1972

Passage of Section 2991 of Social Security Act, where Congress provides funding for all costs of treatment for end-stage kidney disease (i.e., dialysis) (Rothman II, 96-109). “Once the line was sharply drawn between money and life, the answer in a democratically elected political forum had to be life. No politician would wish to defend the proposition that the rich could live because they had access to a machine, while the middle-class died because they could not afford it. One might ask why a similar reaction did not promote preventive health measures, or to move down the social scale, why when comparative statistics demonstrated unequivocally that the rich lived longer than the poor and that rates of mortality in black ghettos were many times greater than those in other communities, no reforms were initiated, including national health insurance? The answers, however, are relatively clear. For one, the middle-class character of the dialysis advocates and dialysis patients was a distinct advantage. For another, statistical overviews can never match the power of the particular case” (102-103). . . . In the 1970s, dialysis patients received preferential treatment because of the power of technology creep, middle-class advocacy, American attitudes toward life-saving machines, and a political process which, when the case was framed specifically and dramatically, elevated life over money (107).