South Africa has recently received international attention for discrimination in its system for rationing life saving dialysis treatment. For people with disabilities, hope of receiving dialysis treatment is almost nonexistent.
In South Africa, fewer than one in five people needing dialysis treatment receive it. To reduce the racial discrimination that was evident in these life-and-death decisions in the county’s recent apartheid past, to governemnt created a committee to oversee the process.
The committee proceeded to create a system categorizing social and medical factors in each individual to determine who would receive the expensive treatment. These factors include an individual’s job and their life expectancy, which has led to class discrimination similar to that in the U.S. system in the 1960s, before the federal government began covering dialysis through Medicare.
People with disabilities are rejected almost immediately. According to South Africa’s psychological exclusion criteria for determining who can receive dialysis, “any form of serious mental illness or incapacity which, as shown by psychiatric and medical examination, would preclude the patient and/or family or available support group from successfully managing the patient, considering his/her impairment, through dialysis, a transplant, and extended follow up care.”
For almost everyone in South Africa, dialysis is only available through public funding because it costs nearly $20,000 to pay for it out of out-of-pocket expenses, which is nearly double the county’s GDP per capita.