Medicare provides health coverage for any American with end-stage renal disease - that is, kidney failure - regardless of their age or income. In 2020, Medicare spent nearly $51 billion on treatments for these patients. In the U.S., nearly 80% of the market for treatment of end-stage renal disease - dialysis - is controlled by two companies that together we call "Big Dialysis." Those two companies exercise a powerful duopoly that puts profits before people. Advocates for Fair Dialysis aims to change that.