Md. assailed for halting dialysis benefits

December 23, 1990|By Michael Ollove

Gov. William Donald Schaefer's decision to end state payments for dialysis treatment beginning Jan. 1 will greatly imperil Marylanders with kidney disease, three nephrologists have warned.

"It's terrible; it's cruel," James Carey, chairman of the Maryland Commission on Kidney Disease, said at a news conference Friday to protest the demise of the program. "This decision will put a risk-prone population at greater risk."

The governor's action, said Dr. John Sadler, the commission's prior chairman, "is not only unkind and unwise but dangerous."

Maryland's Kidney Disease Program, which Dr. Carey's commission regulates, pays benefits to more than 4,200 Marylanders with the disease. The program is used to pay for costly dialysis treatments and for medications associated with kidney disease. Medicare pays for 80 percent of dialysis treatment. The kidney program is used to pay the remaining 20 percent.

Last month, the state Board of Public Works, accepting the recommendation of the Department of Health and Mental Hygiene and Governor Schaefer, voted to end the 19-year-old program.

The end of the program is expected to save $3 million over the next six months.

Health officials have said that patients suffering from kidney disease do not merit a funding program of their own and claimed that the program was making it difficult for the state to meet its obligations to Medicaid patients.

Officials also have claimed that kidney patients will be able to find other means of payment -- either through private insurance or Medicaid, a health program for the poor.

Joseph Morton, whose wife, Dagmar Maszun, requires dialysis treatments four times a day, sharply disputed the notion that private insurance would be available.

"Everyone knows insurance companies don't take on people with prior conditions," he said. "That's like trying to get fire insurance when there's already smoke in your house."

Without private insurance, Dr. Carey said, the end of the kidney program will cause "the pauperization" of patients. Treatment costs, he said, will drain their assets until their income falls so low that they will qualify for Medicaid.

In the short run, Dr. Carey said, he doubted that the end of the program would mean patients would lose their dialysis treatment, each of which costs an average of $127. Hospitals, he said, are unlikely to turn away dialysis patients because they cannot afford to pay for them. But, he said, those patients will be unable to pay for medication that could keep them healthy.

Without those drugs, he warned, there will be an increased number of hospitalizations and premature deaths.

Dr. James Burdick, head of transplant services at Johns Hopkin Hospital, agreed. He feared that transplant patients who otherwise stood a strong chance of recovery and resumption of active lives would reject their new kidneys, because they were forced to buy food instead of medication.

He labeled the governor's decision "wrong-headed."

Dr. Carey said that since Mr. Schaefer's decision, which he learned only through newspaper reports, he is seeking a meeting with the governor to urge a less drastic measure.

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