...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.