The United States Declaration of Independence guarantees “life, liberty and the pursuit of happiness”. In October 1972, the US Congress passed the Social Security Amendments of 1972. Under this Act, Congress amended the Medicare law to extend coverage to individuals who were under 65 years of age, if they had End Stage Renal Disease (ESRD), and had (or were the spouse or dependent of someone who) worked long enough to qualify for Social Security. Before this law, only 65 years of age and over are entitled to free, no premium payment Medicare.
The US Congress enacted this historic Medicare entitlement for dialysis, the first to cover a particular diagnosis under the guarantee to “life”. A particular diagnosis means this Medicare law does not cover other illnesses, however terminal, i.e. Cancer, AIDS, Heart Disease, etc. It only covers ESRD. The justification for this is that patients with Cancer, AIDS, Heart Disease, etc. can go on remission and live. The dialysis patient will surely die in a matter of days or weeks without dialysis. There is no remission for ESRD but dialysis would rehabilitate a big proportion of the patients. They can work, pay taxes and support their family and the economy, but only if they have the lifesaving treatment they need so badly.
The US law provided for a budgeted program authorizing appropriations of “such sum as may be necessary” to financially assist U.S. citizens or legal immigrants, as it states, “aliens lawfully admitted for permanent residence...Financial assistance was to be for any costs which individuals are unable to pay from funds otherwise available to them,” which in short, means rich people with means to pay for dialysis are not entitled to the free coverage.
Although the unit costs of dialysis seems high, the technological advance could bring them down. “For example, Dr. Sam Kountz, a transplant surgeon at the University of California, has reduced his costs to $8,000 per transplant or no more than any major surgical procedure.” (From: Biomedical Politics, 1991, Chapter: Origins of the Medicare Kidney Disease Entitlement: The Societal Security Amendments of 1972)
Another study in the US showed that lives could be saved if ESRD patients can afford transplantation, otherwise, those will be unconstitutional needless deaths. A national program of kidney transplant through the Social Security Administration was enacted.