The Idea:

We can cure end-stage renal disease (ESRD) and do away with the need for long-term dialysis treatments

(and save hundreds of billions of taxpayer dollars). Yes, billions!

Congress should start a $15 billion, budget-neutral, space-race-like, winner-takes-most competition that uses our economic system’s best weapons --- entrepreneurship, private financing, and the competitive marketplace. The government just primes the pump.

How it would work:

Our goal is to create a technology that allows people to grow new kidneys. What is needed is a federal effort that boosts current research in the small, but growing scientific fields of bioartificial and regenerative medicine. To do this, the U.S. government should first announce a competition where the winner will get a huge, monetary prize for curing ESRD ($5 billion). That will get a lot of media attention. To encourage competition and a variety of approaches, up to 10 companies and/or institutions are allowed to begin competing for the prize. After a successful application screening, each competing group gets $100 million for its first year's work. Every year, some groups would likely drop out because they had taken the wrong paths and approaches. If none of them dropped out, then the one or two programs showing the least promise would be eliminated each year. The remaining groups in the competition would continue to get yearly grants of $100 million or more. These groups could seek out additional private financing at any time. If it is eliminated from the official competition, that group could merge into one of the survivors or seek its own private financing for any direction it wanted to go. As the competition progressed, the surviving groups could also combine efforts or make deals to collaborate. The eventual winner gets a $5 billion grand prize. Over the years, the annual grants to the competing groups and the administration of the competition would cost an additional $5-10 billion.

Another beauty of this process is that it would force these groups to operate as economically, efficiently, and fast as possible. As for the intellectual property that will be created, the companies could own it, but the U.S. government would share in a small percentage of the gross sales revenues for any products and/ services that result, as well as any associated patent royalties. Perhaps some of these revenues could then be used to fund similar competitions for other diseases.

Just like the 1960's space exploration program, I'm sure that there will be numerous collateral discoveries and products coming out of their work that will benefit other branches of medicine, science, and society in general.

We can fund this competition by taking a commonsense approach to ESRD IV drug reimbursement. The drug companies should make profits that are very healthy, but not obscene. The total costs of this competition can be made budget-neutral for the federal government over its lifespan and it will, of course, end up saving hundreds of billions of taxpayer dollars in the coming decades.

We need to take the Center for Medicare and Medicaid Services's (CMS) latest 10-year budget projections for ESRD drug costs, subtract $15 billion, and then decide how to spread this "pain" fairly among the drug companies. Put another way, Congress should lower the Medicare ESRD drug reimbursements to more reasonable amounts, have these payments go directly to the drug companies, and then use the savings to fund this competition.

And just what’s wrong with this idea?

• It would be one of the greatest humanitarian accomplishments of all time….
• It would significantly reduce Medicare expenditures….
• It could spawn a new sector of “medical tourism” that would greatly benefit our national economy….
• It would like lead to numerous scientific discoveries and products that would benefit society….
• It would be budget-neutral in the short run and would save hundreds of billions in the long run….
• It would reward companies that work as efficiently, cost-effective, and rapidly as possible as well as discourage any wasteful spending….
• It would produce hundreds of millions, if not billions, in revenue for the U.S. government….
• It would vastly improve the lives of over 1 million Americans in the next ten years by curing end-stage renal disease and eliminating the need for long-term dialysis treatments….
• It would cure end-stage kidney disease in the individual regardless of the cause(s)….
• It would fund similar projects to find cures for all the major diseases....