Is Dialysis the Answer for Older Medicare Beneficiaries?

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Author: William Richards

There is a law that was passed by Congress nearly 40 years ago that allows only one disease - end-stage kidney disease - to get special treatment. It allows most anyone with this disease to receive treatment nearly free of charge.

"All patients whose kidneys have failed, regardless of their age or ability to pay, can receive nearly free medical treatment," says Alan Weinstock an insurance broker at MedicareSupplementPlans.com. "However, many times older patients, many of whom are Medicare beneficiaries, receive the treatment needlessly."

Original Law and Intent

Also known as "renal failure," end-state kidney disease occurs when the kidneys are no longer able to function at a level that supports daily living. They no longer can remove wastes, concentrate urine, and regulate other important body functions.

The Medicare End Stage Renal Disease (ESRD) Program, a national health insurance program for people with irreversible kidney failure, was established in 1972 with the passage of Section 299I of Public Law 92-603. The original intent of the law was to keep middle-aged and younger people alive and productive. What has happened is that many older patients, Medicare beneficiaries, who have other medical problems, wind up suffering through dialysis as a replacement for their failed kidneys. Unfortunately, they don't live long because other serious and/or chronic diseases kill them.

Possible New Test to Predict Patient Viability for Dialysis

Two different studies suggest that researchers have developed two new tests that may be able to predict which patients with chronic kidney disease are less likely to recover. This means identifying kidney disease prior to its terminal stage.

With over 20 million people in the U.S. with chronic kidney disease, kidney failure can quickly lead to dialysis, transplant or death. The tests could help identify the best patients for dialysis, regardless if they are young or seniors on Medicare, and help streamline care while sparing others from unnecessary interventions.

Choosing "Medical Management without Dialysis"

As difficult as it is for many people to confront the notion that we will all die one day, it is particularly important for older Medicare patients who are suffering from renal failure to consider if dialysis is a benefit to their life. Instead some specialists want to be able to urge these patients to enter a hospice and undergo what doctors call "medical management without dialysis."

Medical management is a way for patients and care givers to review and select recommended treatment plans to assure the appropriate medical care is provided to patients with end-stage kidney failure who chose to forego dialysis. Making a choice between whether to have dialysis or not is strictly personal. However, it is important for all patients, young and old, on Medicare or not, to understand the benefits and risks of their choice.

Medigap insurance can give what the original Medicare Supplement cannot and this is a very effective advantage of the Medigap insurance California.