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Kidney Disease Care and Policy: An Ongoing Affair

      The origin of the affair between kidney disease care and policy can be traced back to the 1960s. Acute dialysis had just become available during and after the Korean conflict, utilized for those with acute kidney injury. Those afflicted with kidney failure due to combat-related injuries were flown to mobile ambulatory surgical units and received life-sustaining dialysis. This treatment reduced the mortality rate associated with this syndrome from >90% during World War II to ∼50%. In 1963, the Department of Veterans Affairs Hospitals announced its intentions to open 30 dialysis centers across the United States to provide chronic sustained dialysis for terminal kidney failure. Following suit, in 1965, the Public Health Service started the Kidney Disease Control Program (KDCP) and awarded 12 grants to start 12 dialysis centers across the country. It wasn't until 1971 that this issue become front-and-center, as outlined by Rettig in a series of articles.
      • Rettig R.A.
      The policy debate on patient care financing for victims of end-stage renal disease.
      • Rettig R.A.
      Special treatment —the Story of Medicare's ESRD entitlement.
      • Rettig R.A.
      Origins of the Medicare kidney disease entitlement: The Social Security Amendments of 1972.
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      References

        • Rettig R.A.
        The policy debate on patient care financing for victims of end-stage renal disease.
        Law Contemp Probl. 1976; 40: 196-230
        • Rettig R.A.
        Special treatment —the Story of Medicare's ESRD entitlement.
        N Engl J Med. 2011; 364: 596-598
        • Rettig R.A.
        Origins of the Medicare kidney disease entitlement: The Social Security Amendments of 1972.
        in: Hanna K.E. Institute of Medicine (US) Committee to Study Decision Making. Biomedical Politics. National Academies Press, Washington, DC1991