Application: The Economics of End-Stage Renal Disease

Application: The Economics of End-Stage Renal Disease

Introduction

Health care is a concept that cannot be neglected in any way. Health is basically the most important concern for the development and progress of any nation. If the population residing in a particular country is healthy physically and mentally then people are able to work better and in an efficient manner. Health care is the diagnosis of a disease, injury, ailment, physical or mental dysfunctions in human beings appropriately, the cure and their prevention. When we talk about the provision of health care then it straightly comes into the mind that it should involve “quality”.

Quality Health Care is a basic right of every resident of a particular state and government is responsible and answerable if this provision is not according to predetermined rules and regulations. That is why government has to allocate a certain budget in this regard. As far as United States of America is concerned, the increased incidence of chronic diseases, elder (aging) citizens and health care involved are responsible for the increased cost of quality care in our region and in the whole world. According to Center for Disease Control (2008), the ninth leading cause of mortality in United State is Renal Disease (Center for Disease Control, 2008). End Stage Renal Disease abbreviated as ESRD is a chronic disease and a permanent kidney damage resulting in kidney failure (Milstead, 2008).

Kidneys are the filtering organs of the body that removes all the unnecessary components from the blood and reabsorb all the essential elements and ions. In this condition kidneys do not perform appropriate function needed for day to day life. Diabetes and hypertension are the two major risk factors of End Stage Renal Disease in United States. These diseases affect the kidney most. Kidney may gradually terminate their functioning over ten to twenty years before End Stage Renal Disease occurs. Chronic kidney Disease is the first step that leads to the End Stage renal Disease. ESRD almost always comes after chronic kidney disease. The kidneys may slowly stop working over 10 - 20 years before end-stage disease results. As other health care issues, the quality, cost and access to quality health care for ESRD is also a big Challenge!

Chief Reimbursement Mechanisms

Medicare and Medicaid are the chief reimbursement mechanisms mentioned in this case study. Milstead stated that Medicare usually cover End Stage Renal Disease and includes coverage for under 65 years of age (Milstead, 2008). The basis for 1972 government legislation (due to which Medicare coverage for ESRD came into existence) was the belief that transplant would be the substitute for dialysis and was soon to become the part of routine therapy. According to Denver Post, Government insurance payment for dialysis was much expensive than the kidney transplant (Booth, 2011).

Below is a chart of The Changing Political Economy of Dialysis retrieved from Journal of the American Society of Nephrology.



(A) Trends in the number of treated ESRD patients. (B) Trends in total direct Medicare spending ...