Infuriating but clear read about one area in which profit-driven healthcare increases death and suffering at great financial cost. Twenty-two percent of American dialysis patients die every year, whereas in Japan it’s 5-6% and Western Europe 9-12%. Why? Largely because the pressure to squeeze dollars out of patients leads to dialysis that is (1) centralized, and not carried out at home, and (2) fast, so they can have greater throughput, instead of overnight (it can be done while a person sleeps!) and tailored to an individual’s system. Fast dialysis can cause sudden blood pressure drops and other problems, leading to stroke and cardiac failure. Meanwhile, dialysis centers have local monopolies, and aren’t afraid to punish patients who complain by labeling them combative and denying them service; the only alternative is often to go to the ER, where there are other risks. ( )