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High-Cost Life Prolongation: The National Kidney Dialysis and Kidney Transplantation Study

ROBERT A. GUTMAN, M.D.
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Duke University and Durham County General Hospital; Durham, North Carolina


Ann Intern Med. 1988;108(6):898-899. doi:10.7326/0003-4819-108-6-898
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End-stage renal disease requiring maintenance dialysis or transplantation is the only disease for which diagnosis alone entitles Americans to Social Security medical benefits (if they or family members have contributed to the system for a period of six quarters). Diagnosis leads to governmental medical support for only a few diseases: leprosy, tuberculosis, and venereal disease are examples. Entitlement to support for care for those diseases continues to be a public health issue.

The end-stage renal disease program was inaugurated because of the overwhelming cost of prolonging life, and it came as no surprise, therefore, that the program was very expensive.

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