Did the controversial in Congress dialysis of 1971 change Medicare?

Some Kidneys (not an actual photo)

Lets look back to 1971!

Dialysis was invented for patients with kidney disease in 1960 but the cost of this procedure was (and continues to be) extremely expensive and private insurance did not cover it. It was a market failure. During the 1960’s, stakeholders for kidney patients sought to have dialysis included as a benefit in existing health programs such as the VA. When Medicare came around the pressure increased to include dialysis as an option for people with kidney disease. At its inception however, Medicare only covered those over 65.

Then in late 1971, the Ways and Means Committee of the House of Representatives (the committee in charge of Medicare), was having a hearing on dialysis. At this hearing Shep Glazer implored Congress to cover the treatment and then was dialyzed in front of the committee. The folklore is that this hearing caused Congress to pass ESRD coverage.

Politics, however, is much messier than that. In order to be passed, the inclusion of ESRD would be part of the less controversial bill that included coverage of disabled individuals in Medicare. During negotiations, the Senate Finance chairman, Russell Long, was pushing hard for Medicare drug coverage (which was an initial recommendation by Medicare for inclusion). Long lost this battle and settled for ESRD coverage in hopes that this would further other similar conditions to be covered by Medicare.

So while an “in Congress dialysis” did do a lot for public opinion and raising the issue of dialysis, like all things in politics negotiations and appearing to “win” was the real reason that hundreds of thousands of people with kidney disease can afford coverage.

Interestingly, Glazer experienced a sudden drop in blood pressure five minutes into the procedure in the Ways and Means Committee room and the physician ended the dialysis immediately. So in reality there were two myths to this story: the testimony did not draw Congress to act and a full dialysis was never preformed.


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