…in Arizona. This isn’t even rationing. It’s very nearly murder:
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.
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.
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.
Republicans in Arizona—members of the same party that railed against health care rationing and warned us all of politicians convening death panels during the health care debate—will save $4.5 million by murdering Randy Shepherd and the other 97 people who were relying on AHCCCS for life-saving and already-promised care.
98 people dead to shave $4.5 million off a $1500 million budget deficit.
I’m so glad Obama stood up to this sort of madness and understood why single payer universal coverage was the only way to save lives. Oh wait…..
Ditto to Last of the Time Lords.
And if everyone signed up to become organ donors this kind of thing would never happen. Just sayin.
Maybe he should try India? We are the third world, we are the people making an uglier future for eveyone who isn’t wealthy. That’s what Teabaggers stand for.
Having several doctors in my family, I would suggest not signing up to be an organ donor, but to instead tell your next-of-kin that you want your organs harvested when your time has come.
Your loved ones will ensure that you really are beyond saving before they consent to pulling the plug. A doctor with a blank check (organ donor card) might place the interests of the person awaiting a transplant above your interests.
I’m not necessarily blaming the doctors who make that decision: the calculus often works out. I just happen to value my life more than I value the life of someone I’ve never met. That means that I want to keep my organs in my body if there’s a decent chance I might still live, even if that means the transplantee will definitely die.
Murder?
Really?
Danny.
You hysterical little pussy…..
The taxpayers are guilty of MURDER if they do not pony up?
Really?
Perhaps you would like to pay the $4.5 million.
Are You guilty of MURDER, Danny, if You refuse to pay for these treatments?
No?
But the taxpayers of arizona are?
You hysterical clueless little pussy…..
1
yeah.
sweet.
maybe they can find a couple of thousand other people’s treatments to cancel and make a REAL dent in that deficit…..
(ps- when you Liberals start gushing CASH out those bleeding hearts get back to us; in the meantime kindly STFU…)
See, his mistake was being born. As long as people remain a fetus, the right wing will throw all their support behind them. Once you’re born, of course, conservatives just say “Fuck You.”
@10, It’s the sport fisherman mentality. It leads to opposition to abortion and support for the death penalty, under the principle of throwing back the little ones so you can catch them when they’re bigger.
@7, 8 Wow, your compassion is just … overwhelming. It brings a tear to my eye. Tell ya what, let’s compromise. We’ll take the $4.5 million from the Federal military budget. Won’t even make a dent in that $663 billion hole that the conservative agenda has drilled into the budget, and 98 people get to live.
Because conservatives view life as so sacrosanct, right? As long as it’s their own lives their talking about. I mean, we can protect those things with the lives of the young men and women who enlist and $663 billion in taxpayer money for defense spending, right? But 100 people with organ failure, for whom it would cost less than $50K per person to help? Fuck ’em.
This is the state that gave Cindy McCain’s father a monopoly to distribute beer, so he could make a fortune, and she could buy seven houses for them to live in, so her husband can make sure that working class people are condemned to death for lack of health insurance. Because taxing the McCains would harm economic development, you see.
Right after this story aired there was an NPR news segment with Boehner saying how the health care reform law will destroy the “greatest health care system in the world.” Pshaw.
At the rate they’re going, Arizona will soon have a lower standard of living than the Mexicans across the border that terrify them so much.
@7: The man purchased the health insurance, and the state agreed that it would cover his heart transplant. He paid his insurance premiums, and he’s entitled to receive the services that he paid for.
By your logic, insurance companies should be allowed to refuse to pay out to their clients, huh? What is happening here IS “very nearly murder” (key words: very nearly).
@8: You seem to think that conservatives pay taxes and liberals mooch off the government. Well, I’ve got news for you, boy. There’s a reason that red states tend to get money from the federal government, and blue states tend to contribute instead. (http://www.taxfoundation.org/taxdata/sho…)
Fnarf – That outcome may solve the Arizonians perceived immigration “problem”.
As a part time resident of the state I have experienced the backwardness of the “leadership” there. The Sheriff Joe mentality still holds sway.
@9 and 13,
It costs a lot more that $50k to give someone an organ transplant. The transplant itself is extremely expensive, there’s the lifetime of antirejection meds, and some people need multiple transplants throughout their lives. I’m guessing that the $4.5 million figure is what’s estimated for the people who get transplants before they die, which won’t be all 98 of them.
13
Compassion?
Are you donating your own personal money to help these folks?
That would be ‘compassion’.
Taking other people’s hard earned money by force (aka Taxes…) to fund your pet charity causes is not compassion.
It’s ‘very nearly’ robbery……
Actually, taxes are what you pay to enable a civilization that provides the security to have abstract notions like “money”. In fact, “your” money is just a contract with all the rest of us, and if you don’t pay your dues it doesn’t exist at all.
Get over yourself you greedy fuck.
@17, health insurance companies refuse to pay out to their clients all the friggin’ time.
Don’t worry everybody, the Free Market will save this man! Duh-duh-duhna!
…oh, right.
I wish I had the money for these people…
I live in Arizona and work at a doctor’s office; we give away a lot of free care to patients who have AHCCCS because we can’t get it to cover routine things. *shrugs* What’re you gonna do when you live in a state where the very title of Medicaid suggests it doesn’t want to help people? I mean, this is not “Arizona Health Care For People In Need”, this is the “cost containment system”. Even the name shows that they don’t give a shit.
As a Canadian, this kind of story makes my heart break. It’s so hard to watch what is happening to your country and not be able to do a thing about it.
Agony: Single-payer systems make these kind of calls all the time. Britain will pay about £30,000 per QALY (quality adjusted year of life added). Canada will pay about $50,000 per QALY. If a treatment costs more than this, you will not get it.
Well, the next time one of the folks who voted for this claims to be “pro-life” he or should out to catch a hailstorm of criticism for hypocrisy.
Let’s see how long it takes for CNN and other public news outlets to hold them accountable. This act is sicken and yet these Republicans get away with it everywhere and none of their voters are ever the wiser until it’s too late and they’re stuck without help. 🙁
…That happens to be the health insurance I’M on, as an Arizonan ex-foster child…
Note to organs: DO NOT FAIL RIGHT NOW PLZ.
@31: Uhh… Right! “Everyone” should fill out the organ donor card! It makes “everyone” better off!
Every hear of the Prisoner’s Dilemna, you ignorant fuck? Look up the Wikipedia entry, then get back to me.
@33: I’m familiar with Prisoner’s Dilemma. Assuming you are as well, you should explain exactly how it relates to the situation at hand; I don’t have the foggiest idea.
First, I apologize for the tone of the last post: I was drunk and surly due to work-related issues. I say this not as an excuse but as an explanation.
At the 30,000 foot level, the Prisoner’s Dilemma reveals that what is best for society is not what is best for any one individual in that society. As applied here: society as a whole is best off when everyone carries an organ donor card (cooperation). But each individual is best off when everyone except him carries an organ donor card (defection); further, that individual will never be worse off by electing not to carry an organ donor card. My guess is that most people arrive at this conclusion themselves– “carrying the card will never make me better off and it just might make me worse off”– which is why the number of organ donors is low.
So I (actually, my medical professional relatives) propose “tell your loved ones” as a solution: it hopefully alleviates the concern of possibly being worse off for being an organ donor. Assuming your loved ones don’t stand to inherit lots of money should you die, of course.
The federal reserve just printed 600 billion dollars and you’re telling me 4.5 million of that can’t go to keep 100 people alive? Man, fuck that.
@35: Attempting to apply game theory to the masses is pointless, as it assumes that people as a whole will behave logically and rationally.
Also, you keep on assuming that there are negative effects of being an organ donor. Can you point to one case in which someone was taken off life support prematurely because they were an organ donor?
20,
people like you make me ill, which is bad since i don’t have health insurance. this person can’t work and make “hard earned money” due to something that happened to him when he was a child. otherwise, i’m sure he’d have some form of health insurance which would help him in this sitation. because a private health insurance company would NEVER say no to him because of a pre-existing condition right? oh wait…
as someone without health insurance (i have a job but because insurance is ridiculously expensive, i can’t afford to put $300+/month towards something i may or may not use), situations such as these scare the shit out of me. what kind of country are we if we allow our citizens to die because they can’t afford to live?
@37: Your response is “game theory doesn’t work”? Then I suppose all the research over the last 60-some-odd years, including work that resulted in several Nobel Prizes, was worthless? Are you sure you know what you’re talking about?
The number of non-organ donors is precisely the result predicted by this type of “game”: one where the game is only played once, among people who have no prior connection, and with whom there can be no retaliation for defection.
I am not a doctor, so I have no first-hand knowledge of someone being taken off life support early. All I have are second-hand accounts provided by family members, which I believe. It isn’t that difficult to see, either. I doubt any doctor would ever harvest organs from a healthy patient, but I could see some doctors being tempted if the donor patient has a 10% chance of survival. And still more would be tempted at a 1% chance. There’s a judgment call made at some point– it’s very rare to get someone at a mathematical 0% chance of survival– and someone thinking of “the greater good” might call the death sooner than someone thinking of your good.
You don’t have to believe me if you don’t want to; go on thinking that game theory is bullocks and doctors are all perfect people who would never make morally gray decisions. I’m better off that way.
@39: You’re an idiot. Read what I said about game theory again and get back to me.
Also, you don’t know much about organ transplants, do you? No doctor would harvest someone’s organs under the assumption that they’re not going to make it anyway. You know why? Because if they wait until that person finally succumbs, THE ORGANS WILL STILL BE JUST AS TRANSPLANTABLE. If a doctor thinks that an organ donor isn’t going to make it, they’ll wait and see, while still providing their best care. Here’s some game theory for you: if a doctor lets someone die to harvest their organs, they’ll get no pay-off, and there’s a definite chance that they’ll go to prison for a while (i.e., small chance of a big cost). Game theory predicts that any sane person would play it safe, since there is nothing to be gained by taking such a big risk.
You may want to loosen up the tinfoil hat a bit.
This is the bleak reality of the current state of the Arizona budget. The transplants that were revoked have a low outcome of success. If we have limited resources, is it better to use that 4.5 million to extend the lives of 98 people through transplants, or would it be better to use that money to cover more people? For example, 4.5 million in blood pressure screening and drugs would save a lot more than 98 lives.
The Republicans in the Arizona Legislature do not care about poor people. They are not going to give AHCCCS more money; in fact, they are likely going to cut more come January. If they, say, closed the loophole that makes country club memberships exempt from sales tax (I’m not making this up), they could save at least one of these 98 people’s lives, but I would bet money that they won’t do it. So this isn’t the last time we’re going to have to decide which people we are going to let die.