Valuing Lives

The Policy Debate on Patient Care Financing for Victims of End-Stage Renal Disease

by Richard A. Rettig

Download

Download eBook for Free

FormatFile SizeNotes
PDF file 2.1 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

Purchase

Purchase Print Copy

 FormatList Price Price
Add to Cart Paperback52 pages $23.00 $18.40 20% Web Discount

Since 1972, Public Law 92-603, particularly Section 299I, provides Medicare coverage to all victims of end-stage renal disease (irreversible deterioration of kidney function). Medicare covers the high costs of treatment by hemodialysis or renal transplantation. This paper examines the decision to enact Section 299I and the policy debate which preceded it. Four characteristics of that debate are significant: (1) The debate was lengthy, beginning in the early 1960s and resolved in 1972. (2) The critical importance of paying for the cost of therapy was always clearly understood. (3) Strong resistance to expanding the federal government's responsibility from health research to include financing of patient care was encountered at every major juncture in the debate. (4) The resolution of the debate in the enactment of Section 299I occurred after very limited discussion and was inconclusive with respect to any definitive interpretation. The various medical and political factors affecting the policy debate are analyzed, and the implications of the decision are explored.

This report is part of the RAND Corporation paper series. The paper was a product of the RAND Corporation from 1948 to 2003 that captured speeches, memorials, and derivative research, usually prepared on authors' own time and meant to be the scholarly or scientific contribution of individual authors to their professional fields. Papers were less formal than reports and did not require rigorous peer review.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

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.