The Medicare End-Stage Renal Disease Program: A Report from the Institute of Medicine

DURING the 1960s it became increasingly clear that patients with permanent kidney failure, previously certain to die, could be kept alive and in at least reasonably good health by long-term dialysis. At the same time, kidney transplantation was becoming increasingly successful as a result of improved programs of immunosuppression. Because of the high cost of these forms of therapy, especially long-term dialysis, and limited and fragmentary sources for payment of these costs, many patients were unable to obtain medically appropriate treatment for lack of funds. In 1972, Congress amended the Social Security Act to provide an entitlement to Medicare for . . .