ABSTRACT
The most comprehensive analysis of the End-Stage Renal Disease (ESRD) Program of Medicare was completed by Richard A. Rettig in 1980. Rettig's report is a detailed account of the first six years of the ESRD Program wherein he examines the implementation of the program and studies the mechanisms by which policy control is exercised within the federal bureaucracy. Some important lessons with application to heart transplantation may be learned from the ESRD experience, but there are limits in the scope of application. In an attempt to control the number and distribution of providers of ESRD services, the statute included provisions which imposed constraints on potential providers of ESRD services in the form of minimum utilization rates. As a result of the 1978 amendments, several optional incentives intended to increase the use of home dialysis and transplantation were introduced.
