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The American Health Care System Previous Volume 328:366-371 February 4, 1993 Number 5

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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What happens when the federal government is virtually the only payer for a medical service that is privately provided? The best example of this is Medicare's End Stage Renal Disease Program. For 20 years, the government has essentially frozen the level of payments to facilities and physicians providing dialysis treatment, sharply reducing the real value of their remuneration. The End Stage Renal Disease Program is the subject of this report, my fifth on the American medical system^1,2,3,4,5.

To provide medical care in a program so constrained, providers have lowered operating costs, boosted productivity, and aggressively sought new patients. Although . . . [Full Text of this Article]

The Evolution of the Policy

Patients

Facilities

Economy Measures

Payment to Physicians

The Quality of Care

References

Related Letters:

The End Stage Renal Disease Program
Robertson J. S., Graves J., Himmelstein D. U., Woolhandler S., Stark P., Goodkin D. A., Iglehart J. K., Greer J. W.
Extract | Full Text  
N Engl J Med 1993; 329:139-141, Jul 8, 1993. Correspondence

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