Follow Up: Arizona Restores Medicaid Coverage for Transplants

Reuters is reporting here that Arizona has restored funds to its state Medicaid program so that it will once again cover organ transplantation once again. See one of my previous posts here where I vociferously attacked the cuts and the humanity of all involved in letting a lady die as a result of the cuts.

Its good to see that the people of Arizona (as reflected by the action taken by their elected representatives) have taken appropriate action to rectify an unconscionable piece of legislation which was resulting in the deaths of citizens of Arizona.

Again, this was not only a government-made disaster, but it was also a man-made disaster on many levels including the family, community, and medical field levels.

I dare to hope that there were some hospitals which performed transplants as charity care during the time when there was no Medicaid coverage. But I'd love to actually see some proof of that.

NYTimes Explores Dialysis: At What Cost Do We Keep People Alive

See this interesting (though slanted) article about dialysis, governmental policies which cover the cost of ESRD, and end stage renal disease (which includes dialysis treatment), and the NYTimes's slant that people who are very sick and very expensive to treat may be better off dying than going on dialysis (remind anyone of death panels?).

The NYTimes does do thoughtful readers and listeners a service by allowing dialysis patients to describe their lives in their own words. Listen here.

The bottom line is this - irregardless of what the NYTimes thinks. People living with ESRD, their doctors, and the stakeholders who pay for the treatment (like Medicare, insurance companies, and Corporate Self-Insurance health plans) should insist on the highest quality evidenced based standard of care for ESRD treatment which includes dialysis treatment. If this standard of care is applied, people with ESRD can live longer and costs can be contained.

Confronting the Intrenched Organ Donation System: It is possible

Below are examples of some blogs, websites, and articles which all confront the reality of the current (possibly semi-dysfunctional) organ transplant disbursement system and attempt to shine light on it, study it, and offer ways to improve it. Or, they break with the current system altogether and blaze alternative paths to increase the supply of organs available for transplantation.
I don't attest to the veracity of the claims made in these links. Make your own judgment. But the current system can most assuredly be improved. It will take people and organizations similar to those linked to below who aspire to improve the current system to create the change necessary which will lay the foundation to increase the supply of organs and thereby save lives.

For a live kidney donor recipient's personal outlook on the entrenched interests opposing live-donor donation see this website.

For a blog about alternative methods to increase the supply of organs available for transplantation see here.

For a website that attempts to link live organ donors with people in need of a transplant see this website.

For a press release about a grant awarded to study the outdated organ disbursement method and how it causes unequal access to donated organs based on where a person live see here . Also see here for an old post on the issue where I propose a study designed partly to determine the effect of a person's distance to a transplant center and the time it takes for the person to receive an organ. Yes, its a very technically worded post so don't say I didn't warn you.

And finally, see this link for a book titled, "The U.S.Organ Procurement System" where the authors, David L. Kaserman and A.H. Barnett engage in a thorough economic analysis of current U.S. organ transplant policy, the problems with it, and a proposal explaining how organ markets would operate in a manner which would save lives by increasing the supply of organs available.

Jonas Salk created the Polio Vaccine...Lessons for Kidney Transplantation

"Hope lies in dreams, in imagination and in the courage of those who dare to make dreams into reality."
The preceding statement comes from a memorial at the Salk Institute which captures
Dr. Salk's vision.
Dr. Jonas Salk prevented millions and millions of deaths when he created and engineered the polio vaccine in the 1950's. I am keenly aware of the human suffering he prevented...my grandmother grieved the rest of her life for her 17 year old son, Martin, who died of polio in September, 1954 - while Salk's new vaccine was being tested on one million school children.
Presently, in California, there is the Salk Institute which carries on the legacy of Dr. Salk which researches various phenomenon ranging from cancer, diabetes and birth defects to Alzheimer's disease, Parkinson's disease, AIDS and plant biology. See the Salk Institute's description here.

I was thinking about the quote..."Hope lies in dreams, in imagination and in the courage of those who dare to make dreams into reality."
Until their are enough courageous people willing to attempt to find a solution to the current shortage of kidneys available for transplantation, the hope to solve the problem is like a fleeting and illusory dream - and not a very hopeful dream on the cusp of being turned into reality.

Steve Jobs' Health, Apple Computer, and Organ Transplantation Possibilities

You probably have heard about Steve Jobs, CEO of Apple, taking a medical leave of absence so that he can focus on his health. Here is the press release. Previously, he has battled pancreatic cancer and undergone a liver transplant.

Original post from Monday, January 24, 2011 is found below:

I wish Steve Jobs all the best and a quick and complete recovery and respect his right to privacy.

I hope Apple champions an intra-company live donor organ donation program whether Steve Jobs is currently in need of a transplant or not because this can bring a revolution to the world or organ transplantation. Corporations like Apple pay towards their employees health insurance costs so they have an economic incentive to keep their employees as healthy as possible. Also, the good-will created by saving and improving the quality of life of their employees is priceless. And it may just contribute towards saving the life of their CEO, Steve Jobs.

I think that an astute Medical Coordinator or Benifits Manager at Apple may want to sieze on the oppurtunity created by the Steve Jobs health situation and implement a corporate initiative to encourage live donor donations from healthy Apple employees to other Apple employees in need of transplants (FYI - therefore, this would work for kidney donations, bone marrow donations, and partial liver donations, depending on transplant center policy.)
Three previous blog posts linked to here, here, and here discuss various statutory laws that decrease the ability to increase the quantity of organs availible for transplantion along with a few of my ideas to improve the situtation including intra-company live donor donation programs.

Do You Really Want Government In Charge of Healthcare?

An article by the AP linked to here regarding Arizona reducing its Medicaid coverage and the probable death of a second person as a result of it is mind-boggling and anger inducing for many reasons.
The travesty of this extends to the hospital system in Arizona - do they not have charity care? And what are the procedures at the organ distribution organization in Arizona - do they deny organs to people without insurance because of insurance status because they are worried about organ rejection if the patient cannot afford the expensive anti-rejection medicine?
And if what I surmised above is correct, what about the docs/hospital execs that have connections to pharmaceutical companies through reps - could no deal be quickly put together to have one of the pharmaceutical companies provide charity medication to this person?
And no family, good Samaritans, or friends to pitch in?
This makes me sick!

I'm in a hurry so I have to continue later, but I sense that the government through the Medicaid program is creating economic phenomenon of crowding out the market for charity medical care not only in Arizona, but throughout the country.
Hospitals, doctors, pharmacies, etc. are used to at least being able to collect some level of reimbursement from Medicaid so why bother to give anyone free care - even if the patient will end up dead as a result of this inaction!

First Successful Organ (Kidney) Transplant Donor Dies 56 Years Later; Brother Survived for 8 Years

The following press release was taken in its entirety from a box that popped up when I went on the American Society of Nephrology's website today. Basically, a brother donated his kidney to his brother and the brother who received the kidney lived for 8 more years, an unbelievable success for the world's first recorded successful organ transplant. This reminds us that the courageous people who challenge the status quo and don't accept so-called medical realities and, as a result, improve medicine and human progress for all mankind.
Although, I have a feeling Mr. Ronald Lee Herrick might have said he was just doing what any other brother would do to keep alive his sibling or family member - just about anything he could do.
Death of Mr. Ronald Lee Herrick, Pioneer Transplant Donor

Ronald Lee Herrick died Monday, December 27, 2010, at age 79, in Augusta, Maine.

Mr. Herrick, a math teacher for almost four decades, donated his kidney to his twin brother, Richard, on December 23, 1954, in what is recognized as the world's first successful organ transplant. Ronald's courageous act helped change the face of medicine by advancing development of the field of organ transplantation. This revolutionary surgery took place 56 years ago at what is now the Brigham and Women's Hospital and was performed by Dr. Joseph E. Murray. Dr. John Merrill, one of the founders of the discipline of Nephrology and chief of the Renal Division at the Brigham, was a member of the team caring for transplant recipients including Mr. Herrick.

Receiving a kidney from his brother allowed Richard to live an additional eight years. The American Society of Nephrology gratefully acknowledges Mr. Herrick's major contribution to medicine.

Joseph V. Bonventre, MD, PhD, FASN
President, American Society of Nephrology