Brow Beat

John Oliver Explains Why the Kidney Dialysis Industry Shouldn’t Be Run Like a Taco Bell

As we’ve long pointed out, Last Week Tonight is at its best when its host is tackling subjects that might otherwise seem dull or esoteric, and Sunday night’s segment on kidney dialysis, of all things, was no exception. Even John Oliver was fully aware of just how unsexy the topic is: “I know right now you’re getting ready to push the button on your TV remote marked Dear God Literally Anything Else,” he said. “But I promise you, this is worth listening to.”

But what, exactly, is kidney dialysis? Well, as Oliver explains it, “dialysis is basically where a machine acts as your kidneys by taking blood out of your body, cleaning it, and then returning it to you.” Chronic kidney disease is still the ninth leading cause of death in the U.S. despite an incredible amount being spent on dialysis care. In 1972, Richard Nixon signed a law saying the government will pay for dialysis for anyone who needs it, basically establishing universal health care for only one of the body’s organs. “It’s like your kidneys, and only your kidneys, are Canadian,” pointed out Oliver.

Since then, a vast industry has built up around kidney dialysis, mostly revolving around two for-profit companies: Fresenius Medical Care and DaVita. While both have issues, Oliver focused on DaVita and its CEO (and The Man in the Iron Mask enthusiast) Kent Thiry. DaVita facilities tend to be understaffed, have been accused of scamming the government by wasting medicine, and openly treat their patients like they’re on an assembly line so that the company can keep a tight schedule, even at the expense of proper hygiene. Thiry has even directly compared running his facilities to managing Taco Bells—and in case you can’t immediately see the problem with treating health care like a fast-food chain, Last Week Tonight has a commercial to show exactly why that’s wrong.

Even assuming you’re not already a cog in the for-profit kidney dialysis industry machine, there is something significant you can do to help: You can help ease the kidney shortage by becoming a donor yourself through a website like Or, if you’d rather wait until you really are not using those kidneys anyway, you can just tweet #WhenIDiePleaseTakeMyKidneys to establish your preference to become a donor after your death.