Health and Fitness News

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John Oliver on kidney dialysis, Taco Bell and death

By Amy B Wang, Washington Post

During the three years that HBO’s “Last Week Tonight” has aired, host John Oliver has skewered one political absurdity after another.

But the late-night comedian has also used his platform to delve into more complicated issues — the debate over net neutrality, for example — often with comical and significant results.

On Sunday, Oliver once again turned his attention to a topic that he admitted would risk prompting viewers to “push the button on your TV remote marked ‘Dear God Literally Anything Else.’”

Kidney dialysis.

Oliver explained dialysis as a process in which a person is hooked up to a machine that removes blood out of the body, cleans it, then returns it to circulation. “Think of it as a Brita pitcher for your blood,” he said.

And he urged people to learn about the for-profit dialysis industry, however boring it may seem, because an increasing number of people in the United States suffer from kidney disease and rely on the “exhausting process” of dialysis to stay alive.

Kidney disease is the ninth leading cause of death in the United States, according to the Centers for Disease Control and Prevention. Oliver also cited a 2010 ProPublica investigation that revealed the United States “continues to have one of the industrialized world’s highest mortality rates for dialysis care” despite spending more on it than other nations, by some accounts.

“So we’re spending the most to essentially get the least,” Oliver said. “We’re basically paying for a fully loaded Lamborghini and receiving a drunk donkey on roller skates.”

Oliver recounted the history of how the country’s for-profit dialysis industry came to be — the result, he said, of good intentions mixed with “bad incentives, poor oversight and profiteering.”

In 1972, President Richard Nixon signed a bill into law saying the government would pay for dialysis for anyone who needed it.

“Essentially we have universal health care in this country, for one organ in your body,” Oliver said. “It’s like your kidneys, and only your kidneys, are Canadian.”

At the time, only about 10,000 patients needed coverage, but over the past four decades, the rise of diabetes and high blood pressure has led to nearly half a million people requiring dialysis, Oliver said. The cost of covering dialysis now accounts for 1 percent of the federal budget, he added.

As a result, a network of outpatient dialysis clinics sprung up around the country to accommodate these patients’ needs. Two large companies own 70 percent of these clinics, Oliver noted: Fresenius Medical Care and DaVita. [..]

Oliver ran through other complaints that have been made against DaVita, including questionable doctor referrals and accusations that the company purposely wasted drugs to be able to bill the federal government more.

“If it’s beginning to feel like DaVita is being run like a volume business …” Oliver started, before cutting to a clip that showed Thiry comparing his management of DaVita to that of Taco Bell. (Before the show ended, Oliver would apologize — to Taco Bell.)

Toward the end of his segment, Oliver emphasized that problems with the for-profit dialysis industry were not limited to DaVita.

He also called for better government oversight, as well as improved incentives for kidney transplants and health care “to keep out of dialysis in the first place.”

Oliver also praised those who were willing to donate one of their two kidneys while still alive.