Monday, May 15, 2017

Medicare Entitlement for Dialysis

   In 1944, in Nazi-occupied Holland, Willem Kolff invented a primitive artificial kidney machine.  After the war, Kolff sent his machines to Europe and the United States.  In 1960, Belding Scribner of the University of Washington in Seattle and Wayne Quinton, an engineer, invented a permanent vascular access device.  Their first patient Clyde Shields, lived 11 years on hemodialysis.  The disease is fatal unless patients are treated by either kidney transplantation or dialysis.  

   Before Public Law 92-603, 92nd Congress, H.R. 1 October 30, 1972, only those over 65 qualified for Medicare benefits.  Patients, their families, and physicians, as well as the National Kidney Foundation, worked to get the federal and state governments to provide financial coverage for treatment of kidney disease.  Congress passed and sent to President Richard M. Nixon the Social Security Amendments of 1972.  Nixon signed the bill.  He was overwhelmingly reelected.

  Public Law 92-603, considered kidney disease as a disability, “shall be deemed to be disabled for purposes of coverage under parts A and B of Medicare subject to the deductible, premium, and copayment provisions of title XVIII” (

   Sec. 299I, states that every individual who has not reached the age of 65 but is medically proven to have chronic renal disease and requires hemodialysis or kidney transplant is entitled to monthly insurance benefits.  “Medicare eligibility on the basis of chronic kidney failure shall begin with the third month after the month in which a course of renal dialysis is initiated and would end with the twelfth month after the month in which the person has a renal transplant or such course of dialysis is terminated.”

   This entitlement covers over 90% of all U.S. citizens with severe kidney disease.  It resulted in prolonging survival for many years.  A unique feature of this law is that the Social Security Amendments of 1972 is the only entitlement for a specific disease, chronic kidney failure.  In a negative sense, the provision of the law was that it is unfair to those who suffer from other ailments.  Public Law 92-603 was within American policy for health care.  Public facilities for treatment of mental illness and mental retardation have been available since the 19th and 20th centuries.  

   Nixon is only remembered for the Watergate scandal.  Now let us remember him by the millions of kidney patients who receive Medicare at any age, and Jehovah who put him in his position.  

   "Let every soul be in subjection to the superior authorities, for there is no authority except by God; the existing authorities stand placed in their relative positions by God." (Romans 13:1)

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