Show #377 Airing Sunday, 3/4/07
As we get older, our body begins to break down. In some cases, we may need a new organ to survive, maybe a liver, kidney or heart.
The good news is that advances in medicine have dramatically increased the success rate for organ transplants. The bad news is that there aren't enough organs to go around. Right now, in the United States, there are almost 100,000 folks waiting for organ transplants. We hope and pray that an organ will become available for them, in time.
Have you ever wondered how it's decided who gets an organ, and who does not? Since there aren't enough organs for everybody who needs one, the allocation process is very important.
In 1984, Congress adopted the National Organ Transplant Act, and that law created a national system designed to guarantee fairness for making decisions about who will be chosen for a transplant. The Federal Department of Health and Human Services contacted with a non-profit group, the United Network for Organ Sharing, to set the rules and make the allocation decisions.
So how does it work? The United Network for Organ Sharing has set rules about who's entitled to get transplants - different rules for different organs. In general, decisions are made based on:
- Medical urgency.
- Blood, tissue and size match with the donor.
- Geographical nearness to the donor.
- And one of the most important considerations is the time spent on the waiting list.
Some people believe that rich folks, or celebrities, get preference, or can pull strings to move up on the waiting list. I have to tell you, to the best of my knowledge, that doesn't happen. Wealth, celebrity, race and ethnic background are not considered in this national program.
While I'm comfortable with how the program has been running, I'm deeply concerned about a proposed change. The United Network has proposed giving kidneys to patients who would live the longest after the transplant. In other words, older people who need a transplant and who have waited the longest would be dropped from the top of the wait list to the bottom.
I understand why the proposal was made. Should a 75 year old with heart disease, who may not survive long even with a transplant, get a kidney in preference over an otherwise healthy 10-year-old girl? I get that. But this proposal troubles me greatly. Should we really be telling a 50 year old that he's too old to get a kidney transplant because a 35 year old just went on the list?
And I'm worried that this is a first step down the slippery slope of rationing health care and generally limiting access to high cost care for older people. Keep in mind that 80% of the Medicaid budget in Ohio pays for the oldest 20% of the population. In these times of tight budgets, our legislators could be tempted to save a lot of money, just by cutting access to expensive health care for our elders.
To learn more about how organ transplants work, check out one of these websites:
And if you're concerned about the proposal to change the transplant allocation rules, which will move older Americans way down the wait lists, contact your federal representatives at 202-224-3121.
