make money. It would take millions, maybe 10s of millions, to do clinical trials. But how do you make money when all you need (after some surgery akin to a colostomy) are a couple buckets, some cheap food additives, a hose, and tap water? Home Depot and GFS have those sewn up already.
So the project got shelved.
From our results, we think it might not have worked as well as hemodialysis. But the main purpose of dialysis isn’t to remove waste, it’s to remove water (technically, you drown before you are poisoned with kidney failure). That’s easy for intestinal dialysis. Then you’d only have to go for hemodialysis once a week or month, instead of 3 times a week. Lower cost and fewer infections.
Since then, all I can do is relay this story to anyone that might be interested in hope it reaches someone who would be interested. It’s not a panacea, but maybe it can help someone.
Feel free to PM me if you have questions.
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Exactly my reaction. He says this shit as clickbait; we scroll past the atrocities; much useless chatter; he wins.
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The one thing that instantly helps all organ donors is to have “automatic donation” as the default setting.
In Norway, you are automatically on the organ donors list unless you specifically opt out. This both tespects free will/personal choice while allowing us to lazily improve supply.
Canada is now implementing this policy. It will be huge for organ transplant recipients.
If the US inplements this policy, it would go a loooong way to improving outcomes for everyone, without paying poor people (especially those in 3rd world countries) to give up organs to a middleman for 1/100th their value.
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I know there’s a lot of guffawing here, but it turns out this is actually a really important change being made.
Some details here:
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Any link to a research paper? (Or an instructable?)
They could import them from China, except the tariffs would be too high.
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It’s entirely conceivable that a person who doesn’t know what “busing” was and who doesn’t know that there were no airports in the Revolutionary War (of 1812) really does not actually know what a kidney is.
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