After imploring viewers to not press the “Dear God Literally Anything Else” button on their remotes, comedian John Oliver devoted most of Sunday’s “Last Week Tonight” to the for-profit dialysis industry.
The segment focused on one of the country’s largest providers, DaVita, which has settled lawsuits about kickbacks to physicians, Medicare billing discrepancies, and the overuse of a medication. (Oliver also spends some time ruminating about DaVita CEO Kent Thiry’s personal eccentricities, such as making dramatic entrances riding a bicycle or horse while wearing a medieval costume.)
Kidney disease is the ninth-leading cause of death in the United States, according to the Centers for Disease Control and Prevention. In 1974, a few years after Medicare began offering universal coverage for people with severe kidney disease, about 16,000 people were covered. Today, over 450,000 people are on dialysis, which Oliver called a “Brita pitcher for your blood.”
Some of the show’s staffers attended one of DaVita’s dialysis education sessions. During a recording played on the show, a woman identified as a “DaVita educator” presented long-term dialysis as an option instead of receiving a kidney transplant — which Oliver called the “moral equivalent of watching someone tread water in the middle of the ocean and not encouraging him to take a [expletive] rope.”
“We focused on DaVita because they have the most patients” and because of Thiry’s particular quirks, Oliver said, but he noted that some of the issues were present throughout the industry. (Oliver also mentions settlements paid by another large dialysis provider, Fresenius.)
“We need to make sure that dialysis clinics have better oversights and we need to create better incentives for transplants and for treating kidney disease earlier to keep patients out of dialysis in the first place,” Oliver concluded.
Fresenius did not release a statement following the segment. In response to STAT’s request for comment on the segment, a DaVita spokesperson said, “We are proud of our differentiated clinical outcomes, our teammates’ dedication to patient care and our strong culture. Our teammates are passionate about delivering high-quality patient care and enabling our patients to live fulfilling lives. We will continue to advocate for our patients and invest in our teammates and our culture.”
SEIU-United Healthcare Workers West, a major health care industry union in California, released a statement after the show that highlighted a bill in the state’s Legislature that would require annual inspections for dialysis clinics, among other provisions. A rally supporting the bill is planned for May 23 in Sacramento; a vote on the bill should happen in early June.
This story has been updated to add a statement from DaVita.