The coming fiscal crisis: Nephrology in the line of fire

Martin J. Andersen, Allon N. Friedman

Research output: Contribution to journalArticle

10 Scopus citations


Nephrologists in the United States face a very uncertain economic future. The astronomical federal debt and unfunded liability burden ofMedicare combined with the aging populationwill place unprecedented strain on the health care sector. To address these fundamental problems, it is conceivable that the federal government will ultimately institute rationing and other budget-cuttingmeasures to rein in costs of ESRD care, which is generously funded relative to other chronic illnesses. Therefore, nephrologists should expect implementation of cost-cutting measures, such age-based rationing, mandated delayed dialysis and home therapies, compensated organ donation, and a shift in research priorities from the dialysis to the predialysis patient population. Nephrologists also need to recognize that these changes, which are geared toward the population level, may make it more difficult to advocate effectively for the needs of individual patients.

Original languageEnglish (US)
Pages (from-to)1252-1257
Number of pages6
JournalClinical Journal of the American Society of Nephrology
Issue number7
StatePublished - Jul 1 2013

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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