National Kidney Foundation marks 50th anniversary of End-Stage Renal Disease program
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The National Kidney Foundation is recognizing the 50th anniversary of Congressional approval of the End-Stage Renal Disease program.
“Fifty years ago, a kidney failure diagnosis was tantamount to a death sentence,” Kevin Longino, CEO of the NKF, said in a press release. “Even though technology existed to extend the lives of kidney patients, it was extraordinarily expensive and unavailable to the majority of patients nationwide. Before the Medicare End-Stage Renal Disease (ESRD) program, patients literally had to beg for their lives to access this technology, but with a sweep of a pen, Congress and President (Richard M.) Nixon changed all that,” Longino said.
Congress wrote legislation that led to Section 299I of Public Law 92-603 creating the ESRD program and extending Medicare benefits to cover the cost of medical care for individuals with kidney disease. Nixon signed the legislation into law on Oct. 30, 1972, according to a historical account of the program written by researcher Richard A. Rettig, PhD, in the book Biomedical Politics.
At the time, legislators estimated the cost of dialysis would be “$22,000 to $25,000 per year per patient in a hospital; $17,000 to $20,000 in a hospital-related dialysis center; and $19,000 in the first year of home dialysis with a subsequent cost of about $5,000 per year,” Rettig wrote. He also estimated that 60% of patients would return to work.
“Preliminary estimates indicate an annual cost of approximately $250 million at the end of 4 years with the first full-year cost at about $75 million,” Rettig wrote.
“By guaranteeing access to dialysis in 1972, the Medicare ESRD benefit transformed kidney care in countless ways,” Longino said in the NKF release. “When it was enacted, only 10,000 Americans received dialysis. Today, more than 550,000 kidney patients in America access this critical, life-extending care. Another 240,000 have received the life-saving gift of a kidney transplant. Over the past half-century, millions of lives have been saved by the Medicare ESRD benefit.
“The ESRD program has improved not only the lives of the thousands of patients in need of a kidney but has advanced the entire field of transplantation,” Longino, himself a kidney transplant recipient, continued. “Advances in surgical technique, immunosuppression, histocompatibility, organ preservation, operational efficiencies and other innovations were made possible due to Medicare coverage of kidney transplants. These advancements benefit all transplant recipients.”
The kidney care community should mark the anniversary of the ESRD Program by looking toward the future, Longino said.
“Through our Innovation Fund we will accelerate the development of technologies such as a portable dialysis machine or an artificial kidney. Our professional education will equip the next generation of kidney care clinicians with the skills, information and resources they need to prevent, delay and treat kidney disease,” Longino said. “And we will advocate for increased federal investment in kidney health, expanded access to home dialysis and transplantation, delivery of more patient-centered care and policies that transform the lives of kidney patients.”
References:
NKF recognizes 50th anniversary of life-saving Medicare End-Stage Renal Disease Program. www.kidney.org/news/nkf-recognizes-50th-anniversary-life-saving-medicare-end-stage-renal-disease-program. Published Oct. 27, 2022. Accessed Oct. 31, 2022.
Rettig R. Origins of the Medicare kidney disease entitlement: The Social Security amendments of 1972. Published in: Biomedical Politics. Institute of Medicine (US) Committee to Study Decision Making; Hanna KE, editor. Washington (DC): National Academies Press (US); 1991. https://www.ncbi.nlm.nih.gov/books/NBK234191/. Accessed Oct. 31, 2022.
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