Monday, June 29, 1998
Sale of dialysis unit raises concerns
PRIVATIZATION: Center patients question level of care, company’s
profits
By Kathryn Combs
Daily Bruin Senior Staff
Since June of 1997, administrators for the UCLA Dialysis Unit
have been planning to sell. Now, after a one-year search, the UC
Board of Regents approved the sale during their last meeting.
According to Marshall Salomon, director of corporate development
and planning for Total Renal Care (TRC), they are slated to take
over the management and operation of the UCLA Dialysis Center
sometime in the next four or five weeks. TRC is the third largest
provider of dialysis services in the United States.
However, employees and patients are concerned that the quality
of care will decrease due to the unit’s sale to a for-profit
corporation. One employee expressed concern about the corporation’s
cost-cutting method of reusing dialyzers.
Medical center officials argue that they chose TRC because of
the company’s impressive track record.
"TRC has really demonstrated their commitment to our academic
and research programs, and that was very important to us as an
academic medical center," said Frances Ridlehoover, associate
director of professional and ambulatory services with the UCLA
Medical Center.
"They have a comprehensive quality management program led by
renowned experts in the dialysis field, and our current medical
directors will continue as the medical directors under TRC," she
said. "The quality that our program has had under current directors
will continue under TRC."
However, Miriam Blum, a peritoneal dialysis patient with UCLA,
said, "Quality means different things to different people. This
definition is probably different for someone on dialysis than for
an administrator or businessman."
Blum also spoke against the sale of UCLA’s dialysis unit at the
last regents meeting on June 18, when the actual sale was
approved.
"Total Renal Care plans to implement changes that increase their
profits but that decrease our care," she asserted during her
speech.
However, Salomon disagrees, asserting that both he and
representatives from TRC intend to meet with the patients and are
looking forward to doing so.
"UCLA is a world-renowned institution with a very well-known and
prestigious research program, and we are very interested in working
with them in the advanced studies of kidney failure," he said.
"We look forward to working with their staff and patients. TRC
is absolutely dedicated to providing our patients with the clinical
outpatient services required," he added.
Ridlehoover also said the new relationship between UCLA and TRC
will not only help the UCLA Dialysis Unit financially but will also
help to further research efforts at UCLA.
"The medical center has really experienced a decline in the
contribution margin of the program in the last three years," she
said.
"This is the amount the program can contribute to cover their
expenses. Plus, the market for dialysis services has become
increasingly dominated by international companies," she added,
explaining that corporations such as TRC can still provide quality
service while cutting costs.
However, Blum argues cost-cutting measures are often at the
expense of the patient. She cited the reuse of dialysis filters as
only one example of this.
"We don’t have kidneys that work anyway; now we have this
technique that works. Now they are saying it is OK to compromise
our care by reusing filters over again and again and again in order
to make more money."
Salomon said TRC is committed to the provision of quality care
at low cost.
"In terms of quality of care … we feel that we are the most
respected dialysis provider, and this is because we are a
quality-driven company," he said.
"The quality of care (at UCLA’s Dialysis Center), if anything,
will be enhanced," he added.
Salomon added that TRC does not typically face such opposition
from staff and patients and said that in fact, TRC has already met
with staff members and intends to meet with patients to discuss
this move.
"I think it is fair to say that if you spoke to them now you
would come away with a very positive feeling about the impending
acquisition," he said.
However, employees with the UCLA Dialysis Unit feel differently.
One employee fears that the corporation’s interest in profits may
compromise quality care.
Other employee concerns have been the potential for layoffs as a
result of this acquisition. However, UCLA officials say TRC’s
offers to employees have been generous.
"TRC will make offers to current employees at their current
salaries with an incentive payment in addition," Ridlehoover
said.
"(TRC) has also agreed to pay their health care benefits for the
next year, and we will work very hard to internally reassign
employees, should they not accept this offer."
In addition, Ridlehoover asserted that labor was not the reason
for the sale.
"The business driver on this deal is not labor expenses, it is
the economies of scale that a nationwide company brings," she
said
"A key contributor to selecting TRC for us was that they have
demonstrated a solid commitment to research and our academic
programs," she continued.
Blum, however would like to see the sale delayed and believes
patients should be consulted first.
"Patients were completely excluded, and if anyone really
believes that the medical director fully represents the patient’s
interests, I beg to differ," she said.
"Somebody has to stand up and say this is wrong."