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Arizona Governor: No to Medicaid Transplants

Discussion in 'Political Discussion' started by scout, Nov 24, 2010.

  1. scout

    scout Rookie

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    #15 Jersey

  2. Real World

    Real World Moderator Staff Member

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    I'd personally prefer to see ( and I'm not sure why they didn't) a few million bucks slashed elsewhere, than there, but I'm not from there so I'm not sure why that wasn't the case. What this does point to though, is the "death panel" angle of gubmit care. To keep costs in order, it will be decisions like these that have to be made. Questions like whether or not it's viable to spend $500k dollars on a transplant for a patient who has a 10% chance of surviving the operation, and only so for a limited time should he. As a human being I want everyone to live, but from a non emotional standpoint, is that realistic? At what point do you say the cost for X treatment isn't worth it? I know this sounds inhumane, and barbaric, but it's a legitimate issue none the less.

    It's easy to say that at some point a line does have to be drawn in the sand, in order to keep the costs remotely managable, when you're not in need of urgent care. If you're one of these 98 people, or their family, you obviously won't see it that way. Nor would you/I/anyone see it this way if we/me/anyone was old, or in need of risky treatment in order to stay alive. This is one of the biggest conundrums that HC reform faces. Where do the moral obligations stop, and the fiscal limitations begin? Or should there even be any?
  3. Michael

    Michael Moderator Staff Member PatsFans.com Supporter

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    #12 Jersey

    And now for some facts:

    The cuts represent a savings of about $4 million per year, AHCCCS officials say. AHCCCS spokeswoman Monica Coury said her agency had the "horrible task" of putting together benefit reductions, and that the transplants affected represent a small number of patients....

    A lung transplant does not cure cystic fibrosis, Coury said.
    "Patients with cystic fibrosis who get a lung transplant might get extra time with a good quality of life, but inevitably the CF will reinfect the new lung," she said. "It's a horrible discussion to have, but that's the situation."
    A University of Arizona College of Medicine report from earlier this year said 78 AHCCCS patients statewide were waiting for a transplant that won't be covered. But Coury believes 78 is a misleading number.
    "Not everyone on that list is going to get an organ anyway," she said in an e-mail. "There is a shortage of viable organs for these folks waiting on the list."
    Coury stressed that AHCCCS is still covering transplants that have what the agency says are good success rates. All transplants for children will still be funded, she noted.

    Transplant dream fading

    Keep voting for Obama care. It will get muuuuch better. :rolleyes:
  4. Mrs.PatsFanInVa

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    #11 Jersey

    Apparently a roof was more important.

    These Republicans could have covered the shortfall by directing funding from the Stimulus for this life-saving program, but chose instead to spend over $1 million in Stim money to repair the roof of a sports stadium. What’s worse, had they applied the Stim money to save the transplant program for the uninsured, the state would have been eligible for an additional $15 million in matching funds from the federal government.

    Pensito Review GOP AZ Gov Brewer, Legislature Kill Transplant Funding for Uninsured – Republicans’ ‘Death Panel’ Selects Who Will Die Based on Income
  5. scout

    scout Rookie

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    #15 Jersey

    I guess it only matters when a tragedy hits home to count. Let's not give a transplant to a CF patient, because eventually they will need another transplant. BTW, the CF disease gets no funding from the government. Not enough patients.
    It's only a matter of time before someone combs through the Arizona budget and finds items containing waste.
    As for you "facts", how do you know? Saw a show the other night where a major health care professional (Signa) apologized to Michael Moore for his blatant distortion of facts and attacks on Moore's movie Sicko. Of course, let the campaign begin to damage this person's reputation.
  6. Mrs.PatsFanInVa

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    #11 Jersey

    Let's not also forget that they are denying bone marrow transplants, also, which have a 45% long term survival rate.
  7. Real World

    Real World Moderator Staff Member

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    Not exactly.

    I'm not trying to be insensitive or anything, but the use of "some" would indicate that only certain bone marrow transplants are being denied. Probably for similar reasons, i.e. survival rates.
  8. Mrs.PatsFanInVa

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    #11 Jersey

    AHCCCS no longer funds non-relative bone-marrow transplants, along with lung transplants and certain types of heart, liver and pancreas transplants.

    AHCCCS says the benefit reductions were made based on studies showing they would affect the fewest people or, in the case of transplants, represented the least effective treatment.

    But Schriber says lawmakers based their decision to cut the transplants on flawed data from AHCCCS, which showed that no patients had survived beyond one year following the procedure.

    Schriber, director of the state's largest adult bone-marrow transplant program at Banner Good Samaritan Medical Center, has been trying to alert Brewer, legislators and AHCCCS officials since last year that his own data show a 42 percent survival rate for his patients over the past seven years.


    Arizona Democratic Party: AHCCCS memo from 2007 said transplant cuts could kill; special session mulled
  9. lostjumper

    lostjumper Rookie

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    There is alot more to deciding who does and does not receive a transplant than money. It's going to become a higher part of the equation due to the rationing of care that is coming, but right now its a very small part. You're wading into a discussion that you most likely have no idea about.

    They have to consider the age of the candidate, relative health, the disease/incident that caused the original organ to fail, their lifestyle, and their blood type and antigen match. Then they have to match up a donor. For Bone marrow, liver, and kidney you can have a live donor, which they are saying they will continue to cover. That ups the success rate dramatically. But that 78 figure is most likely a misleading number. It's probably a couple.
    Last edited: Nov 24, 2010
  10. Mrs.PatsFanInVa

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    #11 Jersey

    There are 98 people in Arizona who have been affected by this law. All 98 of them were already accepted into transplant programs and were on the waiting lists. I assume, therefore, that they had already met all of the criteria necessary, such as age, relative health, disease/incident, etc., which are deemed necessary to be enrolled in a transplant program.

    It follows, logically speaking, that the only reason they are being denied is financial.

    As to the live-donor marrow transplants, they are no longer covering non-relative live-donor transplants.
  11. lostjumper

    lostjumper Rookie

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    You are incorrect in your assumption. Just because you are on a transplant list does not mean you are guaranteed a transplant as long as funding is there.

    Truthfully, its a case by case call. Since this is all Hippa protected, we'll never really know how accurate this is.

    I wonder when we'll start to see people taken off of dialysis machines? That treatment is expensive, and if its not being used to carry someone over until they get a transplant, should it be used only to extend someone's life? Ahh, the decisions that need to be made when healthcare is rationed!
    Last edited: Nov 24, 2010
  12. DarrylS

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    Gee that sounds like a death panel, who decides who lives and who dies???
  13. Mrs.PatsFanInVa

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    #11 Jersey

    Getting on a list means you have been pre-screened and have met all necessary criteria. I never said anyone was guaranteed a transplant simply because they were on the list - of course their condition could have changed in the meantime, the donated organ needs to go to the most compatible recipient, the area you are in will matter, etc.. However, getting on the transplant list does mean that you are guaranteed a chance......which is what the people who have been taken off the list due to their financial status in Arizona are being denied.

    To be included on the national waiting list, a patient must first find a transplant team that will treat him or her. The transplant team, a group of surgeons, nurses and other health professionals at a hospital, evaluates the patient to decide whether he or she is a good candidate for transplantation. In addition to assessing the patient's physical condition, the team will consider the patient's attitude, psychological state and history of drug abuse, among other factors. Donated organs are a rare and precious commodity, so doctors don't want to proceed unless they are confident that a patient is physically and mentally prepared for the procedure, as well as life after the procedure. For the most part, patients who are unwilling to give up unhealthy drugs, including cigarettes and alcohol in many situations, will be automatically disqualified.

    If the transplant team feels that a patient is a good candidate for transplant, they will contact the UNOS Organ Center in Richmond, VA, in order to put the patient on the national waiting list. The Organ Center operators record all relevant information about the patient, including his or her physical condition, blood type, tissue type and age. This information is entered into the national database.

    When an organ becomes available (when an organ donor is pronounced brain dead at a hospital, typically), the local organ procurement organization (OPO) will gather all relevant information about the donor and enter this data into a program maintained by the UNOS Organ Center. Based on the criteria established by the UNOS board of directors, the program generates a ranked list of potential recipients. The criteria involves several factors, including the physical compatibility between the donor and the recipient, the health of the recipient and how long the recipient has been waiting for an organ. The purpose of the criteria is to choose a recipient who is a good match and stands a good chance of recovery, while also taking into account who has been "in line" longer.


    Discovery Health "Getting on the List"
  14. Real World

    Real World Moderator Staff Member

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    And Mrs.DB poster strikes again. Ah, the Dem party memo. Nice! I got mine from the OP's article.



    Read more: AHCCCS budget cuts cost Phoenix-area man his chance at liver transplant

    Arizona Budget Cuts Put Organ Transplants At Risk : NPR
  15. Real World

    Real World Moderator Staff Member

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    Ultimately it will be a bunch of suits who sit in a room, crunch a bunch of numbers (data), and then determine an arbitrary set of rules & cut offs for care. The term "death panel" basically refers to this process. It won't be strictly relegated to life and death treatments either. It will be things like knee surgeries, hip replacements, MRI's, etc. All types of treatments and conditions will be analyzed, so that dollar efficiency versus need is best maximized. They already do this overseas, and to an extent, here. It's the only way to keep costs managable. It's the part of the issue that no one likes to talk about. Understandably so.
  16. Mrs.PatsFanInVa

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    #11 Jersey

    Yes, I know...and "some bone marrow transplants" are those which come from an unrelated donor, as the article I linked to explained.

    And bone marrow transplants from non-related donors have a 42% survival rate.

    From one of your own articles:

    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.

    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.

  17. Real World

    Real World Moderator Staff Member

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    Some, some, some, some, some, some, some, some.....
  18. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    That's terrible. If the cuts amount to about $4,000,000/year, as Michael's link shows, that means that the right wing is so awful that for 75 cents a person, they would not want to prolong the life of someone's dad or child. It's immoral. The the right wing could justify the early death of someone so they can keep an extra 3 quarters in their pocket, just shows how badly miserliness and avarice have corrupted their sense of responsibility and of human decency.
  19. lostjumper

    lostjumper Rookie

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    you're right. It's certainly more moral to go the left wing way. Destroy our children's future by stealing their money and putting the coming generations into massive amounts of debt that they can never get out of. Patters, you can't pay everything for everyone. The government simply can't do that. Where do you draw the line? You have no sense of morality or decency in your twisted logic.
  20. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    Yeah, you have really good evidence to support your point of view. Just think how your grandparents destroyed the future of your parents and your parents destroyed your future, all because of deficit spending. The country has really declined since the good old days when people worked longer hours, lived shorter lives, and had fewer rights.

    As far as where you draw the line, you draw it where it makes sense. It's expensive to run a great nation and the fact is that taxpayer dollars are returned to the investors, who invest in those companies that directly or indirectly receive taxpayer dollars. So, you implement a more progressive income tax like we used to have under the good economies of Eisenhower (93% top income tax bracket), Kennedy (70% top bracket), and so on. We can and should pay for a lot more than we do. For instance, we should have much more job training and paid job programs for the poor and disabled, but welfare is a lot cheaper.

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