One of the canards slung at the Affordable Care Act is that it creates “death panels” that would allow the government to deny patients lifesaving treatments, even though two independent and non-partisan fact-checking organizations found it would do no such thing.
I don’t bring this up now to rehash the debate, but because the New York Times had a recent story on Arizona’s decision to deny certain transplants to Medicaid enrollees — “death by budget cuts” in the words of reporter Marc Lacey. His story profiles several patients who died when they were unable to raise money on their own to fund a transplant. Lacey quotes a physician expert on transplants who flatly states: “There’s no doubt that people aren’t going to make it because of this decision.”
Arizona Medicaid officials told the Times that 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.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
Do you recall the severe rationing of food and water the Chilean miners had to endure to survive? The rationing was done to stretch their limited resources. I would argue the state of Arizona’s new policy to not cover organ transplants for patients on Arizona Health Care Cost Containment System (AHCCCS) or their version of Medicaid is a similar form of rationing.
AHCCCS, as many Medicaid programs, is underfunded. They are trying to operate on a limited budget. Something has to give. Sadly in this case, many (NPR reports 98) had already been granted approval for organ transplants which they may not receive.
Francisco Felix, 32, who due to hepatitis-C needs a liver transplant, is reported to have made it to the operating room, prepped and ready for his life-saving liver transplant when doctors told him the state’s Medicaid plan wouldn’t cover the procedure. The liver he was to receive went to someone else. Read more »
*This blog post was originally published at Suture for a Living*
The New York Times profiles research by Harvey A. Liu and Kenneth J. Balkus Jr. of the University of Texas at Dallas to create a therapeutic nitric oxide releasing bandage. Nitric oxide can play a significant role in peripheral vasodilation, relaxation of pulmonary vasculature, and other physiological processes, such as penile erection. Therefore, an effective method of delivering this free radical should allow the development of new types of vascular stockings, bandages, and other therapeutic (or recreational) devices.
A snippet from NYT:
As they describe in a paper in Chemistry of Materials, the researchers use a zeolite, an aluminosilicate mineral that has a three-dimensional cage structure. Zeolites have been shown to be able to store and release nitric oxide and other chemicals. They embed the mineral in fibers of a biocompatible polymer, polylactic acid, as they are spun and form a tissue-like mat. The fibers are then infused with nitric oxide; by controlling the porosity of the fibers, the researchers could control the release of the gas.
The researchers say the resulting material could be incorporated into socks for diabetics that would deliver nitric oxide through the skin. It might also prove useful before transplants as a wrapping for organs to help preserve them outside the body for longer.
More from the New York Times…
Abstract in Chemistry of Materials: Novel Delivery System for the Bioregulatory Agent Nitric Oxide
*This blog post was originally published at Medgadget*
I was reminded that April is National Donor Month by a post over at Donorcycle. I am a strong organ donation advocate. My driver’s license is signed. My family has been informed of my wishes.
It is a point of a contention in my family, hopefully a small one that will be resolved (or never come up for real). My niece, K, who is in nursing school has signed her driver’s license to be an organ donor. Her mother, my sister, J, will not give her permission if asked – not readily anyway. “I don’t want my baby cut up.” That is her reason.
My niece, K, is a giving soul. Her wishes should be honored. She should be allowed to make that last gift if the time ever arises.
I need to find a way to reassure my sister that we don’t “butcher” the body when donor organs are harvested. I need to get her to read Dr Cris’ blog post “Organ Donation from the Inside”
Transplant surgeons care about donors. Staff respect them, and the decision they have made. Their job in this case is to implement the wishes of the donor and not waste their sacrifice. …… I have assisted at an organ retrieval for transplant, and that is why I am on the Organ Donor Register
Another of my sisters recently was widowed when her husband died of heart failure. He had had many heart attacks over the last several years. In the end, he was told he needed a heart transplant. He didn’t live long enough, but I use this to show that the need it there. The need is great. If we would be receivers of the organs, then we need to be givers when able.
**This blog post was originally published at Suture For A Living.**