Abstract
Since the passage of the renal disease provisions of the Social Security Law, the percentage of patients in the United States utilizing self-care treatment has declined from 40% to about 15%. The background and provisions of the Rostenkowski Bill, H.R. 8423, are summarized. Primary aims of the bill are to remove disincentives for use of self-dialysis, remove certain disincentives to transplantation, and to provide for peer review and goal setting for network use of various treatment modalities. Studies of the Health Standards and Quality Bureau, and activities of the Veterans Administration and the Artificial Kidney -Program of the National Institute of Arthritis, Metabolism, and Digestive Diseases relevant to self-care dialysis are briefly summarized.