The Federal Government and Social Planning for End-Stage Renal Disease

Past, Present, and Future

by Richard A. Rettig, Ellen L. Marks


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The history of federal policy toward end-stage renal disease is considered in the years from 1960, when hemodialysis and kidney transplantation emerged as treatments for permanent kidney failure, through the Social Security Amendments of 1972 and the "kidney amendment" (Sec. 2991), to the imminent issuance of a final rule implementing changes in reimbursement policy required by legislation enacted in 1978 and 1981. This Note interprets this history in light of the "tragic choice" dilemma of saving lives vs. conserving resources.

This report is part of the RAND Corporation note series. The note was a product of the RAND Corporation from 1979 to 1993 that reported other outputs of sponsored research for general distribution.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.