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How Many Transplant Centers Do We Need?

Belding H. Scribner, MD
JAMA. 1973;226(10):1225-1226. doi:10.1001/jama.1973.03230100047012.
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The publication of the 1973 kidney transplant registry report in this issue has very special importance because beginning last July 1, all of the costs of transplantation now are covered by Medicare. Among other things, the report indicates that approximately 1,300 transplants were performed in 1971. Although the 1972 figure undoubtedly will be higher, it will fall far short of the estimated 4,000 to 6,000 transplants that must be carried out annually to meet the projected need that is rapidly becoming apparent, since Medicare assumed a major funding responsibility for these patients. How should this need be met?

Traditionally, American medicine has expanded its capability to meet a new health care need through self-generated programs sponsored either by individual physicians or local hospitals and clinics. In many expansion programs the free enterprise system continues to work well. However, in recent years this system has been getting American medicine deeper and

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