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Letter to the editor: Ask CMS to revise its proposed ESRD rule

Thursday, July 25, 2013 - 12:01 am

I am one of 400,000 Americans with irreversible kidney failure. I am a dialysis patient in Crown Point where many of my clinic mates are in the group of the 85 percent of patients with kidney failure who rely on Medicare’s end-stage renal disease (ESRD) benefit for life-sustaining dialysis care.

As a citizen of northwest Indiana and a person who relies on dialysis to stay alive, I am writing to express my concern over the recent proposal from the Centers for Medicare and Medicaid Services (CMS) that would cut Medicare’s end-stage renal disease benefit by 9.4 percent and the potential effects that cut would have on my dialysis care. Specifically, I am writing to urge you to intervene with CMS to ensure that this “proposed rule” — when it does become law — is reasonable and protects my access to quality care.

I am most concerned that additional deep cuts by CMS could affect my access to dialysis treatments. Cuts could also affect my ability to receive the appropriate type of treatment that works best for me. Limiting choice and availability of treatment options will not only inconvenience me, but may also affect my ability to be employed, stay out of the hospital and live an active life.

Further, I am concerned that my access will be reduced to crucial staff such as nurses, social workers and dietitians. Finally, if local facilities close or consolidate as a result of Medicare cutbacks that are too deep, my fellow patients and I will undoubtedly feel the effect. These cuts threaten to close smaller rural clinics, and this would undoubtedly affect my clinic in Crown Point.

We take dialysis three times a week for four hours a day, so having a clinic that is close to home is imperative. Please remember we have no choice; you submit to dialysis or you die.

My personal story is that I am an ESRD patient who suffers from polycystic kidney disease (PKD). I have lost several members of my family to PKD, including my father. In the clinic where I take dialysis, most of the people are brought in by ambulance, some are amputees and most have canes or a walker. Many are confined to nursing homes. I am your advocate for the state of Indiana, for the National Kidney Foundation, an ambassador for the Dialysis Patient Citizens and an ambassador for the PKD Foundation. I speak on behalf of my clinic mates, who are too sick and unable to speak for themselves. These cuts affect the very least of us.

I urge you to ask CMS to revise its proposed rule to ensure that funding levels are adequate enough to cover the cost of providing the life-sustaining treatments and maintain access to quality dialysis care. I urge your readers to do the same. Here is a link to an online petition where people can protest: www.change.org/petitions/center-for-medicaid-and-medicare-services-cms-;withdraw-the-proposed-cuts-to-dialysis-centers-and-esrd-patients.