The federal governments's role in management of end-stage renal disease.

This presentation traces the history of the Federal government's support of research and development related to the therapeutic modalities dialysis and renal transplantation. A description is presented of the Federal government's role in introduction of these new treatment methods into medical practice and of the gradual assumption by the government of responsibility for funding of the cost of dialysis and transplantation in the United States. Current issues and problems related to the federally subsidized End-State Renal Disease Program are discussed. The concept of "technology assessment" is introduced followed by discussion of the vital role it must play in any future federal development and support of new medical treatment technologies which must be paid for with public moneys because of their high cost.