President Trump has promised to fight for the forgotten men and women of America—those whose needs and suffering have been too often unheeded by their government. One forgotten group in healthcare is the millions of Americans with some stage of kidney disease—especially the more than 700,000 Americans suffering from the final, deadly stage of the disease, kidney failure. That includes 826 patients here in Vermont, most of whom must go through the incredibly draining experience of receiving kidney dialysis several times a week, for several hours each time.
But there is good news. President Trump recently signed an executive order launching a revolutionary initiative at the U.S. Department of Health and Human Services called “Advancing American Kidney Health.” The initiative aims to help prevent Americans from experiencing kidney failure in the first place, provide more options for treatment once that has occurred, and deliver more life-saving transplants.
This is especially important because kidney disease particularly burdens our low income and minority citizens. Kidney failure is three times more common among African-Americans than among whites, and low-income Americans are 50 percent more likely to suffer from it than those with higher incomes. Black and Hispanic Americans are also less likely to receive the transplants that represent the best treatment for kidney failure.
To prevent kidney disease and provide more treatment options, we’re launching new ways for Medicare to pay for kidney care. For example, nephrologists will soon be able to receive bonuses for preventing the progress of kidney disease in their patients. We’ll give providers a financial stake in getting their patients healthy, as opposed to just paying them for performing more procedures.
We have also proposed a Medicare initiative to give about half of America’s dialysis providers new incentives to provide patients with dialysis at home or even in their beds at night, rather than having them travel to dialysis centers. Today, only 4.6 percent of kidney patients in Vermont receive dialysis at home, an option that’s much more common in other countries. Home treatment is especially important for individuals and communities struggling to provide for their families—patients who cannot afford to leave their jobs and families several times a week for dialysis.
To provide more kidney transplants, we will be revising how kidneys are obtained from deceased organ donors, allowing better identification of kidneys for transplant. The executive order also calls for us to expand support for the generous living donors who choose to donate organs.
Changing how we identify transplantable kidneys from deceased donors, by itself, could produce life-saving organs for an additional 17,000 Americans each year—including some of the 59 individuals currently waiting for a kidney in Vermont.
The President’s kidney initiative also includes working with the private sector to develop artificial, implantable kidneys, and continuing support for research into precision-medicine treatments designed to target kidney disease in the populations who are more likely to be genetically predisposed to the disease, including African Americans. We’ll also undertake a national awareness campaign about kidney disease, which is often undiagnosed in its early stages, like breast cancer and prostate cancer once were.
Too often, Washington focuses on some of the same tired fights in healthcare, year after year—doing nothing for decades to improve how we cover and treat something like kidney disease.
President Trump is shaking that up, and delivering American patients the affordability you need, the options and control you want, and the quality you deserve—especially to patients, like those with kidney disease, who have been forgotten for too long.
Alex M. Azar II
Secretary of Health and Human Services