Posted on 06/07/2013 5:31:41 AM PDT by Kaslin
If I were the parent of a child who might be kept alive -- if only for a few more years -- by a lung transplant, I would move Heaven and Earth to get it done. It's completely understandable that the parents of 10-year-old Sarah Murnaghan have made her an Internet and cable news celebrity in a desperate effort to get her on the adult list for a lung transplant. No one with a particle of human sympathy can fail to be moved by the family's situation.
The story, however, has loosed a torrent of demagoguery -- some of it coming from the very people who should be most alarmed about the politicization of cases like Sarah's and of health care generally.
Talk radio and TV have been ringing with strident and even hysterical accusations that HHS Secretary Kathleen Sebelius is "letting this little girl die," or "choosing who will live and who will die." Some are linking Sebelius's supposed callousness to the terrible, politicized rationing of care that Obamacare will inaugurate.
This is all backwards. The people calling upon Sebelius to intervene and grant a waiver from the usual rules regarding children and transplants are the ones urging the politicization of medical care -- at least in this case. They would be the ones responsible for setting a terrible precedent. The lesson would be this: If you can muster public pressure through social media, the press, and politicians, your loved one can gain an advantage over others waiting for a lung or kidney or liver. Photogenic patients or those with media-savvy or even politically well-connected relatives would go to the head of line. That is exactly what conservatives ought to fear.
It may well be that the rules about eligibility for lung transplants need an overhaul. But the laws of economics dictate that when a commodity is scarce, there are two ways of allocating it -- by price or by rationing. Organs are scarce. As Sebelius noted in response to a congressman demanding that she change the rules, 222 people are waiting for lung transplants in Sarah's region alone, including six children aged 10 and younger. Nationally, about 1,700 people are waiting for lung transplants, including 31 children 10 and younger. Lung transplants are very high risk -- only 50 percent of recipients survive longer than five years.
Deciding who among the desperately sick should get a lung or other organ when they become available is managed by a nonprofit group called the United Network for Organ Sharing. UNOS has developed a complicated scoring procedure for those seeking a lung transplant that takes many matters into account, including how sick the patient is and how long he or she would be expected to survive post-transplant.
The statistics for people with cystic fibrosis are grim. A lung transplant is not a cure -- CF ravages other organs as well. A 2007 review of the data from the US Cystic Fibrosis Foundation found that the benefits of lung transplants for children with CF were hardly clear. Of the 248 children who received donor lungs between 1992 and 2002, only five were found to have benefited significantly.
Any system of allocating organs must be as fair as possible to all concerned, which means employing neutral criteria to decide who gets organs when they become available. Sebelius has agreed to order a review of the policy that separates pediatric and adult cases, but those pressing her to help one particular patient are corrupting the system.
This kind of politicization of medical care is one of the chief objections to Obamacare. Its enormous bureaucracy, its Byzantine rules, the IPAB and the discretion handed to (yes) the Secretary of HHS, threaten to make politicization of treatment the order of the day. It's exactly the reverse of what we need.
There is an alternative that would help patients like Sarah and the rest of us reduce the scarcity. Decades of pleas for donations have not worked. If we permitted a system of payments (carefully regulated) for those donating organs, we'd take a huge step toward making more available for those who desperately need them.
The same principle applies more generally. Rather than permit the government to ration care, reform should focus on creating more supply. The cries of some talk show hosts notwithstanding, Kathleen Sebelius isn't in control of whether Sarah Murnaghan lives or dies. But if Obamacare is fully implemented, she and her successors will have such power over all of us.
So whose lungs are they going to rip out?
Years ago the governor of Texas, himself, selected I Dream of Genie actor Larry Hagman to get a liver transplant over a TI engineer. Hagman had destroyed his own liver by drinking it to death. The TI engineer, as I recall, picked up hepatitis while in the hospital.
The question is, why was the governor involved? Transplants have always been political. As the author notes, it’s not the decision that should be attacked, it’s that the decision is in political hands at all.
I tend to agree with Mona. The worst of all possible ways to allocate organs is by political pressure.
Werewolves of London...you better stay away from him; he’ll rip your lungs out Jim; I’d like to meet his tailor.
—Warren Zevon—
Yup.
I took her comment to mean promoting more organ donations.
That’s it.
And his hair was perfect!
Because of reported abuses of such donations, fewer people are willing to sign organ donation documents, fearing unethical medical personnel who are just a little to itchy to get their hands on the “goods.”
The departure from principle that we see throughout politics and the professions breeds such distrust.
Avast has given me trojan warnings this morning now to this Town Hall page, as well as for Drudge.
“222 people are waiting for lung transplants in Sarah’s region alone, including six children aged 10 and younger. Nationally, about 1,700 people are waiting for lung transplants, including 31 children 10 and younger. Lung transplants are very high risk — only 50 percent of recipients survive longer than five years.”
Of course, noone is asking the foundational question. Why is the director of HHS even relevant to this process? Where does government get the power to take one person’s organ and give it to someone else? Is that an enumerated power of congress?
“So whose lungs are they going to rip out?”
Lungs would really be better for the common good in a randomly chosen 12 year old than in some Tea Partier, don’t you think? And, you can make the 12 year old’s parents beg their Lord for the lung also—a nice side benefit.
The sliver lining in this cloud is that a ton of potential donor's now see the need for organs to be donated.
Yup.
She doesn’t have that power.
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