"The government" in Arizona is pulling the plug on 98 screened and approved transplant surgeries for 98 people, fellow humans, who were promised them. We all, so far at least, have to die eventually, but like this?
Most here have big hearts and a goodly supply of the milk of humankindness. We also fight, I do anyway, against a sense of the futility of opposing the massive momentum of Me-Mine-More-ism, which seems to be the fuel for our increasingly self-destructive human Juggernaut. The poorer the Richer make us, the more violently we seem to fight over the scraps rather than biting the hand that steals from us.
How about extending a helping hand to those 98? How about a micropayment account that, with maybe some of our collective charity (that is a GOOD word, by the way), these folks get a chance?
I have no idea how to go about this. I have no idea what the total cost for even a few of these surgeries would be, though a quick check gives some averages:
Transplant expense
Organ Cost Range Average Cost
Heart $50,000 - $287,000 $148,000
Kidney $25,000 - $130,000 $51,000
Liver $66,000 - $367,000 $235,000
Pancreas $51,000 - $135,000 $70,000
Heart/Lung $135,000 - $250,000 $210,000
Source: Battelle Institute/Seattle Research Center
http://www.chfpatients.com/tx/transplant.htm
I don't know whether the medical professionals and management of the hospitals and rehab locations that would care for these people would be willing or able to eat some part of the costs of care, though as a nurse I know that happens routinely in many situations. Lots of unknowns. I am also reasonably sure that some in this group have the experience and the skills to carry this forward.
What I know is what I read, starting around 0400 today, and searching for more details on the 98 people facing an early death on account of a REAL "death panel" with a reactionary, plutocratic face.
There's a whole set of other faces, too. Here's one, chosen by the writers at NPR:
In Arizona, 98 low-income patients approved for organ transplants have been told they are no longer getting them because of state budget cuts.
The patients receive medical coverage through the Arizona Health Care Cost Containment System (AHCCCS), the state's version of Medicaid. While it may be common for private insurance companies or government agencies to change eligibility requirements for medical procedures ahead of time, medical ethicists say authorizing a procedure and then reversing that decision is unheard of.
A Matter Of Heart
Randy Shepherd is 36 and 6-foot-3, but he has to toss baseballs to his 3-year-old son, Nathan, while sitting in a lawn chair. Shepherd has cardiomyopathy; his heart muscle is deteriorating. The condition is the result of rheumatic fever he had as a child. As a teenager, he had his heart valves replaced, but that was 20 years ago.
"The muscle's gotten tired and distended," Shepherd says. "It's just worn out."
You can hear the weakness in his voice, even though doctors implanted a pacemaker in 2008. They've told Shepherd that he needs a heart transplant to survive.
AHCCCS (pronounced like "access") was the only health insurance Shepherd could get because he had a pre-existing condition and, since he was forced to stop working in his plumbing business, little money. The agency authorized his transplant more than a year ago.
"The nurse who's the transplant coordinator did tell me about two months ago that I'm the next one of my body size and blood type, so the next [heart] that's available is mine," Shepherd says.
A Question Of Ethics
But as of Oct. 1, AHCCCS said it is unable to pay for Shepherd's transplant. In fact, facing a $1.5 billion budget deficit, Arizona has cut out all state-funded lung transplants, some bone-marrow transplants and some heart transplants -- including transplants for the condition Shepherd has.
"To basically renege on what you promised was [going to] be a chance at life is a very, very bitter indictment of the ethics of the Legislature," says Arthur Caplan, head of the Center for Bioethics at the University of Pennsylvania.
Caplan calls the reversal "awful" behavior because Arizona is going back on a covenant it made with its patients, and because these are patients for whom time is critical -- patients who spent months, some years, thinking they were covered.
"They then stop trying to raise money, stop trying to see what Uncle Fred might be willing to give them," Caplan says. "They don't have the bake sale. They don't make the appeal in church."
Saving Money?
Arizona says the cuts will save about $4.5 million this year. [Wow. Huh. Big deal.]
No one from AHCCCS would agree to an interview with NPR. But the state agency provided data it also gave to legislators to make their decision. It says only 15 percent of those waiting actually ever find transplant matches. The problem is, however, that no one knows ahead of time which 15 percent that will be.
The state's data also show the procedures have poor outcomes and that most patients die after the transplants. But critics say the data was cherry-picked, as it included only patients enrolled in AHCCCS and only for a two-year period.
A coalition of Arizona transplant centers, including well-known programs at the University of Arizona and the Mayo Clinic, recently gave the state data for a broader patient group and a longer time period. It showed much better outcomes.
Waiting Until January
State Rep. John Kavanagh, a member of the House Appropriations Committee in the Arizona Legislature, has looked at the new information.
"It's a terrible situation," Kavanagh says, "but we don't want anybody to die because of a faulty data set. So if we made a mistake, we're [going to] reinstate those that require it."
Kavanagh is promising a hearing when the Arizona Legislature convenes in January. He says the state can cut the money somewhere else.
Meanwhile, one patient has found a private bone-marrow donor.
Shepherd says he and his wife were bitter when they first learned his approval for a new heart was taken away, but they have learned to appreciate the time and the medical procedures he has already had.
"If I were to die because they didn't give me the transplant, I've had the last 18 months with my kids that I wouldn't have had otherwise because AHCCCS paid for my pacemaker," Shepherd says.
Now on federal disability, he will become eligible for Medicare next year. That gives him some hope whatever the Arizona Legislature does. Meanwhile, 96 other patients in Arizona wait.
This is complex stuff. But then so are so many other right-to-death issues. Yeah, transplants are expensive to perform and difficult to maintain. Lots of folks die anyway, during the surgery or shortly after, sometimes (often?) because the treatment has been delayed, by lack of donor organs, by line jumping by better-connected patients, by bad faith by "Unsurance" companies, by sudden exacerbations, lots of reasons.
But a lot of what this site and progressivism is about, it seems to me, is the steady drumbeat of that old "random acts of kindness and senseless acts of beauty" thing, where that stuff you learned about the Golden Rule, and playing nice, and no hitting, and treating others fairly and respecting them, comes from.
I read that the decent people in Vermont are maybe on their way to putting single-payer health care (NOT goddam "health Unsurance") in place, maybe even California if somebody kicks Grover Nordquist and his coterie off the US Highway 1A cliffs.
Change obviously goes all different ways, in response to movements of human hearts and heartlessnesses. (Says the Arizona kill-the-possibly-illegal-migrant-worker-but-only-after-sweating-him legislature, HAPPY HOLIDAYS! GO SPEND MONEY IN THE BIG-BOX STORES! HELP THE ECONOMY RECOVER AND SEND MORE MONEY UP THE PYRAMID!)
So I ask, is there anyone out there smarter than me and more adept at netizenship that could maybe sort out a mechanism for caring folks to contribute to a fund that might undo the death panel decisions handed down to these 98 individuals, and the truckload of sorrow just delivered to them and their families?
Might an action like that be one piece in the puzzle of how you restore the damaged heart of this country? I got two sawbucks I would be happy to drop in the box right now.