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April 01, 2011


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Amy B

Interesting post, and the article is sure to generate controversy and fear.

One question for you-- where did you come up with the figure that only 25,000 people have access to Medicare as a result of the 1972 act?

The USRDS point prevalent count shows there are 300,000+ people under age 65 with ESRD. http://www.usrds.org/2009/ref/B_Ref_09.pdf

The largest number of people with ESRD is in the 50-59 age group. Even accounting for the number of ESRD patients who are not eligible (because of not meeting the other criteria re: work history, etc.) it still seems that many more than 25,000 people under age 65 with ESRD would be eligible for Medicare. How did you arrive at that figure?

Amy B

Ah, I amend my comment, as I just found your earlier post that referenced the different ways people are qualifying for Medicare. So you are saying that the vast majority of ESRD patients under age 65 qualify for Medicare because they are disabled, not solely because of having ESRD, am I understanding correctly?

If that's what you are saying, it seems like a false argument, because they wouldn't be disabled in the first place if they didn't have ESRD. Right?

I apologize for my ignorance on the topic-- thank you for your fantastic, and very interesting, blog!

Bill Peckham

Thanks for reading and the kind words Amy. My point is, the people discussed in the article aren't covered under "the law", no matter what unnamed kidney experts say (see second NYT excerpt).

I don't think it is a false argument - though I heard something similar via a frequent email correspondent after that earlier post. This article and many others like it paint a picture of a "special entitlement" "for one particular disease", "spinning out of control", sucking up "vast amounts of federal money" and it just isn't true.

Medicare covers people who are old and who are disabled and that Medicare is what is costing the federal government a lot of money because it is that Medicare that requires the federal government to pay 80% of the cost of dialysis for the people discussed in the article, in addition to hundreds of thousands of others.

Section 299I covers me: I've used dialysis for 20+ years, I've had Medicare as my primary insurer the entire time and about half the time I have been able to earn my secondary insurance through work (and half the time I have purchased secondary insurance through a State of Washington's kidney program).

Without Section 299I I would have had to seek a disability designation back in 1988, at the age of 24. My story sounds a lot like how Section 299I was "sold". I say Section 299I has been a success and continues to be a good idea. The NYT article never really talked about the program.


I am currently in hospital with renal failure. 20 years on dialysis = Please tell me more or where to find your story

Bill Peckham

Cutler that sucks. There is a pretty large, active community on line that you can use to help you navigate the road ahead. The thing to know is that other people have been in your shoes and those people have made it through.

You can read more about me on this blog (there is a biography project gathering dust that takes you to 1994), but here are some resources to connect through discussion boards:

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