Gale Adcock

Getting to know my patients and learning about their lives has always been one of the highlights of my career as a family nurse practitioner. That love of helping people is also what inspires me to serve my fellow North Carolinians in the North Carolina House of Representatives. It is a privilege to help both my constituents and my patients.

My time in both of these roles means that health care issues are particularly important to me. And right now, dialysis patients need help. Many dialysis patients younger than 65 are responsible for covering 20 percent of the costs of their treatment that Medicare won’t cover given that federal law doesn’t require insurers to offer Medigap plans to them. These leftover costs add up and can be a huge burden for patients to afford.

Dialysis treatment isn’t optional. It is essential, life-saving care. Patients must receive this treatment to stay alive, and don’t have the option to not pay for what Medicare won’t. We must help them.

The Jack Reynolds Memorial Medigap Expansion Act is how we can do just that. It is a new bill with bipartisan support in the U.S. Congress that would make sure patients can get plans to cover the 20 percent that Medicare doesn’t, meaning the treatments and medications they need are more affordable.

This Medigap extension wouldn’t raise overall costs of Medicare much, either. A recent Health Management Associates report shows that the cost of extending Medigap coverage to those patients under 65 would add little to federal spending over the next 10 years while saving more people money and allowing them to afford their prescribed medications. With that, we’d see an uptick in overall health for kidney patients who are struggling.

Payment isn’t the only thing dialysis patients struggle with. There are many gaps in the care they receive since being on dialysis often requires patients to see multiple health care providers and specialists. Often, each one prescribes different medications and treatment plans without consulting the others.

This leaves patients navigating between health care providers to make sure everything is working cohesively. But patients often don’t speak the same medical language as health care providers or aren’t able to communicate the treatment plans as thoroughly. Patients need a coordinated care system where their health care providers can communicate with one another.

Transportation also is a major issue since patients must go to a treatment center multiple times per week. Sometimes these centers are located near where they live, but sometimes they are several miles away. If patients can’t get to the center, they don’t receive treatment, and if they don’t receive treatment then they are putting their life at risk.

Even if patients can get to dialysis treatment and afford the extra costs, this doesn’t mean they are receiving all of the health care they need. A lot of patients don’t have access to dental care, for example, which is crucial for potential kidney transplant recipients.

The Better Kidney Care Act, another important bill before Congress that has bipartisan support, would address each of these problems by providing coordinated care for all dialysis patients, while also providing transportation services and dental care.

It would be a different story if we didn’t know how to help dialysis patients, but we know what we can do to help, and it’s time for Congress to act. The tools are right in front of us.

Gale Adcock of Cary is the deputy Democratic leader in the North Carolina House of Representatives, serving her fourth term, and a family nurse practitioner. She is a graduate of East Carolina University.

Contact Bobby Burns at and 329.9572.