Description: The aim of this project is to prepare a book-length manuscript about federal government policies--medical research, capacity development, treatment financing--toward end-stage renal disease (ESRD) from 1960 to the present. This embraces the therapies of dialysis (hemodialysis and peritoneal dialysis) and kidney transplantation. The ms. will attempt to provide a coherent, full-length history of a unique policy response to expensive, life-saving medical innovations. The audiences will be policy makers, clinicians, and the attentive public. This ms. will attempt to draw lessons regarding the clinical, epidemiological, and ethical issues involved in federal government policies toward this chronic disease. Part one of the ms. will deal with the emergence of hemodialysis and kidney transplantation in the early 19605 through the enactment of the Social Security Amendments of 1972. Part Two will deal with events from 1972 to the present, focusing on the Medicare ESRD program. Part Three will consider the U.S. experience in light of several cross-national country case studies. The ms. will be prepared in the following way: (l) a working outline will be established; (2) the author's published and unpublished writings will be integrated into a working draft ms.; (3) systematic revision of the draft ms. will be done by (a) circulating the draft ms. to key individuals for review, conducting telephone interviews with them, and seeking access to their personal files, and by (b) reviewing documents and files in the possession of the author, the key individuals, and relevant executive agencies and congressional committees. cross national analyses will include a set of case studies (probably the United Kingdom, France, Italy, Canada, as feasible).