LEGISLATION AND THE AMERICAN DIALYSIS INDUSTRY - SOME CONSIDERATIONS ABOUT MONOPOLY POWER IN RENAL CARE

Abstract Monopoly power in the dialysis industry in the United States is linked to Public Lau’92‐603 (section 2991) of the Social Security Amendments of 1972 under which 90 percent of all patients with end‐stage renal disease became eligible for Medicare coverage In effect, Congress spawned a new government enterprise by removing the constraining factor of price to the consumer and legalizing government‐subsidized monopoltes in renal care which were empowered with the right to supply renal care services within designated areas without competition Those who suffer from renal insufficiency encounter monopoly on the supply side of the product (dialysis units) market, and the labor market (kidney specialists) since outside nephrologists are not permitted to treat patients‘assigned’ to “closed staff” units Copyright © 1991, Wiley Blackwell. All rights reserved