The social and economic costs of end-stage renal disease. A patient's perspective.

The soical and economic effects of end-stage renal disease are enormous. This case history of our experience with dialysis and transplantation details our life with these two modes of treatment. Despite the common notion that Medicare covers most of the expenses, the detailed records of our financial experience show that Medicare paid only 53 per cent of our total costs; the remainder came from a mixture of private and public sources. In seeking alternative financial support, we encountered many problems, including complex and constraining requirements for aid, invasion of privacy, high insurance and bank-interest rates and termination of employment. Even those in middle-income brackets find it difficult to maintain their independence under such circumstances. New legislation extending Medicare coverage of home dialysis and transplantation should help to alleviate these problems in the future.