In further news that the U.S. residents among us can be unspeakably proud of, the state of Arizona has, thanks to budget cuts, stopped funding some life-saving organ transplants for patients who cannot pay for them themselves. The result is that those who cannot come up with the money to fund a potential transplant — and let’s face it, if one was relying on state Medicaid, one doesn’t have endless supplies of money to pay for highly expensive medical procedures readily at hand — are being dropped from transplant lists. The NY Times reports:
Even physicians with decades of experience telling patients that their lives are nearing an end are having difficulty discussing a potentially fatal condition that has arisen in Arizona: Death by budget cut.
Effective at the beginning of October, Arizona stopped financing certain transplant operations under the state’s version of Medicaid. Many doctors say the decision amounts to a death sentence for some low-income patients, who have little chance of survival without transplants and lack the hundreds of thousands of dollars needed to pay for them.
“The most difficult discussions are those that involve patients who had been on the donor list for a year or more and now we have to tell them they’re not on the list anymore,” said Dr. Rainer Gruessner, a transplant specialist at the University of Arizona College of Medicine. “The frustration is tremendous. It’s more than frustration.”
Organ transplants are already the subject of a web of regulations, which do not guarantee that everyone in need of a life-saving organ will receive one. But Arizona’s transplant specialists are alarmed that patients who were in line to receive transplants one day were, after the state’s budget cuts to its Medicaid program, ruled ineligible the next — unless they raised the money themselves.
If one can get past the unbearable horror of the situation long enough, they will also find the irony to be quite rich:
State Medicaid officials said they recommended discontinuing some transplants only after assessing the success rates for previous patients. Among the discontinued procedures are lung transplants, liver transplants for hepatitis C patients and some bone marrow and pancreas transplants, which altogether would save the state about $4.5 million a year.
“As an agency, we understand there have been difficult cuts and there will have to be more difficult cuts looking forward,” said Jennifer Carusetta, chief legislative liaison at the state Medicaid agency.
During the debate on health care reform, many on the right-wing used scare-mongering tactics to suggest that a public health care system would result in “death panels” as the government rationed resources. This argument ignored how commonly insurance companies deny medical procedures and how frequently those without insurance are already unable to access care — but they also ignored that if anyone was going to favor balancing a budget over human lives, they were certainly not primarily going to be leftists. If anything in existence deserves to be called a death panel, it did not result from a commitment to public health care, but from the refusal to recognize health care access for people of all income levels as a human right. These cuts are not public health care gone wrong, but the devaluation of public health care systems reaching its logical conclusion.
The one positive thing to report is that so far, none of the approximately 100 people affected by the cuts have died directly as a result of them. And the good news is that many donors have come forward to assist those families that now need the help as a result of this decision.
But I would suggest that we shouldn’t wait for someone to needlessly die before we get outraged — if we do, we’ve already waited much too long. Further, while the stories of people wanting to help are heartwarming, and those who can assist with personal funds should continue to do so in the meantime, it’s my view that human rights are far too important and fundamental to leave to the chance of charity and individual goodwill. The lives of low-income people should not be left at the mercy of wealthy donors. And I should hope that those wealthy donors who have it in their hearts to offer assistance also know that this set up is ultimately far from ideal, unsustainable, and not right.
In the U.S., there are laws stating that one cannot buy or sell a human organs. These laws attempt not only to protect those poor individuals who could easily be exploited by an organ trade, but also to reinforce a basic value that the right to human life should not be able to be bought or sold. One’s right to live, we believe at least on the surface, should not depend on one’s ability to pay. Though it seems clear to me that these funding cuts do not in any way actually violate laws regarding the buying and selling of organs, it seems equally clear that they do violate the principles that such regulations represent. Because for those in need of the transplants for which funding has been cut, needing to be able to buy the right to continue living has become a terrifying reality.
But I also think that while the outrage at this particular funding cut in Arizona is genuine and entirely warranted, it’s incredibly myopic to treat it as an isolated abuse of health care resources. Thanks to the U.S. model of health care as commodity rather than right, people have been dying as a result of their inability to buy the continued ability to live for a long time. But the people who die all the time because they know something’s wrong but cannot afford to see a doctor in a timely fashion don’t usually make the news. Those who might not have died if they hadn’t needed to ration their necessary yet highly expensive prescription medications don’t tend to inspire the same outrage. People who don’t have access to a primary care physician and only receive health care when things get bad enough to go to the emergency room are rarely the recipients of large donations from strangers. After all, there’s just too many of them.
The U.S. for-profit health care system that puts tax cuts ahead of lower-income peoples’ lives is broken, and it’s taking lives every day. This particular example of just how broken it is certainly is outrageous, and particularly dramatic. But as we rightly express our anger and despair, it’s important to remember that this is merely a symptom of the problem, not the problem itself. We don’t need to restore transplant funding in Arizona; we need to create a system where the idea that poor people, and only poor people, can’t access potentially life-saving care seems not just absurd but also unfeasible.
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