Date of Submission

Spring 2020

Academic Program

Global and International Studies; Global Public Health

Project Advisor 1

Helen Epstein

Abstract/Artist's Statement

Across nearly all categories, the United States kidney care system ranks below its global counterparts. With a high prevalence of kidney disease, poor treatment outcomes, and high expenditures, there is no doubt that the U.S. kidney system needs revamping. In 2019, the Trump administration released the Advancing American Kidney Health Initiative, which, among other things, both restructures the Medicare payment systems for kidney care to incentivize new treatment practices and outcomes and alters the kidney transplant system in an effort to increase transplant rates. Alongside the goal of improving patient outcomes, the proposal seeks to reduce the expenditures of this Medicare entitlement program. While the proposal answers many of the major requests of the kidney community for improvements, the proposal must also be interrogated with the awareness of the Trump administration’s intentions of eliminating such entitlement programs and the general hostility of President Trump towards Medicare. Alongside this potential issue are several pitfalls in the proposal, including lack of transparency for patients, penalization of providers, absence of a safety net for poor and high-risk patients, and, some allege, a potentially risky living donor reimbursement program. This project aims to identify the promising aspects of the proposal alongside the potential risks of this new care model while drawing on the experiences of other industrialized countries in the realm of kidney care.

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Open Access

Creative Commons License

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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