RT Journal Article
SR Electronic
T1 The Coming Fiscal Crisis: Nephrology in the Line of Fire
JF Clinical Journal of the American Society of Nephrology
JO CLIN J AM SOC NEPHROL
FD American Society of Nephrology
SP 1252
OP 1257
DO 10.2215/CJN.00790113
VO 8
IS 7
A1 Andersen, Martin J.
A1 Friedman, Allon N.
YR 2013
UL http://cjasn.asnjournals.org/content/8/7/1252.abstract
AB Nephrologists in the United States face a very uncertain economic future. The astronomical federal debt and unfunded liability burden of Medicare combined with the aging population will place unprecedented strain on the health care sector. To address these fundamental problems, it is conceivable that the federal government will ultimately institute rationing and other budget-cutting measures to rein in costs of ESRD care, which is generously funded relative to other chronic illnesses. Therefore, nephrologists should expect implementation of cost-cutting measures, such age-based rationing, mandated delayed dialysis and home therapies, compensated organ donation, and a shift in research priorities from the dialysis to the predialysis patient population. Nephrologists also need to recognize that these changes, which are geared toward the population level, may make it more difficult to advocate effectively for the needs of individual patients.