April 17, 2012

Medicare Already Has a Death Panel in Place

Okay, I am being over dramatic, but this is scary. People that are on Medicare and receive a kidney transplant only have about three years of life remaining, per the direction of Medicare. Yes, Medicare will pay for the transplant, but after three years on immunosuppressants, Medicare pulls the plug and will no longer pay for the immunosuppressants. If the patient can pay for these, they are in the minority.

Between 1993 and 1995, Medicare did raise the length of time for immunosuppressants support from one year to the present three years. The one exception to this is for those over the age of 65 and that have work-related disabilities. They are eligible for lifetime immunosuppressants.

While this is technically not a death panel, it is completely arbitrary and governed by those in charge of Medicare. This policy is the only one of its kind among industrialized countries where state-funded life-time coverage of immunosuppressant drugs is provided to all kidney transplant recipients. It is therefore not surprising that long-term survival rates are substantially higher than in the United States.

This may now explain why I have had friends that were on dialysis that stopped their treatment, chose the time of their death than get their transplant, and take the regimen of immunosuppressants. They would have been limited to three years. This does not seem appropriate for this to happen in the USA.

Another argument against this practice is that transplant kidneys are lifesaving gifts made possible by living donors or by families of deceased persons and are of immense value to society. The current policy undermines the value of this gift and does jeopardize the organ-donor system. Providing lifelong immunosuppressant drug coverage would restore value to the system.

The current legislation before Congress seeks to correct this problem, but faces many foes and may end up like a similar attempt that was defeated in the Democratic Congress of 2009. The current bill (H.R. 2969) would correct this harmful policy and bring the U.S. Inline with the rest of the industrialized countries.

This is probably the reason that this article that I included in this blog is so important and the medical profession is determined to succeed in making this happen. Having kidney transplants without immunosuppressants is one way of taking Medicare out of the equation on immunosuppressants.

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