Defunding of Organ Transplant in the State of Arizona - Case Study Example

A Memorandum Regarding the Defunding Of Organ Transplant In The of Arizona I. Policy History Organ transplant used to be covered by the Arizonahealthcare system but in 1987 when Republican Governor Evan Mechan assumed into office, government funds were scarce that the governor had no choice but to cut budget in the different agencies of the government. Due to budgetary constraints and changes in priorities of the government, the Arizona State legislature voted to eliminate the funds intended for most types of organ transplants from the state’s health care program for the indigents, the Arizona Health Care Cost Containment System (AHCCCS). Most members of the committee on health of the State of Arizona believed that the cost of organ transplant is too high and if the money intended for organ transplant is used for other healthcare services, more people would benefit from it. Despite the opposition of the Committee Members who belong to the Democratic Party, the legislation withdrawing funds for organ transplants in Arizona was passed. As a result, the funds that used to be for the benefit of people who needed organ transplant will now be used for other purposes including basic health services like prenatal care for pregnant women and healthcare for children between the age of 6 to 13 years old. Unfortunately, shortly after the passing of the legislation, a woman named Dianna Brown who needed liver transplant died because the State refused to fund the procedure. Due to media pressure, several legislators in the State of Arizona questioned the withdrawal of the funds for the organ transplant. II. Competing Goals The legislature presented competing goals when tacking the issue of organ transplant. For those who are in favor of continuing the funds for organ transplant, their goal was to preserve the lives of those who are terminally sick and in need of organ transplant. According to a letter sent by Dr. Jack Copeland to the Arizona legislature, since the government will most likely have to spend money for the care of a terminally ill patient until the patient dies, the government might as well spend money for organ transplant that may save the life the patient. Aside from preserving lives, another goal of those who are in favor of funding organ transplant is to provide comprehensive healthcare program especially for those who are poor. The implied trade off in this situation is that since organ transplants are costly, only few people are likely to use up huge amounts of money from the government. The cost benefit ratio in this case would be so high. Another trade off here is that since Arizona will fund organ transplant, people from other states that do not fund this kind of procedure may come to Arizona and one they become resident of the state, they will be eligible for medical health benefits from the state. When this happens, the government of Arizona will end up paying for the medical bills of people who were not originally from this state. On the other hand, those who are against the allocation of government funds to pay for organ transplant wanted to use the money for other healthcare services, particularly for pregnant women and children between the ages of 6 to 13 years old. Those in favor of withdrawing financial support to organ transplant propose to use the funds to increase benefits for other types of healthcare services. Another goal for this group of legislators is to use scarce government resources equitably and reach more beneficiaries. III. Points Raised in the Debate to Defund Organ Transplant The debate regarding the withdrawal of funds for organ transplant was long and arduous. According to Leonard Kirscher, head of the AHCCCS, “a public program with limited resources must establish clear priorities for treatment.” As it is, he favors a broad base health care for the poor over organ transplant coverage. He pointed out that there are so many mothers out there who do not get good prenatal care because of lack of money and when these mothers give society bad babies, the cost of caring for these babies would be astronomical. He also pointed out that babies who are born to mothers who did not care for themselves properly during pregnancy are more like to suffer from “low IQ, low lifetime learning expectancy, won’t be able to function, mental retardation and seizures.” The second argument advanced by Kirscher is that not all people who have undergone organ transplant will survive. He said that organ rejection is very common after transplant and the patient whose body rejects the organ transplant is very much likely to die. When this happens, the money of the government goes to waste. Since organ transplant patients may not survive for long, Kirscher believes that it is an unacceptable practice for the government to spend so much of its scarce resources in ways that do not really further the interest of the public and do not result to the common good of the public. The goal of Kirscher is to provide more healthcare benefits to the masses by cutting off funding to expensive procedures like organ transplant. The tradeoff here is that those who are terminally sick will have to die in order for mothers and their young children to have more healthcare benefits. For its past, the AHCCCS administrators argued that if AHCCCS will cover the cost of each request for organ transplant, “it will not be long before healthcare insurance carriers would cease to consider organ transplant as covered benefit on the theory that AHCCCS (and the taxpayers) is the paying alternative.” The AHCCCS administrator also argued that the Health Care Financing Administrator (HCFA) had insisted that the cost of organ transplant should be covered “the way other medical costs are covered.” This means that the HCFA will not match federal money with every case of organ transplant paid by the AHCCCS. As it is, the AHCCCS may have to draw more money from its coffers to pay for the cost of organ transplant. Since the AHCCCS only have limited resources, it must trade off organ transplant in favor of broad base healthcare services. In arguing in favor of funding organ transplant, Dr. Jack Copeland presented his views that organ transplant such as heart transplant are only performed on patients with less than 12 months life expectancy and the procedure itself would not be too expensive. He also added that since his center would be likely to be among the 10 clinics to be accredited by Medicare for heart transplant, the government of Arizona will only have to pay for a fraction of the cost of the procedure. Since the AHCCCS only have limited resources, the proposal of Dr. Copeland to continuing funding organ transplant will result to a trade off where the government gets to spend more money on few individuals while reducing the benefits for majority of the poor people. IV. Analysis of Legislatures Action The decision of the legislature to withdraw the funds intended for organ transplant stems from the realization that more people will be able to benefit if the government will cease to pay for expensive treatments. As pointed out by Kirscher, a single transplant would cost hundreds of dollars while healthcare for pregnant women and for children ages 6 to 13 will only cost about $2,000. The huge difference between the cost of organ transplant and other health care services prompted the legislature to stop funding organ transplant and instead, increase the benefits for prenatal care and for children ages 6 to 13. Technically, the cost of organ transplant is what swayed the legislature against continuing to fund it. The government only has limited funds and it needs to cut back on cost. It is just unfortunate that organ transplant happens to be expensive and benefits only a few individuals. V. Conclusion I believe that my candidate should spend the resources of the government wisely. Although organ transplant may save lives, it is too expensive for the government to fund and taxpayers should not be made to foot the bills of these expensive treatments. We have to understand that there are so many people out there who needs healthcare and if the government will spend much of its money to provide healthcare for few individuals, it would in effect deprive the majority of the people with the benefits that they deserve. Reference The President And Fellows of Harvard College (1988) Matters of Life and Death: Defunding Organ Transplants in the State of Arizona. Read More