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Home > Archive > Kidney Failure > October 2004 > social work and dialysis: USA - Germany
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social work and dialysis: USA - Germany
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| Hatice 2004-10-03, 10:21 pm |
| Hi
As a former dialysis patient in Germany I am now writing a dissertation on
the role of social work in the dialysis treatment. There is a lot of
literature about the social worker role in the US and it seems to me that
it is a lot
more advanced than in Germany. For instance it is claimed that a social
worker is always part of the dialysis treatment team. My question now is,
has anyone some experience with the situation in the US?
How accesible is this service to everyone there? Do you find it useful?
Thanks Hatice
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| Pierre 2004-10-03, 10:21 pm |
| I don't know about the US, but in this part of Canada, the social worker is
definitely a part of the team, just like the dietician. The social worker
specifically assigned to the dialysis unit drops in regularly, and is always
just a phone call away. The social workers also regularly facilitate support
groups. They help with things like getting forms signed for disabled
transport, income tax disability form, etc., plus they help in any way they
can with any problem at all. They are very useful, when you need them. A
social worker is also part of the renal team for pre-dialysis patients, and
sees the patient at every follow-up appointment. As a patient, it's
reassuring just knowing you can call someone like that who knows your case
and your circumstances if the need arises.
Pierre
"Hatice" <haticeoe@nospam.web.de> wrote in message
news:54d1a7672c34a101a60d9eec82a2dac4@localhost.talkaboutsupport.com...
> Hi
> As a former dialysis patient in Germany I am now writing a dissertation on
> the role of social work in the dialysis treatment. There is a lot of
> literature about the social worker role in the US and it seems to me that
> it is a lot
> more advanced than in Germany. For instance it is claimed that a social
> worker is always part of the dialysis treatment team. My question now is,
> has anyone some experience with the situation in the US?
> How accesible is this service to everyone there? Do you find it useful?
> Thanks Hatice
>
>
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| Hatice 2004-10-03, 10:21 pm |
| Thanks, Pierre. It definitely does not work this way in Germany. When I
told my supervisor about the social worker involvment in the treatment he
was sceptical and said that only a certain class can get such a service.
Does it cost anything and is it available to everyone, or only with
certain health insurance?
All the best
Hatice Özmen
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| Pierre 2004-10-03, 10:21 pm |
| Glad to help, Hatice.
No, it doesn't cost a dime. It's just a normal part of the universal
healthcare system here, so it's available to every single pre-dialysis and
dialysis patient, and transplant patients too. It may be different in other
parts of Canada, I don't know. I live in a major city. I'm not sure about
the US. I'm guessing that for dialysis patients, it's similar to how it
works in Canada, except that the delivery of services is by private
companies rather than the government.
Pierre
"Hatice" <haticeoe@nospam.web.de> wrote in message
news:cb62b23337f0eacc14759422b2f2969e@localhost.talkaboutsupport.com...
> Thanks, Pierre. It definitely does not work this way in Germany. When I
> told my supervisor about the social worker involvment in the treatment he
> was sceptical and said that only a certain class can get such a service.
> Does it cost anything and is it available to everyone, or only with
> certain health insurance?
> All the best
> Hatice Özmen
>
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| Larry Krzewinski 2004-10-03, 10:21 pm |
| On Sat, 12 Jun 2004 14:54:17 -0400, "Pierre" <pierrot51@hotmail.com>
wrote:
>Glad to help, Hatice.
>
>No, it doesn't cost a dime. It's just a normal part of the universal
>healthcare system here, so it's available to every single pre-dialysis and
>dialysis patient, and transplant patients too. It may be different in other
>parts of Canada, I don't know. I live in a major city. I'm not sure about
>the US. I'm guessing that for dialysis patients, it's similar to how it
>works in Canada, except that the delivery of services is by private
>companies rather than the government.
>Pierre
It's the same here in the states, Pierre. The government picks up the
majority of the tab, 80% of it, and if you have private insurance it
generally pays for the rest. I always had a social worker and
dietician I could consult with and they consulted with us at least
once a month on a regular basis and were available if you had any
questions. In my case I was extremely lucky to have a doctor that
consulted with me twice a week during my almost 9 years on
hemodialysis and he and I became friends and he taught me a lot during
that time.
Larry
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| ssaal 2004-10-03, 10:21 pm |
| Hatice <haticeoe@nospam.web.de> wrote:
> Hi
> As a former dialysis patient in Germany I am now writing a dissertation on
> the role of social work in the dialysis treatment. There is a lot of
> literature about the social worker role in the US and it seems to me that
> it is a lot
> more advanced than in Germany. For instance it is claimed that a social
> worker is always part of the dialysis treatment team. My question now is,
> has anyone some experience with the situation in the US?
> How accesible is this service to everyone there? Do you find it useful?
> Thanks Hatice
I've often felt sorry for the dialysis social workers. They train to help
people, but I find they spend most of their time doing paperwork. For
example, arranging transportation, and most often, making sure their
insurance (primary and secondary) are in order, paid, etc. Thus, it is an
advantage to the patients, theoretically, because emotional help/support
is available, but it is a huge advantage to the unit - especially the
chains of dialysis units (Gambro, in my case), who will now get maximum
reimbursement.
Example: my dialysis was hospital based, but the hospital sold the unit to
Gambro because they were too incompetant to make money with it. The first
thing Gambro did was have the social workers make sure every patient had
secondary insurance to cover the 20% Medicare doesn't cover. The hospital
never did that. I don't know any business that can forego 20% of income
and stay profitable. Since then, the unit is up and running and one
siocial worker quit and the other is there only one (orv two) day(s)
per week.
--
Sam Saal
ssaal@sonic.net
Delete NOSPAM to reply
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| Larry Krzewinski 2004-10-03, 10:21 pm |
| On Sun, 13 Jun 2004 16:17:58 GMT, ssaal <ssaalNOSPAM@sonic.net> wrote:
>Example: my dialysis was hospital based, but the hospital sold the unit to
>Gambro because they were too incompetant to make money with it. The first
>thing Gambro did was have the social workers make sure every patient had
>secondary insurance to cover the 20% Medicare doesn't cover. The hospital
>never did that. I don't know any business that can forego 20% of income
>and stay profitable.
It's also illegal. The Medicare co-pay must be collected from the
patient or his Medigap insurer or the medical provider is in violation
of the law and can be legally prosecuted. It's is hard to believe the
hospital's business manager was unaware of that. Medicare is usually
pretty strict about enforcing that provision.
Larry
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| ssaal 2004-10-03, 10:21 pm |
| Larry Krzewinski <Feerless_Freep@madmagazine.com> wrote:
> On Sun, 13 Jun 2004 16:17:58 GMT, ssaal <ssaalNOSPAM@sonic.net> wrote:
[vbcol=seagreen]
> It's also illegal. The Medicare co-pay must be collected from the
> patient or his Medigap insurer or the medical provider is in violation
> of the law and can be legally prosecuted. It's is hard to believe the
> hospital's business manager was unaware of that. Medicare is usually
> pretty strict about enforcing that provision.
Maybe I wasn't clear. Those patients who had secondary insurance were
covered by it. Those that did not have secondary insurance were not
billed, but were not helped to get it, either. I don't believe it amounted
to anything illegal; just foolish.
--
Sam Saal
ssaal@sonic.net
Delete NOSPAM to reply
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| Larry Krzewinski 2004-10-03, 10:21 pm |
| On Sun, 13 Jun 2004 20:06:51 GMT, ssaal <ssaalNOSPAM@sonic.net> wrote:
>
>
>Maybe I wasn't clear. Those patients who had secondary insurance were
>covered by it. Those that did not have secondary insurance were not
>billed, but were not helped to get it, either. I don't believe it amounted
>to anything illegal; just foolish.
It is illegal, Sam. A lot of doctors were doing forgiving the co-pay
to help their poorer patients and Medicare cracked down on them. The
co-pay has to be paid in order to comply with the law. I can
understand the doctor's generosity but the law is the law. The law
may have been written that way to help circumvent Medicare fraud.
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| ssaal 2004-10-03, 10:21 pm |
| Larry Krzewinski <Feerless_Freep@madmagazine.com> wrote:
> On Sun, 13 Jun 2004 20:06:51 GMT, ssaal <ssaalNOSPAM@sonic.net> wrote:
[vbcol=seagreen]
> It is illegal, Sam. A lot of doctors were doing forgiving the co-pay
> to help their poorer patients and Medicare cracked down on them. The
> co-pay has to be paid in order to comply with the law. I can
> understand the doctor's generosity but the law is the law. The law
> may have been written that way to help circumvent Medicare fraud.
Larry
I'm not disagreeing with you. My only issue was that the sale of the
dialysis unit displayed incompetence on the part of the hospital,
not just whatever legal failing. I'm not sure whether I wish they'd
get caught for the legal part. Seems to me that getting caught - and
being forced to fix the problem - would have set a different scenario
than their calculation to sell the dialysis unit. But now it is too
late. Furthermore, that hospital is so screwed up in so many ways,
I doubt the threat of legal action would unmire them.
--
Sam Saal
ssaal@sonic.net
delete NOSPAM to reply.
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