Hi Evan,

It dawned on me a few days later what JohnR was really pointing out (at least I think)...

Both dialysis and transplants are paid for by the SAME entity here.

In the U.S. I **believe** that dialysis is mandated by the Federal government as being "free" (though I'm sure that the good ol capitalist system has come up with many service and consumables charges for the patients).
In such a case the insurer has no real incentive to authorize a transplant because there is NO OFSETTING COST - the cost of dialysis - to make it a smart business decision.

And, even though my transplant cost me $12.00 total, including after-care since, I am still upset with a fast-one they pulled on me!
The cost of the drugs is NOW mainly my responsibility, since the governments all had financial hardships and cut drugs that were covered (and are now very slow to add new drugs to the list). They used to be free for life on the basis that:
1) the transplant brought about their need;
2) transplant cost + drug costs for life is still FAR LESS COSTLY than even a year of dialysis.
These things cost me over $650 per month, and that's with Cyclosporin still being free! That truly did piss me off because I had absolutely NO forewarning and never would have expected that from healthcare here.

cheers, from a person who feels 35 again when he felt like 85 before the transplant.

PS I have a friend on overnight peritoneal dialysis and it is a fine thing as far as he's concerned.


>>You hit the nail on the head. A successful renal transplant is *far* more cost-effective than ongoing dialysis unless there are different payers for transplant vs dialysis in which case they both try to shunt.
>
>The only problem up here is the shortage of organs. To blame are
>- effective anti drinking and driving campaigns
>- seat belts
>- motorcycle helmets
>
>I worked in a renal unit 3 years ago. One new program they are trailing is nocturnal dialysis. You get a 7 days a week, 8 hours per night run on a hemo machine. This allows people to not have to take the time out of the day (or quit work) to go on hemo, plus they get a full proper dose of hemodialysis that actually makes the patients feel relatively normal.
>
>But ya, I've seen the stats, transplants are cheapest.