Supply and demand can play a cruel twist of economic reality when it comes to medical care.
Three days a week, Paul Kresch and wife, Jackie, drive 64 miles round trip to Carson City for 3.5 hours of dialysis treatment. Kresch is among about a dozen patients who must drive from South Lake Tahoe for treatment.
Barton Memorial Hospital does not have a dialysis center because the number of patients requesting the service does not justify the expense of building a specialized facility.
The Kresches, who retired to the South Shore four years ago from Southern California, say they realize there are drawbacks to living in the Sierra -- like limited medical services. Still, they hope some day Barton will find the money to build a dialysis center.
"If you consider travel time, especially during winter, it takes us two hours to drive there and two hours on the return," Jackie Kresch said.
About two years ago, Paul Kresch suffered an aneurysm in which his aorta nearly burst. The aneurysm led to kidney problems, which forced the former Jet Propulsion Laboratory engineer into dialysis.
More than 20 million Americans have diseases of the kidney and urinary tract. About 400,000 have kidney failure and need dialysis to stay alive.
Dialysis cleans the blood of toxins and excess chemicals and removes fluid from the body, performing the same basic functions as do healthy kidneys.
With at least 12 people on the South Shore with kidney problems, Paul Kresch's friend, Daniel Sullivan, has asked Barton to explore the possibility of opening a treatment center.
"A hemodialysis center located in South Lake Tahoe would fill an increasing need within our community, as well as being profitable for the provider," Sullivan wrote to the Barton board of directors.
At any give time, there are six to eight Lake Tahoe residents receiving care in Carson City, and the same number traveling to Reno for treatment because the Carson center is full, Sullivan said.
"Since patients are normally too ill to drive, especially following a dialysis treatment. Friends and family members must provide transportation," he said. "Sadly, some patients have been forced to move away from Lake Tahoe because no one was available to drive them."
Barton spokeswoman Linda Thompson said while the board of directors has not ruled out building any new wing of service, the limited demand for a dialysis center doesn't justify building one.
"Barton hospital is a small community hospital, and we are fortunate to have the many services currently provided," Thompson said. "Although we do offer a lot of specialty care, we cannot provide everything.
"The board of directors must continually evaluate the future direction and the potential growth of the hospital through adding services that may be more appropriate to a larger population base here at the lake. Dialysis is a service currently offered in Reno (and Carson City), and it is not something that is on a top priority list for Barton to offer. "
The centers in Carson City and Reno are all operating at capacity, Sullivan said.