We must protect quality kidney care

Having played in the National Basketball Association for 15 years, and having also survived a potentially terminal health problem, I’m often astounded by how much in our lives is determined by chance. A last-minute desperation three-point shot or the slight angle of the ball circling the rim can determine a win or loss in a big game.  Similarly, a timely versus a delayed physical exam can mean the difference between life and death. 

Life is full of seemingly inconsequential decisions that have lasting, life-altering effects.

Chance was on my side in 2000 when an annual, pre-season physical exam revealed that I suffered from focal glomerulosclerosis, a condition that inevitably leads to kidney failure. Shortly after the diagnosis, my kidneys deteriorated to the point where they were ineffective in filtering toxins from my blood. I needed either to begin dialysis or undergo a transplant. I was fortunate. I had a family member whose tissue matched mine, and who was willing to donate his kidney to me. I was truly blessed. I underwent a kidney transplant, and miraculously I was able to resume my career in professional basketball.

Today, 400,000 Americans rely on life-sustaining dialysis treatments three times weekly and supportive care provided by dialysis professionals. For millions of Americans with kidney disease, the stars don’t always align as they did for me. With a shortage of kidney donors and a nationwide increase in kidney disease, dialysis is the normal course of treatment for individuals with kidney failure.  

The Medicare program makes dialysis possible to the vast majority of individuals with kidney failure.  Forty years ago, Congress saw the wisdom — and the need — for government to step in and make sure that dialysis is available to people  whose kidneys have failed, whether those people are young or old. In 1972, Congress made the important decision to save the lives of millions of individuals who had been facing a sentence of certain death.

Congress faces a similar decision now.  

As lawmakers grapple with difficult issues related to reducing the national debt and cutting the deficit, it would be easy for them to take a "treat everyone the same" approach to cutting funding.  But individuals with kidney failure are not the same as everyone else. They have special requirements that Congress understood and acted upon 40 years ago. It is equally important to realize that dialysis is not the same as all other health care. Dialysis providers have spent the past two years tightening their belts, implementing payment reforms, and achieving efficiencies evident in no other part of the health care system.  

While I'm neither a provider nor a policymaker, I know enough to understand that when Medicare funding is deeply cut, there are consequences for patients. Especially for a program like Medicare's End-Stage Renal Disease (ESRD) program, where the economics are so fragile.  

For the past 10 years I have worked with members of the kidney community as they have successfully improved care and increased patient survival rates, and as they have begun to implement Medicare reforms that are saving taxpayer's money. I am proud of the work the community has done. But further reducing Medicare funding for end-stage renal disease — especially at a time when dialysis payment reforms are midstream — could be damaging. So, as Congress and our policymakers debate potential cuts in Medicare, I urge them to remember the covenant their predecessors made with kidney patients more than four decades ago: to provide some of America's most vulnerable citizens with the life-sustaining care they need. Protecting funding for dialysis — and for the individuals who rely on it for life — should not be left to chance.

Mourning is a former 7-time NBA All Star, philanthropist and national kidney disease awareness advocate.

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