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You Can Have An Organ Transplant, But You Can’t Have The Drugs You Need To Keep It Healthy?

kidney_unc_470pixIn a provocative analysis of a 30-year old Medicare coverage loophole, John Schall explained the following (at the Medicare Policy Summit event):

1. Medicare covers kidney transplants for patients with end stage renal disease (ESRD). Transplant patients, of course, require life-long immunosupressive drugs to keep their bodies from rejecting the new kidney.

2. Medicare only covers immunosupressive drugs for 36 months total. These drugs are too expensive for most patients to afford out-of-pocket.

3. Many kidney transplant patients covered by Medicare are unable to continue their immunosupression regimen after 36 months, and slowly go into organ rejection.

4. Once they have rejected their transplanted kidney, they are eligible to receive a new one, fully covered by Medicare, with (you guessed it) 36 months of immunosuppresive drug coverage to follow.

Wouldn’t it just be cheaper to cover immunosuppresive drugs for the lifetime of the patient who receives an organ transplant? Yes, and that’s what lobbyists have been arguing for 30 years now, without a change in the rules.

Government-run healthcare can have its challenges… and this is only the beginning.

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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