Althouse: "Should Sebelius step in and do something? No. She doesn’t have all the facts."

June 5, 2013

"Should Sebelius step in and do something? No. She doesn’t have all the facts."

"... said New York University bioethicist Arthur Caplan. Acting under pressure from a media savvy family 'or the noisiest person in line' is bad policy, he added."

122 comments:

J.R. said...: I totally agree. This is a bullshit story.I'm no fan of her, but she has done nothing to deserve grief on this one.; 6/5/13, 5:29 PM
Anonymous said...: To the best of my knowledge, this is the first time in recorded history that a bioethicist has been right about something.; 6/5/13, 5:32 PM
bagoh20 said...: I agree that the squeaky wheel is not a good or fair method of organ allocation, but the rule stopping her from getting in the the adult line is an arbitrary one, set at 12 years old. It would still be sound to use her condition and need as deciding factors other than just a number picked statically, if it's even that scientific. She is either a good candidate based on need and likely success or not, regardless of her numeric age. Not all 10 year olds are the same.

Of course the problem with that approach is that someone has to actually decide and take responsibility for the decision. I wouldn't want that job.; 6/5/13, 5:37 PM
Amartel said...: Agree.
If Sebelius were to step in and give a lung to this little girl, she'd be taking it away from somebody else.
Getting health care shouldn't come down to whether you can launch an effective social media campaign.; 6/5/13, 5:38 PM
MayBee said...: I think this is a fascinating political turn, considering how Natline Sarkkisian was used to launch the 2008 health insurance debate. A lot of people argued for Obamacare on the basis of mean, for profit insurance companies letting people die.; 6/5/13, 5:39 PM
Brian Brown said...: Acting under pressure from a media savvy family “or the noisiest person in line” is bad policy, he added.

Well, no shit, but welcome to ObamaCare, pal! You're going to have to be politically connected to get life saving treatments when Commissar Sebelius is through with you, you silly dope!; 6/5/13, 5:39 PM
Anonymous said...: If she decided to let whoever appeals to her have the next organ, what happens to the one who died because the organ he was next in line for was given to someone else who has jumped the line?

Sebelius, a one woman death panel.; 6/5/13, 5:41 PM
Birches said...: I don't think the girls parents' are trying to get the girl at the top of the list. They merely want her to be on the list where she should be. Instead, she is at the bottom of the list because some panel decided any kid younger than 12 shouldn't be getting adult lungs. The reality is the girl is probably going to die, but by raising awareness the next 10 or 11 year old might live because they will be properly placed.; 6/5/13, 5:42 PM
MayBee said...: The question isn't Sebelius giving a lung to this girl. It's whether the girl can go on the list for people 12 years and up. They don't want her to jump the line, or anything.

The only question is whether 12 is too arbitrary to let kids die who would otherwise benefit from being on the list.; 6/5/13, 5:43 PM
mccullough said...: Maybe the federal government should not get involved in regulating organ donations in the first place. Odd use of regulating interstate commerce.; 6/5/13, 5:43 PM
Lem Vibe Bandit said...: The family might be media savvy but, apparently, they don't know how this administration works.

Meet with Obama for about half a million and watch Sebelius move.

Despite the best efforts on Sebelius part, not everybody has gotten the word on how things work in Washington today.

Change is not easy.; 6/5/13, 5:44 PM
Martha said...: If her last name was Obama she would be first on the adult list--12 year old age limit be damned.; 6/5/13, 5:45 PM
MayBee said...: It's like they drew a line in your neighborhood and said, "anyone on the wrong side of this line can't have his life saved". Most people would fight like crazy to stop an arbitrary rule like that from killing their kid. It doesn't mean you are asking to be the first life saved or anything.

(if it's true an adult lung can be used for under 12s); 6/5/13, 5:47 PM
Mark said...: I wouldn't want that job.

Ain't that the truth.

On the other hand, this situation illustrates just one reason why politics should be kept out of health care. And what should be obvious now is that all functions of Government are on some level political.

Does anyone believe that if the girl's parents were big contributors to the DNC and/or Obama the girl wouldn't have a new lung by now?; 6/5/13, 5:51 PM
I'm Full of Soup said...: Mark Levin wondered why these issues are governed by the feds- any idea why that is Bago? [I remember you are an organ recipient and figue you are knowledgeable about this stuff]; 6/5/13, 5:52 PM
Anonymous said...: mccullough said...
Odd use of regulating interstate commerce.

Interstate, yes. Commerce?; 6/5/13, 5:54 PM
edutcher said...: Sibelius is used to letting kids die.

Her best bud in KS was Tiller.

Great little warm-up for ObamaTax, as Jay notes.

When the IPAB and all its flunkies start making decisions based on arcane regs and political expediency, Sarah Palin is going to look like the greatest visionary since Isaac Newton.; 6/5/13, 5:57 PM
MayBee said...: I can see how you'd want to have some rules, so wealthy people don't buy their way to the top or poor people aren't manipulated into selling. But I always thought this was at a state level.; 6/5/13, 5:58 PM
madAsHell said...: This is the other side of the George Zimmerman smear campaign. The if-I-had-a-son-he-would-look-like-Trayvon bullshit.

This is why government needs to get out of health care. They will never be able to do enough for everyone.; 6/5/13, 5:59 PM
mccullough said...: Elkh1

The only reason it's not commerce is cause the Feds won't let anyone sell their organs, whether interstate or in-state.; 6/5/13, 6:04 PM
tim maguire said...: They barely touch on what seems to me to be the most important consideration--can an adult lung be safely and usefully put into a child? If yes, then the child should be on the list. If no, then the child should not be.

I don't care about the ethicists and the politicians, what do the doctors say?; 6/5/13, 6:07 PM
Brian Brown said...: So a judge replaces one arbitrary federal standard with their own made up arbitrary federal standard.

What a great day for American jurisprudence!; 6/5/13, 6:09 PM
MayBee said...: Exactly, Tim Maguire.; 6/5/13, 6:10 PM
Anonymous said...: Well, this is the job Sebelius accepted. There will be more of this. If it's not courts ordering action in spite of medical advice, it will be politicians ordering in spite of medical advice or to favor their partisans. Then, of course, will be the media monster erratically careening about ginning-up emotion under the guise of compassion to sell adds on their medium of choice.

Toss in the idiotic mandate that donors not be compensated for their contribution while doctors, hospitals, drug companies and insurance companies profit. In any market scenario, when you keep the price for a good or service artificially low, this will impact supply and you will have people waiting.

Get used to waiting, chumbalones.; 6/5/13, 6:13 PM
Methadras said...: Amartel said...

Agree.
If Sebelius were to step in and give a lung to this little girl, she'd be taking it away from somebody else.
Getting health care shouldn't come down to whether you can launch an effective social media campaign.

Since the child doesn't qualify for a lung transplant from the adult list, then what would you expect her parents to do? Sit and watch her die without at least trying to help her. She can go on the list, but she still may not get the lungs and she may die after all. The parents appealed to her because she is the final authority on the law asking for a waiver. I don't see this as a bullshit story at all, but rather an example of what is to come.; 6/5/13, 6:14 PM
KCFleming said...: **cough** Death panels **cough**; 6/5/13, 6:15 PM
Amartel said...: Dang! Good memory, Maybee. Natalie Sarkkisian and MEAN CIGNA. Because replacing a collection of large faceless frequently unaccountable byzantine bureaucracies with a universal state monopoly bureaucracy with virtually no accountability makes complete sense. If yer stupid. Progress!; 6/5/13, 6:17 PM
chickelit said...: At this point, she'll never live it down if the poor kid dies. Maybe she wants to go on record as the first Death Panelist. This could cement her image as a person of fear (POF) which is becoming more of an asset than a liability.; 6/5/13, 6:17 PM
Amartel said...: Okay, but jumping the line might mean she got a lung before someone else who needed it just as badly.; 6/5/13, 6:18 PM
Amartel said...: And I'm not faulting the parents for doing whatever is needed to save their child.; 6/5/13, 6:19 PM
lemondog said...: Another option that has been tried in some occasions: transplanting from a living donor, like a parent, Caplan said.

Local news has been broadcasting this for several days. I had been wondering about transplants from living donors.

Can a small portion of a lung be donated and, if so, have family members considered donating?; 6/5/13, 6:19 PM
Hammond X. Gritzkofe said...: But........but.......I thought with the Government in control, EVERYONE's needs would be satisfied.; 6/5/13, 6:20 PM
Methadras said...: bpm4532 said...

Toss in the idiotic mandate that donors not be compensated for their contribution while doctors, hospitals, drug companies and insurance companies profit. In any market scenario, when you keep the price for a good or service artificially low, this will impact supply and you will have people waiting.

Get used to waiting, chumbalones.

Aside from the horror show that the transplant industry already is, the least that could be done is to at least allow for the fair compensation to the person's family or spouse for said organs, but oh now, that would be to macabre. Oh the irony.; 6/5/13, 6:20 PM
KCFleming said...: I wrote about this in 2006:

"While advocates of a single-payer system say that it will bring about equality in care, the reality is invariably different. For example, a significant proportion of Canadian doctors have allowed prominent people, wealthier residents, and personal contacts faster access to services. Similar queue jumping by famous sports figures and politicians has also elicited complaints.

There is, in effect, a three-tiered system in Canada. The wealthy jump queues by going to private clinics or the U.S. for rapid treatment, and a second tier of "the well-informed and aggressive can push their way to the front of the line"; those left in the third-tier queue are often the elderly, poor, and disenfranchised. With bureaucratically determined rationing of goods and services in Canada, this has "worsened rather than improved unequal access because socialism meant queues that the well-connected could jump."; 6/5/13, 6:23 PM
MayBee said...: Amartel-Mark Geragos was trying to get the insurance executives charged with murder. John Edwards campaigned with the mother. It was all about how profit allowed kids to die.

I remember the LA times writing up another story about a guy who couldn't get his insurance company to fly him to another state for a transplant when he was lower on the list in California. The problem there, again, was profit.

These were all stories about how our government was going to solve these problems now that Obama was president.; 6/5/13, 6:25 PM
Methadras said...: Amartel said...

Okay, but jumping the line might mean she got a lung before someone else who needed it just as badly.

6/5/13, 6:18 PM
Blogger Amartel said...

And I'm not faulting the parents for doing whatever is needed to save their child.

I don't think jumping in line was the issue. I think getting on the list was, which she wasn't qualified to do due to her age. If they were asking to list hop, that is something I would probably not be in favor of, but getting her on the list at least to get a shot if she is a biocompatible match, go for it.; 6/5/13, 6:25 PM
MayBee said...: Amartel- as I understand it, the parents are not asking to jump the line. Just to get on this adult donor list. Not at the top or anything.; 6/5/13, 6:26 PM
rhhardin said...: I can see how you'd want to have some rules, so wealthy people don't buy their way to the top or poor people aren't manipulated into selling.

Walter Williams describes his daughter's grief after his death, and would she like to donate his organs?

"No. Daddy should be buried as he came into the world, complete," she sobs.

"It's worth $100,000."

"Take anything you need."; 6/5/13, 6:27 PM
Anonymous said...: Good for this Federal judge. If she isn't a good candidate for the lung, they won't transplant one. At least she's got a chance now.; 6/5/13, 6:32 PM
chickelit said...: There is, in effect, a three-tiered system in Canada.

1st class, 2nd class and steerage. All that's missing is an iceberg.; 6/5/13, 6:33 PM
Big Mike said...: And they laughed when Sarah Palin called them "death panels."

Those rules Sebelius salutes are going to send each and every one of us to an earlier-than-necessary ending, with the exception of those who die from suicide or accidents or violence.; 6/5/13, 6:46 PM
Nomennovum said...: "1st class, 2nd class and steerage. All that's missing is an iceberg."

Reality = iceberg.; 6/5/13, 6:51 PM
Nomennovum said...: "1st class, 2nd class and steerage. All that's missing is an iceberg."

Reality = iceberg.; 6/5/13, 6:52 PM
Michael K said...: What medical school did Sebelius graduate from again ? She is an idiot.

Children lung transplants are done from adult lungs by using one lobe on each side. Vaughn Starnes )USC chief of surgery) has done a bunch using parents as live related donors and taking one lobe from each parent. The argument that adult lungs are too big is ignorant.

This is how it's done.; 6/5/13, 6:53 PM
Amartel said...: As the article points out, the problem is the limited supply.
"The issue is inherently charged and complex because there aren’t enough organs for everyone who needs them, and people do die waiting."
This is a problem whether the government is in charge of making the decision, or an insurance company. In either case there is a potential for unfair favoritism but if the government is in charge that risk grows because pols are more susceptible to heart-strings cases like this one, less easily sued, and also because of the potential for wide-spread undetected political favoritism.
I see that the issue here is whether the rule is a correct one. That's why Sebelius needs more facts; to see whether this little girl even qualifies to be on the adult list. There must be common sense rules to ensure fairness in doling out this limited supply. I can see why the rule limiting transplants of adult lungs into children might be sensible if an adult lung might not be feasible in a child, would have a better chance of being accepted in an adult. No doubt this is a medical decision, based on the facts of an individual case.; 6/5/13, 6:53 PM
virgil xenophon said...: "All that's missing is an iceberg."

Sorry, chicken-man, but the health-care ice-berg is already among us in the form of present and future illegal aliens who are sucking up health-care dollars at an ever-increasing rate. Their presence and concomitant health-care demands upon the national fisc is steadily ripping a gash below the financial water-line in the Ship of State as we stand witness to its slow foundering as budget deficits continue to expand like a ships hull ripped open..; 6/5/13, 6:55 PM
edutcher said...: Inga said...

Good for this Federal judge. If she isn't a good candidate for the lung, they won't transplant one. At least she's got a chance now.

The She Devil of the SS always did have a thing for the Beautiful Doctor.

He was good at this, too.; 6/5/13, 6:57 PM
Dante said...: Why not allow a percentage of organs to be bid for?

The money could go to the families of those who donated organs. This would provide a more personal incentive for people to sign up as organ donors.

Goulish, yes, but I'd bet this would increase the pool of donors.; 6/5/13, 7:02 PM
mariner said...: Repeat after me, "If it saves the life of JUST ONE CHILD ..."; 6/5/13, 7:03 PM
Kelly said...: I'm curious as to why the age of twelve was reached as the starting point for kids to receive adult lungs. I searched and everything I could find said children and adults have pretty much the same outcome on lung transplants. I also read that just the lobe could be used if the lung was to big.

Why go by one size fits all when it should be on a case by case basis?; 6/5/13, 7:03 PM
Bender said...: Ten Year Old Girl: Can I get some powerful hormones that will have who knows what effect on my growing pubescent body, in addition to preventing anyone who commits statutory rape against me from having to pay child support?

Sebelius: Absolutely! And you can have it for free and without your parents knowledge, even though we are going to force your parents' employers to pay for it.

Ten Year Old Girl: Can I get a lung to save my life?

Sebelius: I don't know enough. Get back to me next year.; 6/5/13, 7:04 PM
Dante said...: but the rule stopping her from getting in the the adult line is an arbitrary one, set at 12 years old.

I heard on the radio today the rule is on account of children not having the capacity to accept adult organs.

However, I think the procedures may have changed to allow transplanting only part of an adult lung.

So, I agree the rule ought to go in this and similar cases.

Meanwhile, who can think of a child dying in 3 or 4 weeks, vs. all the others we don't know dying who knows when, and not care about the child?; 6/5/13, 7:06 PM
chickelit said...: No reason to be sorry Virgil. I'm not quibbling with the certainty. You sound a bit like Thomas Andrews, the ship's architect, having just completed sounding the ship and informing Captain Smith. The truth is that the passengers don't know--yet. One reason so many lifeboats put out so unfilled was that people didn't know the gravity of the situation until well after the collision. The good officers and crew did their level best to avoid any sort of panic because the captain knew it would worsen things.

Why is the price of ammo through the roof?; 6/5/13, 7:07 PM
Unknown said...: So Inga, what about the people who won't have the ear of someone important to pull a favor from Sebelius?

Political decisions in health care are coming, and it is going to be pervasive.

Thanks, progressives! You're so great! This arbitrary rule mandating only 12 year olds can get adult transplants, why, that's so much better than letting a doctor decide!; 6/5/13, 7:07 PM
Jim said...: You need a death panel tag.; 6/5/13, 7:08 PM
BaltoHvar said...: She's not "jumping" this "line" like having the velvet ropes lifted.

They are trying to get her into a larger pool of donors because the pool she's in now will likely not produce a suitable donor in time.

This is as much about a suitable biological match as it is about any of the other issues raised.

Transplants are made when the biology matches up enough.

There is no guarantee they'll find a match in time even in the larger pool. And if they do, then she has a chance.

Right now she has none.

And although the "squirrel" of "other kids are just as sick" is quaint, it certainly demonstrates the fallacy of setting arbitrary rules as to eligibility, instead of letting the science of medicine call the shots.

Death Panels indeed, Sarah.; 6/5/13, 7:10 PM
Dante said...: Thanks, progressives! You're so great! This arbitrary rule mandating only 12 year olds can get adult transplants, why, that's so much better than letting a doctor decide!

Oh, Right! And the IRS is going to be in the middle of this. I hope they don't discriminate against Tea Party members.; 6/5/13, 7:10 PM
Rusty said...: Maybe Lou Reed can spare a lung.; 6/5/13, 7:13 PM
Dante said...: Sorry, chicken-man, but the health-care ice-berg is already among us in the form of present and future illegal aliens who are sucking up health-care dollars at an ever-increasing rate.

No kidding. My kid had a broken knee, and the surgery room cost $28,000. Not the real cost. The real cost was a few thousand dollars after the insurance company did their thing.

And of course, that $28,000 is to take care of the people who could not pay. Wonder who they are?; 6/5/13, 7:14 PM
Carl said...: Well, Sebelius has asked for this shit sandwich, and I for one am happy to see her gag on every bite. Chomp, chomp, Kathy! Roll every morsel around on your tongue to taste the rich flavor before swallowing. There's lots more to come.

It's a good idea to stick every clown in government who likes acquiring power with the full responsibility for everything that power touches, however remote, and however unfair and out of proportion that may be. Sebelius has power to affect this case? Then, indeed, hold her 100% responsible if it doesn't work out perfectly for all concerned.

We need to teach the bottom-feeders who go into government to fear the acquisition of power like a nest of poisonous snakes. We want them wiping their brow in sweaty anxiety when they're forced to accept power, and breathing sighs of relief when they can say I'm so sorry, I would help if I could, but unfortunately the law doesn't give me any power at all in these cirxs...

That's where we want Sebelius to be. Shoving power over healthcare decisions as far away from herself as possible in naked fear.

This is a good start it. Pour it on.; 6/5/13, 7:15 PM
bagoh20 said...: "Mark Levin wondered why these issues are governed by the feds- any idea why that is Bago?"

It's been a while, but as I remember it's a national list and the organs are allocated by region since some are too far away to risk the travel. If someone has to handle something national and life threatening, it's gonna be the Feds, because as crazy as it clearly is, the feds are trusted for some reason more than private organizations. The organ program is kind of quasi-government/private organization. When I was waiting for mine there were huge differences in wait times and likely outcomes depending on where you went to have it done. The fastest livers were available at one particular Florida hospital that was a fraction of the wait of one in New York City, which had the worst times and outcomes. It had a lot to do with where intravenous drug user were prevalent. They overwhelmed the system in some places.

I considered moving to a different location, but in the end, I got it kind of suddenly long before I expected to, and had it done at UCLA, close to home, by the number-one transplant surgeon in the country, who had done more of them than anyone, and virtually created the modern method.

It worked out absolutely great, and today it's like it never happened.

Incidentally my surgeon made news by transplanting livers into Japanese gang bosses a few years back in exchange for nice donations to the hospital. They didn't care where the money came from. Money is a useful thing. It's better than publicity, and better than a squeaky wheel.

http://www.telegraph.co.uk/news/2058177/Japanese-mafia-dons-donated-50000-after-jumping-queue-for-US-liver-transplants.html; 6/5/13, 7:16 PM
campy said...: Sebelius may not know enough, but Obama Knows All. Let Him decide.; 6/5/13, 7:16 PM
edutcher said...: It's above his pay grade.

And on a not entirely unrelated line, the NSA has had Verizon hand over its phone records for the past 6 weeks. Won't stop for another 6, either.

As I say, constitutional rights is now a contact sport.; 6/5/13, 7:21 PM
Methadras said...: Dante said...

Sorry, chicken-man, but the health-care ice-berg is already among us in the form of present and future illegal aliens who are sucking up health-care dollars at an ever-increasing rate.

No kidding. My kid had a broken knee, and the surgery room cost $28,000. Not the real cost. The real cost was a few thousand dollars after the insurance company did their thing.

And of course, that $28,000 is to take care of the people who could not pay. Wonder who they are?

In a delicious bit of epic irony, the scenario and outcome you just mentioned is played out in the Progressive insurance commercials currently running showing people driving their cars and then all of s sudden other people jump onto their cars with their mouths attached to it, while the people driving are freaking out. Then the driver stops and a Progressive Insurance spokesmouth is there. The people ask him/her what the hell is going on and the spokesmouth says, "Oh, these are insurance rate suckers and you pay for their bad driving that your cut-rate insurance company passes onto you. So here at Progressive we have this device called Snapshot that you plug into your car to monitor your driving habits and gives you great rates for your great driving." then when the driver plugs it in, the rate suckers start to fall off the car only to find another person driving by that they chase and latch onto.

See the irony is, is that you are being fleeced to take care of those that don't pay and we wonder how this newly created ponzi scheme is going to fly. The double irony is that a company named Progressive, which is really run by progressives is highlighting the economic phenomena of the insurance racket as a function of how the government sets it up. Paying for those that don't pay. Ironically, coming from and auto insurance company.; 6/5/13, 7:34 PM
bagoh20 said...: The waiting list is not just a first in first out deal. There is a scoring system that moves you up or down depending on how ill you are, survivability, and results of blood and other tests. I was suddenly moved to the top when it was determined that my liver had a tumour that was not responding to chemo. At first I was not eligible to be on the list, and just expected to die in a few months because my tumour was too large, and statistically reduced my survivability. Ahh, statistics. So they pumped the tumor full of plastic beads laced with chemo drugs through my femoral artery, which after making me quite sick with wild hallucinations and other side effect, eventually shrunk the tumor below the regulation size and I was then scored at the top of the list, and saved shortly after.

I don't think all this was strictly allowed, or was at least a gray area. I got the impression they tried a bit harder with me and made some extra efforts and stretched the rules since I was very healthy at the time, in my late forties, with no symptoms of liver failure and in some of the best shape of my life. Even so, the surgery and chemo took a huge toll. But I'm back and strong now, with no complaints.; 6/5/13, 7:46 PM
bagoh20 said...: To be clear, I think they made the extra effort because I was in relatively good condition, and they expected a good outcome. They don't want to waste livers on people who will likely die anyway.; 6/5/13, 7:50 PM
Bruce Hayden said...: On the other hand, this situation illustrates just one reason why politics should be kept out of health care. And what should be obvious now is that all functions of Government are on some level political.

Going to just get worse problem is that treatments are going to go to people based on politics and political connections. Seeing that already with politically expedient mandatory coverages, like zero deductible birth control, etc. I expect that ovarian and breast cancer are going to receive much higher priority and funding than many other types.; 6/5/13, 7:56 PM
Ann Althouse said...: "Well, Sebelius has asked for this shit sandwich, and I for one am happy to see her gag on every bite."

That's well put, actually.

Before, it was doctors and insurance companies making these hard decisions. Once it's the govt, govt officials will have to take the political climate into account.

I hope your disease is one of the tragic ones, not a disgusting one, and that your children are adorable.; 6/5/13, 8:01 PM
edutcher said...: bagoh20 said...

To be clear, I think they made the extra effort because I was in relatively good condition, and they expected a good outcome. They don't want to waste livers on people who will likely die anyway.

In a nutshell, the "Useful Lives" concept pushed by Tippytoes' brother, Dr Ezekiel Emanuel, a former advisor on BarryCare.

Swell family, huh?; 6/5/13, 8:04 PM
Titus said...: No she should not.

How did she ever become governor of Kansas by the way?; 6/5/13, 8:13 PM
David said...: bagoh20 said...
"The waiting list is not just a first in first out deal. There is a scoring system that moves you up or down depending on how ill you are, survivability, and results of blood and other tests."

And your age, disguised as other factors.; 6/5/13, 8:27 PM
edutcher said...: Titus said...

No she should not.

How did she ever become governor of Kansas by the way?

Probably the same way Big Sis became governor of AZ.; 6/5/13, 8:37 PM
Jane the Actuary said...: So an adult lung is transplanted into a child by lopping part of it off. What happens when the child grows? Do they perpetually have a child-sized lung? Or does the child later need a new, properly adult lung?; 6/5/13, 8:44 PM
JAL said...: They don't want to waste livers on people who will likely die anyway.

Like Mickey Mantle?; 6/5/13, 8:53 PM
tim said...: Jane, I knew a man who had one half of one lung by the time he died at an old age (70s). WW2 veteran, survivor of the Bataan Death March and life long smoker. I am not saying he was going to run a marathon with his half a lung but he could get around with his walker.; 6/5/13, 9:08 PM
Anonymous said...: Okay, but jumping the line might mean she got a lung before someone else who needed it just as badly.

Other things being equal, skipping over a patient who is, say, 50 years old and giving the organ to a 10-year-old is a good thing.

Peter; 6/5/13, 9:23 PM
RecChief said...: how about not having this be a political decision in the first place?; 6/5/13, 9:34 PM
bagoh20 said...: I remember very vividly that when I came out of surgery and went to my room, there was an elderly Mexican man in the bed next to me who was very sick with liver disease. He seemed to nearly die every day, and the nurses were really struggling to keep him clean, comfortable and alive for about a week. A couple generations of his family would come in all the time, and they were always discussing how they were going to get the money to get him a transplant and calling various organizations that help with that when you are indigent. They were doing whatever they could financially, but everyone knew that wasn't the problem. He just wasn't gonna last long enough to get there. He was just too sick. Then one day they took him out and he never came back. I had mixed feelings of pity and gratitude about how it was just that luck how different our outcomes were. After my surgery, everybody expected me to make it, but nobody really expected him to, yet we had the same problem just different timing. We were side by side, me with a happy grateful family and him surrounded by weeping, pain, and helplessness. The difference was stark. With all this fancy equipment and teams of doctors obviously helpless to save him, it had the air of something primordial. He could have been lying on the floor of a cave for all it mattered. It was entirely too real, too simple, and these people working in the hospital deal with it every day.; 6/5/13, 9:37 PM
Petunia said...: Wonder why neither of her parents has donated part of one of their lungs to her?; 6/5/13, 9:44 PM
bagoh20 said...: "Other things being equal, skipping over a patient who is, say, 50 years old and giving the organ to a 10-year-old is a good thing."

I agree, but if you are the 50 year old, you don't want to even think about it.

The thing is there are more than enough organs to save them all, and it wouldn't cost anyone anything to make that happen. I imagine just a modest percentage of people donating their organs rather than burning them or packing them in embalming fluid is all that's required to save every single child and adult that can be saved. Even paying people for them seems justified to me, but it should be neither necessary nor criticized. There cost/benefit is just too good for that.; 6/5/13, 9:45 PM
Anonymous said...: But Meth says the organ procurement procedure is evil.; 6/5/13, 9:51 PM
bagoh20 said...: I thinks that a feeling a lot of people get because it's so outside of normal life, no seemingly unnatural and counter to the natural sense of body integrety that we seem to posses naturally. There is nothing like it. But that';s also the feeling I get when imagining women giving birth to warm breathing pink watermelons from their lady parts.

I imagine someday it will seem pretty normal, the way sending 300 people through the sky at 500 mph in an aluminum tube thousands of times a day does now. I imagine that would seem crazy, and maybe evil to someone 200 years ago.; 6/5/13, 9:59 PM
Jane the Actuary said...: So what are the stats on people who die with usable organs who have chosen not to be organ donors, or whose family disallows it?

And, if a 10 year old and a 50 year old turn out to both be matches, both equally in need, who gets the lungs? What if it's not a 50 year old but a 45 or 40 year old, who still has young children at home? How many young children do there have to be, or how young do the children have to be, for his life to be more valuable than a 10 year old child?; 6/5/13, 10:03 PM
The Godfather said...: I really don't know which is worse: Having a politico decide this kind of issue, or a federal judge. I'd hate to have my life, or the life of anyone I care about, decided by either one.; 6/5/13, 10:19 PM
Anonymous said...: I'd hate to have a for profit insurance company deciding my fate.; 6/5/13, 10:22 PM
Bender said...: Meth says the organ procurement procedure is evil

This much is certain -- the "harvesting" of organs is all too often made without full and complete informed consent. That is, it is rarely disclosed just when "death" is deemed to have occured so as to allow them to go and gut the donor. And there are increasing pressures to push back that line more and more. He's dead enough is earlier and earlier. That's because if they wait until someone is dead-dead, rather than close enough, then the organs will not be usable.; 6/5/13, 10:26 PM
chickelit said...: I'd hate to have a for profit insurance company deciding my fate.

I don't recall hearing stories (under the old system) of insurance companies playing death panels. Quite the contrary, insurance companies allowed and afforded (those insured) lots and lots of heroic end-of-life care.

Did you work as a nurse under situations where an insurance company told you or a doctor: "let that person die"?; 6/5/13, 10:39 PM
Anonymous said...: CIGNA; 6/5/13, 10:45 PM
bagoh20 said...: "I'd hate to have a for profit insurance company deciding my fate."

Well, that's who saved my life. They never balked, hesitated or questioned a single expense or procedure requested, despite the fact that I will never pay enough premiums to make them whole, and they knew that right from the start. That's what these for-profit companies do thousands of times every day through the simple honest and fair math of free markets.

Now the IRS will be deciding. How wonderfully confidence inspiring that is. Just out of the simple petty meanness and hatred of complete strangers with no profit motive even needed they deny people their basic rights. 90% of them of a single political ideology deciding for us all. I doubt there is any private company of any size with that kind of bias against half the nation. Could there even be a worse choice for this responsibility. I'd trust a communist party run Chinese dog food company further with my health care. They might at least hate me less for being a patriotic American.; 6/5/13, 10:45 PM
bagoh20 said...: IRS; 6/5/13, 10:46 PM
bagoh20 said...: Anybody who is dumb enough to believe there is no profit motive operating in government is unqualified to vote, or teach, or nurse, or raise children, or walk and chew gum simultaneously.; 6/5/13, 10:49 PM
chickelit said...: Inga said...
CIGNA

I personally had them as an insurance company for years. They never gave me or my family any trouble. I'd like to hear more about your bad experience with them for the record.; 6/5/13, 10:56 PM
Anonymous said...: LOS ANGELES — They weep still for their blue-eyed Nataline.

Nataline Sarkisyan died in a UCLA hospital bed on Dec. 20, 2007. She was 17. Her story drew nationwide attention because the liver transplant she needed was denied by her family's health insurer, CIGNA.

For Hilda and Krikor Sarkisyan, who live in the Los Angeles area of Porter Ranch, anguish remains for the daughter who never came back to her pink room. But so too does their determination to keep Nataline's story alive, to save others.

"I am not a politician. I am not a nurse. I am not a doctor," Hilda Sarkisyan said as she sat in her home, where a large portrait of Nataline hangs over the fireplace.

She was diagnosed with leukemia at age 14. After two years of treatment, the cancer went into remission. But in summer 2007 it came back and doctors said Nataline needed a bone-marrow transplant. Her only sibling, 21-year-old Peter, was a match, and he donated his bone marrow the day before Thanksgiving.

But Natalie developed a complication and, because her liver was failing, doctors recommended a transplant, saying she had a 65 percent chance of surviving.

CIGNA denied the transplant, telling doctors in a memo the procedure was "experimental, investigational and unproven services."

CIGNA reversed its decision and approved the surgery, but the girl died just hours later.

CIGNA did not respond to a recent request for comment on Nataline's case, saying the company does not respond during pending litigation. Hilda Sarkisyan has filed a complaint against CIGNA stemming from an incident in 2009 in which she alleges mistreatment by a company employee.

"I lost my child," she said. "They took my child away from me. You could say they even killed my child."; 6/5/13, 10:59 PM
Anonymous said...: http://seattletimes.com/html/nationworld/2018683872_nataline15.html; 6/5/13, 11:01 PM
chickelit said...: You misunderstood Inga: I was asking from your personal experience--not something you googled up.; 6/5/13, 11:05 PM
Anonymous said...: No I didn't misunderstand your request Chickie. It doesn't take a personal account of my own to prove my point.; 6/5/13, 11:07 PM
Mark said...: The question is, Inga, now that the Administration is running the show, will you vote Republican next time because the Obamacrats pulled a CIGNA on that poor girl?

Or is it okay now that your Personal Jesus says so?; 6/5/13, 11:19 PM
bagoh20 said...: No matter who runs it, there will be rules that will deny people, and let them die. It's not really possible to have it otherwise. The differences though are huge. If you think that Cigna does it poorly, you don't have to use them. But now if Obama care says that's the standard of care, then just shut up and pay your damned premium or we will fine your ass, but sorry about your daughter you fucking Republican. Ha Ha Ha.

Or, we will give you your liver if you just return this questionnaire with 90 questions about what's in your prayers and who you voted for last election. Just guess what we're looking for here, sucker.; 6/5/13, 11:27 PM
Mark said...: When we go to single payer you won't have any choice to change providers. You won't be able to buy private insurance, changing jobs won't matter, opting out won't be an option.

It will just be CIGNAs all the way down.; 6/5/13, 11:27 PM
bagoh20 said...: I don't get the point of that story Inga. Do you not realize that there will be thousands of stories like that about Obamacare soon, just like there are about the NHS in Britain, and many much worse. Obama care only has clean hands on this because it's not been in charge yet, plain and simple. The people will be just as dead, and you will be fine with it, because you are a hack.

And you wear hack panties.; 6/5/13, 11:36 PM
Chip S. said...: Any story of a young person's death is a sad one.

But it does seem that a good reporter would've sought out the story of the person who got the liver that "blue-eyed Nataline" would've gotten.

And a really good reporter would've looked into possible ways to increase the supply of transplantable organs, so that both Nataline and whoever got that liver could've been lucky.

Instead, we get an anecdote that's somehow "proof" that a complete mess like Obamacare is just what we need to make sure that no more blue-eyed girls want for livers.

This is the most depressing thread in my memory.; 6/5/13, 11:46 PM
Rich said...: El Pollo Raylan said:
"I don't recall hearing stories (under the old system) of insurance companies playing death panels. Quite the contrary, insurance companies allowed and afforded (those insured) lots and lots of heroic end-of-life care."

Sorry for the blog-whoring but no time right now to write like a human. But in response to El Pollo:

http://problemiserisa.blogspot.com/2009/08/theres-no-remedy-if-your-insurance.html

http://problemiserisa.blogspot.com/2009/09/rising-judicial-chorus-judge-young.html

http://problemiserisa.blogspot.com/2009/10/erisa-to-insurance-companies-its-ok-to.html

http://problemiserisa.blogspot.com/2010/06/word-from-industry-insider-makes-case.html

http://problemiserisa.blogspot.com/2009/09/pre-existing-condition-we-dont-need-no.html; 6/5/13, 11:49 PM
chickelit said...: Transplantation is not an option for leukemia patients because the immunosuppressant drugs "tend to increase the risk and growth of any tumors," said Dr. Stuart Knechtle, who heads the liver transplant program at the University of Wisconsin at Madison and was not commenting specifically on Nataline's case.

The procedure "would be futile," he said. link

The parent's wrongful death was throw out.; 6/5/13, 11:57 PM
chickelit said...: @Rich I see from your profile that you have a vested interest in the topic.

Thanks; 6/6/13, 12:02 AM
bagoh20 said...: Everybody could link crap back and forth for months proving nothing except that people get sick and die, and there is no system that can prevent that, or make it always fair.

The thing to question is whether you trust bureaucrats who do the kind of things you just heard about this week in congressional hearings to be more fair to us all than a company that has to compete with others for the opportunity to serve you and get your dollars. Do you trust a system like that as you do for groceries and haircuts, and pedicures, electronics and clothes, or a government system that just takes what it wants and gives you what they decide, leaving you with no choice whatsoever about it, and not even the choice to refuse it. No place to go, just suck it up regardless of how bad it gets. You can't fire them, cancel, or sue them for fucking you over. Shut up and take it on questions of your very life.; 6/6/13, 12:04 AM
Rich said...: El Pollo Raylan said:
"@Rich I see from your profile that you have a vested interest in the topic."

Agreed. But that doesn't make the linked posts untrue. OTOH I am perfectly wiling to own that my little blog is a polemic.; 6/6/13, 12:06 AM
Rich said...: bagoh20 said:
"No place to go, just suck it up regardless of how bad it gets. You can't fire them, cancel, or sue them for fucking you over."

Unfortunately same thing applies to insurance companies, if your coverage is employment-based, thanks to ERISA. Main grievance of my polemic blog is exactly that.

BTW, bagoh2o, you write really well and I just about always find your comments interesting, provocative and intelligent. Just thought you deserved some props.; 6/6/13, 12:09 AM
Chip S. said...: We've already seen how much better things are going to be in CA w/ the spiffy new Obamacare exchanges.

In the bad old days, there might be one or more cases in which patients were denied coverage for the treatment they wanted at the hospital they wanted from the doctor they wanted.

Now nobody who has to buy insurance thru an exchange can get coverage for any treatment whatsoever at Cedars-Sinai.

Progress!; 6/6/13, 12:10 AM
Mark said...: I have always understood the need for the labor union movement in this country. I grew up in West Virginia, where it was pretty much born.

But tying insurance to employment in the Labor movement's heyday was probably the central evil of its existence. It empowered Labor executives, it empowered Big Business, and it tied blue-collar employees to not one but two yokes.

Which was all well and good when we were the only economy left standing after WWII, but isn't doing us much good in the 21st century.; 6/6/13, 12:25 AM
bagoh20 said...: Thanks for the complement Rich.

"Unfortunately same thing applies to insurance companies, if your coverage is employment-based, thanks to ERISA."

That's certainly true to a point, assuming your employer doesn't care how well his employees are treated and refuses to change companies. I would, and have changed ours due to poor service to employees.

It will be worse now, as the companies essentially are required to be pretty much the same. Government intervention except for rare monopoly busting always reduces choice.

The congress blew it's opportunity to make relatively easy market based reforms that could have really helped, but I think that may be where we end up as this thing collapses in both logistics and popularity. I still hold out hope for this thing being either entirely or constructively reversed, out of necessity. It's the most flawed law ever written, so it just might be dumb enough to accomplish the unheard of: congress fixing something, by undoing it.; 6/6/13, 12:55 AM
kimsch said...: Health insurance became tied to employment because of salary caps and companies wanted to be able to increase compensation. Then Jimmy Carter gave us HMOs which changed it from insurance to pre-paid medical.

We need to go back to insurance for accidents and catastrophic care. We need to be able to have a health care savings account that rolls over that we can pay for our medical needs such as well child visits, annual physicals, and plain old illnesses such as ear infections, flu, what-have-you.

Without the middle-man of the "insurance" companies for regular medical care prices would go down. If we could get rid of ERISA too, to keep people from using the emergency rooms as "free" medical care by not paying their bills we could reduce prices even further. Those of us that do pay our bills won't also be paying for every Tom, Dick, and Harry using the ERs.

Let me buy my health insurance (accidents, hospitalization, catastrophic) from the same place I buy my car, life, and home insurance. Let my company pay me a little more because they won't be purchasing part of my "insurance". Let me save for my health care needs and let me roll it over. The less I use of that savings now, the more I'll have when I get older and presumably will need it more.; 6/6/13, 1:51 AM
MayBee said...: I started the thread by talking about Nataline and the importance of her case is campaigning for democrats who would give us the system we have now.

Nataline was too sick for a transplant, but that didn't stop the democrats from pushing the idea that government-run healthcare would stop such choices from being made.

Remember when Obama told Jake Tapper that the only thing people would have to give up was stuff that didn't work? It was all going to be magical.; 6/6/13, 1:59 AM
MayBee said...: This case is different from Nataline's in that Nataline was not being prohibited from having a transplant, the insurance company was just not paying for it (because a poor outcome was expected). The parents or a benefactor could have paid if doctors were willing to do it.

In the current case, Sarah was not eligible to be on the adult donor list, period. She was prohibited from having the procedure.; 6/6/13, 2:09 AM
MayBee said...: Carl at 7:15pm- brilliant; 6/6/13, 2:11 AM
edutcher said...: Inga said...

I'd hate to have a for profit insurance company deciding my fate.

Better them than the Silver Haired Angel of Death and the She Devil of the SS' Messiah, who let 4 guys get murdered because he was too coked out of his mind to do his job.; 6/6/13, 5:57 AM
Brian Brown said...: Inga said...
LOS ANGELES — They weep still for their blue-eyed Nataline.

Uh, she got the transplant and died anyway.

You're really, really fucking stupid.

You realize that, right?; 6/6/13, 6:26 AM
Brian Brown said...: Inga said...
I'd hate to have a for profit insurance company deciding my fate.

Well, of course no such thing happens, and your silly link certainly didn't show it does, and even if it did, you're here pretending the government, and more specifically judges, "deciding your fate" is a good idea.

You're really, really fucking dumb.

You realize that, right?; 6/6/13, 6:30 AM
gerry said...: My wife and I fostered a cystic fibrosis child until her death, and we learned a lot about the disease as a result, naturally. Unfortunately, this poor little girl seems not to be a very good candidate for a transplant. The lung may offer a greater chance of success in a different candidate.

Let the medical people make the call. This is not a Sibelius-Obamacare "death panel" issue, as this issue has always existed for transplanted organs. Some people simply are not good candidates.; 6/6/13, 7:35 AM
Aridog said...: Those of us 65 and older already have a *taste* of what is to come for everyone under PPACA. Bagoh20 is correct that the new rules will require all coverage to be essentially the same to meet government rules....which means coverage variation based upon need will no longer be available.

Should you be over 65 and need physical therapy, let me know how that works out for you. How promptly it is determined, by the government, to be unnecessary. How every prescription for 6 sessions really means 4 sessions...first is intake-evaluation, and 6th is progress-evaluation, no therapy involved. It is really grand....and you DO NOT have the option of continuing therapy on your own dime, if Medicare happens to reject a billing.

Mind you, I have one of the best plans under FEHBP available, but every year forward I have less and less to say and soon fewer real choices.

The Pelosi Congress had a different model that works well to look at...the Federal Employees Health Benefit Plan (FEHBP). The Pelosi crowd ignored it.

The FEHBP allows wide variation in coverages from multiple providers, with pre-existing condition coverage, portability, and no penalty tax for not buying one plan.

FEHBP is basically what members of Congress have themselves. Even candidate John Kerry suggested adapting FEHBP in 2004. However, the Democratic Congress wanted nothing to do with it...for all y'all proles. It might just have been the single good idea Kerry has ever had, oddly enough.; 6/6/13, 9:57 AM
Scott said...: For all of those who endorse Carl's comments from 7:15 PM...

These people WANT the power, they WANT the responsibility...they will exercise it and sleep the sleep of the virtuous, the pain of others is nothing to them. Perhaps that is inconceivable to most of us here, but if any of you have dealt with senior level government types or high ranking bureaucrats, you know what I mean. People like Seibelius went into government in pursuit of power, it is their raison d'estre; 6/6/13, 10:38 AM
Chip S. said...: These people WANT the power, they WANT the responsibility

Power? Absolutely.

Responsibility? Maybe.

As long at it's the consequence-free type.; 6/6/13, 11:11 AM
MarkD said...: I suggest allowing the next of kin to be paid for organs would render this moot. That would be "unethical" but it's OK to pay doctors to transplant them... So, save the interference of a judge, the girl will have to die, because it's the rule.

Maybe it'll be fixed in Obamacare 2.0.; 6/6/13, 3:27 PM