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Kidney Foundation of the Texas Panhandle

Affiliated with the National Kidney Foundation

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The kidney Foundation of the Texas Panhandle is indeed happy with your efforts on behalf of all kidney patients. the fight against the notion's number four killer has just begun. The general public must be made aware of this quiet, deadly killer that takes more lives each year than automobile accidents. One reason so many people shy away from facing the facts is the enormous expense associated with treatment. In the Amarillo area we have several patients on home hemodialysis and several more awaiting either live donor or cadaver transplants. Most of our home patients were trained at the dialysis center in Dallas, then sent home with an artificial kidney machine on lease from funds furnished by federal grants. Now, due to a shortage of these funds, the home patient will be required to pay for the machine and the supplies. The supplies alone will cost in excess of $600.00 per month, a prohibitive cost for the average salaried worker and certainly prohibitive for patients who have lost their jobs because of the kidney disease.

Another problem faced today is the lack of organ donors, due in part to lack of public knowledge as to how vital a role they play in sustaining life. Lost states have passed liberal laws governing organ donation, but in Texas alone last year 2,500 people died for lack of kidney donors or personal finances to purchase artificial kidney machines.

The local office of the Texas Rehabilitation Agency has very cerefully considered every request for financial aid, but with limited funds and ridgid guidelines for administration of these funds, they have been unable to furnish much-needed assistance. From personal experiences, I am convinced that with the necessary funds available they would be the best agency to administer funds to kidney patients in this area.

18m sure you're aware that except for the initial cost of the kidney machine, it costs no more to sustain a working, tax-paying life than a person with a mental health problem who is confined to an institution and can no longer hold a job in our society. So on behalf of all kidney patients in the Panhandle and the members of this affiliate of the National Kidney Foundation, we urge you to continue the fight against kidney disease. We have many of the solutions, but lack the necessary funds to implement them. If I can be of service, please call on me.

Sincerely yours,'

Your Contribution is Tax Deductible

John Rogers, President

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THE KIDNEY FOUNDATION OF TEXAS
P. O. Box 7226 Dallas Texas 75209

April 13, 1972

Senator John Tower

c/o Jeff Yudin

Room 142

Old Senate Office Building
Washington, D.C. 20510

Dear Senator Tower:

I would like to express the support of the Medical Advisory Board of the Kidney Foundation of North Texas. I speak for all the doctors and the patients involved in this serious disease. Support for patient care is certainly needed. The Bill attached to Vocational Rehab, if they come through in Texas the way they have in Massachusetts, will be a very worthwhile contribution to the medical welfare of the people of the United States.

If there is anything further I can do, including coming to Washington with my experience in your own state with dialysis and transplant, to explain specifically the needs of the people of the whole area, I would be delighted to do so. I know other people involved in this area and any of us would be glad to help out in whatever way we could. If I can be of help, even on this short notice, please feel free to call

me.

Yours sincerely,

Alook dull

Alan R. Hull, M.D.

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KIDNEY FOUNDATION OF OKLAHOMA-SOUTHERN KANSAS

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800 NE 15th Street Oklahoma City, Oklahoma 73104 405-232-8648

April 14, 1972

Honorable John Tower

c/o Jeff Yudin

Room 142

Old Senate Office Building
Washington, D.C. 20510

Dear Senator Tower:

I have been involved in the care of patients with kidney failure and have first hand experience with the financial devastation afforded the families of these patients. The Tower Bill is of vital interest to patients with kidney failure and all of us involved in their care.

Availability of Vocational Rehabilitation funds to supplement other available monies would substantially improve our capability to meet the needs of dialysis and transplantation procedures for patients with renal failure.

Sincerely yours,

BJM: drd

B. J. MATTER, M.D.
Past President

Senator TOWER. Mr. Chairman, at this time in behalf of Senator Williams, Senator Boggs, and myself, I would like to introduce three representatives of the National Kidney Foundation.

I will just ask them to come join me here at the table, if I may. First is Dr. George E. Schreiner, professor of medicine, Georgetown University Medical Center, and chairman of the National Kidney Foundation Legislative Committee.

Next is Dr. E. Lovell Becker, professor of medicine, Cornell Medical Center, and president of the National Kidney Foundation.

And Dr. Samuel Kountz, assistant professor of surgery, University of California, who transplants more kidneys than any other surgeon in the world.

Thank you.

Senator CRANSTON. Thank you very much for your constructive and helpful testimony. Your advice will not go unheeded by this committee. I can assure you that this committee will take affirmative action on this major problem.

Senator TOWER. Thank you very much, Mr. Chairman.

Senator CRANSTON. Thank you.

I now want to welcome each of you in your capacity as witnesses to this committee. We deeply appreciate your coming.

Senator TOWER. If I may, I would like to excuse myself and leave these gentlemen to the tender mercies of the committee to answer any questions that might be forthcoming.

I would like to apologize to them for possible mispronouncing of any of the medical terms, and leave it to them to provide the committee with the expertise necessary.

Thank you very much.

Senator CRANSTON. Thank you, Senator.

May I ask you to proceed in whatever order you wish. I would like to ask that you submit your prepared testimony for the record. We have reviewed that testimony and we have a number of questions that we would like to ask you, rather than having you read your prepared statement; but if you wish to make any summarizing statements, that will be most welcome. Your prepared statement will be printed at the end of your testimony.

STATEMENT OF GEORGE E. SCHREINER, M.D., CHAIRMAN, LEGISLATIVE COMMITTEE, THE NATIONAL KIDNEY FOUNDATION, ACCOMPANIED BY E. LOVELL BECKER, M.D., PROFESSOR OF MEDICINE, CORNELL MEDICAL CENTER, AND PRESIDENT, THE NATIONAL KIDNEY FOUNDATION, AND SAMUEL KOUNTZ, M.D., ASSISTANT PROFESSOR OF SURGERY, UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, CALIF.

Dr. SCHREINER. Thank you very much.

I am Dr. Schreiner, and you have had the other members of the panel introduced.

Dr. Becker and I will be able to answer any questions you may have on dialysis. Dr. Kountz has transplanted more kidneys than any other surgeon in the world and would be very happy to answer questions relating to transplantation.

We, as you suggest, will not read our prepared statements, which are submitted for the record.

Senator Tower really said it all. The beauty of this amendment to the Vocational Rehabilitation Act is that no great new bureaucracy will siphon off the funds. People who need this need it now and immediately. This is the best situation we can imagine to deliver this, where it is needed in an immediate way.

We do not propose funds for construction. We are not competing with any other existing Federal program.

As Senator Tower said, it really removes a bottleneck. As we think more and more about the program and what we are trying to accomplish, it just seems to fit the bill so perfectly that we are extremely enthusiastic about it. I can give you some concrete examples.

I had a patient last week right here in Alexandria with a small business, making about $5,000 or $6,000 a year out of the business. Her husband has uremia and needs to go on dialysis and register for a transplant program.

She has two choices: she can close up her business, in which case they get eligible for the Virginia medicaid and all three children go on welfare. Her husband gets his medical care, medicare, and she will become a ward of the State.

As opposed to this, some rehabilitation funds will allow here to keep her business, support her family, and hopefully dialysis for her husband.

Our association has estimated the dollar cost for this kind of maintenance will be less than one fourth of what the State will actually pay to support her under the existing mechanism. It is not a question of doing this in addition, or spending additional moneys. It is doing it in a more efficient way, rather than the clumsy manner that we have to do it under our existing patchwork program.

All we can say is, it is a wonderful program.

Senator CRANSTON. Dr. Becker or Dr. Kountz, do you want to add anything?

Dr. KOUNTZ. I would like to add to what has been said to say that a large number of these cases are eligible candidates for transplantation, which truly rehabilitates them, and they can lead a perfectly normal life and enjoy and do anything they have done prior to their illness. So that this legislation should provide the opportunity for a greater number of patients to be treated and eliminate the high cost of dying. Dr. BECKER. I would like to echo the statements made by Dr. Schreiner and Dr. Kountz, and emphasize one other aspect. That is, by alleviating the problem of end-stage renal disease, it gives us more opportunity to put our creative efforts on diagnosis and treatment and hopefully to avoid or pending the time when patients develop endstage renal disease.

Senator CRANSTON. I thank each of you very much. I will direct the questions just in your general direction, and however you wish to answer among the three of you, proceed to do so.

First, I would like to ask if you feel that a $25 million budget estimate for fiscal 1973 is adequate to deal with the nationwide problem that we face?

Dr. SCHREINER. "Adequate" is a relative term. The quick answer is that, no, this will not in itself pay the total cost for all the patients who

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