President Trump signed an executive order Wednesday meant to improve treatment efforts for kidney disease and to increase the availability of organs for transplants.
Health and Human Services Secretary Alex Azar said Wednesday morning prior to the signing that the executive order includes efforts to increase organ donations, including kidneys, intestines, and livers from living donors and donors who have died, as well as to encourage and incentivize dialysis treatment clinics to provide dialysis in the patients’ homes.
“Dialysis is like a full-time job,” Trump said Wednesday at the Ronald Reagan Building and International Trade Center. “Patients and families are all impacted by kidney disease. We’re with you every step of the way.”
Azar told reporters in a call Wednesday prior to the executive order signing that live donors would receive federal compensation, as well as childcare, for their time in the hospital. “We’re also making new efforts to address the financial efforts for donors, with federal compensation and childcare,” he said.
Federal funding for both donors and recipients could be the greatest contributor to a shrinking transplant waitlist. While procedures are already paid for by the government, recipients and donors still have to cover travel costs and child care, as well as wages foregone while in surgery and recovery.
The order would have the federal government compensate both parties for expenses related to undergoing the procedures.
This initiative, along with a widespread campaign launch to increase awareness of kidney disease and a shortage of organs, Azar said, will make a significant dent in ever-growing transplant waiting list.
“17,000 people could receive kidneys,” Trump said before signing the executive order. “And we think it could be even higher than that … With other organs [including the liver, lung, intestine], that would be about 28,000 American lives saved each year and that could be higher.”
Another aspect of the executive order would enhance accountability measures of the 58 organizations tasked with finding these kidneys to be transplanted. Organ Procurement Organizations have been charged with under utilizing organs that come from the deceased.
About 115,000 Americans are on an organ waitlist, and, each year, about 6,000 to 8,000 people on that list die.
Many transplant centers limit the amount of organs that can be transplanted based on risk levels of spreading illness from the diseased to the recipient, a factor in the reality that the number of people waiting for organs vastly outpaces the number of available organs. For instance, the kidney of a donor who has died and was infected with Hepatitis C, a curable infection, would not be used by doctors due to any possible risks of the infection being transmitted to the recipient.
For those who have to wait for an organ, dialysis is the only option. The cost of dialysis treatments in a clinic can reach about $70,000, while at-home dialysis, also called peritoneal dialysis, costs about $53,000 per person.
“Dialysis from home is long overdue,” Trump said. “But now we’re getting it done.”
Trump’s plan would include upending the payment models of Da Vita and Fresenius dialysis clinics, which make up the lion’s share of the for-profit dialysis treatment market, by altering the pay-for-treatment model.
The Trump administration says that offering peritoneal dialysis treatment would save the government millions. Medicare currently pays for dialysis treatments. Medicare providers will also be encouraged to monitor people at risk of kidney disease and to prevent end-stage renal disease.
In addition to saving the federal government millions, Trump said, “My executive order will improve the quality of life of kidney patients.”
In Wednesday morning’s press call, Azar said that the administration plans to double the number of available kidneys, both artificial and from live donors, by 2030. Trump confirmed that researchers are working to create viable artificial kidneys.
“This is a first, second, and third step, but we’re going to make progress here that many people wouldn’t even believe,” Trump said as he sat down to sign the executive order Wednesday.
