The one disease that has near-universal coverage

This is Dr. Michael Wilkes with a second opinion. Of all the diseases that people get, what makes

end-stage renal or kidney disease unique is that it's the only one that the federal Medicare

program will pay to treat regardless of the person's age, insurance status, or how much money

they make. This comprehensive coverage started in 1972 because the life-sustaining treatments

of dialysis and transplants were especially expensive. Without government intervention,

most patients would not have been able to afford these treatments. Assuring this access to kidney

care is as close to universal medical coverage as the U.S. has ever come.

It was sponsored by Republicans and Democrats and signed into law by President Richard Nixon.

Today, about 800,000 people have end-stage kidney disease, and most of them are on dialysis.

One-fifth of those on dialysis need a kidney transplant, and while they wait for that

transplant, a dozen of them die every day in America.

End-stage kidney disease is a disease that can be cured by taking a kidney transplant.

End-stage kidney disease typically develops as the final stage of chronic kidney disease.

Several common diseases and risk factors lead to its development, including diabetes,

hypertension, and chronic kidney infections. The condition can also develop from acute kidney

injuries or rare genetic diseases. The treatments are still ridiculously expensive.

In fact, end-stage kidney disease patients account for over $6 million a year.

7% of all Medicare spending, even though they represent less than 1% of all patients.

People with end-stage kidney disease are often socially disadvantaged. Many are people of color,

and they are more likely to be low income. With the cost of care being so high, the government

has been looking for ways to improve the quality of care and reduce the costs for people with

end-stage kidney disease. The government has been looking for ways to improve the quality of care

The most recent experiment was to see if instituting penalties and rewards on providers could improve care.

The goal was to move people away from expensive, private, for-profit dialysis centers to home dialysis,

which is less costly and allows people more freedom.

But a new study published in JAMA suggests that the program with end-stage kidney disease penalties and rewards

does not work to increase rates of home dialysis or increase the rates of people receiving kidney transplants.

Perhaps the reason is that providers are really only part of the story.

Patient preferences also play a role.

And with kidney transplants, organ availability is also a limiting factor.

With elections around the corner, it is time to ask those running for office

if they are willing to make sure.

That evidence-based, cost-effective care is available to everyone who needs it for a chronic condition.

If we want to provide similar universal coverage for the treatment of other expensive chronic diseases,

we will also need to return to the days of bipartisan collaboration.

Another step would be to take out of the health care equation for-profit companies

whose goal is to seek revenue for their shareholders,

and not health for their patients.

This is Dr. Michael Wilkes with a second opinion.