Give Me Your Tired, Your Poor – and We Will Let Them Die


 (The Author, Bob Aronson, is a heart transplant recipient, former journalist,  former Communications Director for a Minnesota Governor and retired international communications consultant.  He lives in Jacksonville, Florida with his wife Robin)

 

If Medicaid dies so does American morality and compassion.  Due to several economic, political and yes, even some human selfishness factors, America’s health care safety net is in danger of disintegration leaving millions of people with only emergency rooms for their primary care.  Most disturbing is the fact that the great majority of terminally ill patients who depend on life saving organ and tissue transplants, dialysis, radiation and chemo therapy, hospice and other complex surgeries and treatments will simply be sent home to die. It is happening in Arizona and it is likely to happen in many other states as well and but for a committed few is being met with apathy and disdain for those affected. 

 

The danger is imminent but many Americans just don’t seem to care.  If we let this happen America will have lost part of what has made it great, Give me your tired, your poor, Your huddled masses yearning to breathe free, The wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me, I lift my lamp beside the golden door!”   These last few lines in a poem by Emma Lazarus, speak for all eternity the words of compassion for which America is known.  If Medicaid dies so do those words on the Grand Lady in the Harbor that inspired so many millions who came to these shores.

 

As our economy worsened the costs of health care and health insurance continued to rise.  Millions of Americans whether employed or not have found themselves with little or no coverage even if their conditions were life threatening.  A good number of these people were critically ill, jobless, had exhausted their financial resources and could only turn to Medicaid for help (Medicaid is partially funded by the U.S. Government but administered by the individual states)

 

Across the width and breadth of the United States many officials were elected on promises of tax and spending cuts so as budget deficits grew tax increases were out of the question, they were considered political suicide.   Unlike the federal government the law does not allow states to end the year with a deficit.  In every state, legislatures meet shortly after election day so the lawmaker’s immediate top priority was budget slashing — often indiscriminate and cruel in its nature.   

 

The top revenue eaters in all states are education and Medicaid.  While there have been some cuts in education most of the emphasis in the new year has been on Medicaid and the cuts and proposed cuts have been both dramatic and life threatening.  While several states like California, New York and Florida are considering huge Medicaid cuts, Arizona took the first step by eliminating the program’s coverage of most organ and tissue transplants.  The move immediately affected 98  pre-approved Arizona citizens who were promised that Medicaid would cover their procedures. 

 

Experts agree that anyone who is approved to be on the transplant list has a life-threatening disease that requires treatment beyond what standard medical procedures and treatments can provide.  In the great majority of cases that means tissue and/or organ transplants which are highly effective albeit expensive will not be available unless you are insured or very wealthy.   A person can only be “listed” if a physician who specializes in their disease is convinced there is no other way to save the patient’s life.  Then, that same expert must convince a hospital transplant committee, also made up of experts, that the patient’s name should be submitted for listing.  At that point the name and condition of the patient is forwarded to the United Network for Organ Sharing (UNOS) in Richmond, Virginia for placement on the national waiting list.  UNOS coordinates all organ and tissue transplants in the United States.  Currently there are over 110,000 people on that list. 

 

When Arizona decided to break their promise to the 98 patients they knew that without the promised transplants every one of these terminally ill people would die. Two have passed on already and a Phoenix transplant surgeon says as many as 30 more may die in 2011 – and that’s just in Arizona and  just transplant patients.. 

 

To make matters worse, the Arizona legislature and Governor Brewer used outdated and erroneous data to justify the action saying “Transplants are Cadillac options and aren’t very effective anyway.”  The truth is that the only option to a transplant is death; there are no other medical remedies for these patients.  And — organ and tissue transplants do work.  Hearts have a 90-95% success rate (this writer is one of them) kidneys have an 85-90% success rate and lung transplants are successful about 75-80% of the time.  The American Society of Transplant Surgeons, the American Transplantation Society and UNOS have together protested the use of incorrect information and have provided the Governor and the legislature with the latest data which shows beyond a doubt that the procedures are not only successful but save money in the long run. http://www.a-s-t.org/news/new-ast-asts-unos-review-concludes-az-medical-data-shows-eliminated-transplants-work  (You can also go the Website of the American Society of Transplant Surgeons web page and click on the first item, December 9, 2010 Arizona Transplant Cuts Based on Flawed Data http://www.asts.org/thesociety/positionstatements.aspx) Governor Brewer and the Legislative leadership have ignored that information and continue to use the same old incorrect data to justify their inhuman action.  Is this any different from perpetuating a lie?  

 

The Arizona lawmakers insist that the transplant cuts will save $5 million but the state’s own research indicates the figures are lower — $800,000 in 2010 and $1.4 million in 2011.  Governor Brewer has $30 million in discretionary federal stimulus funds that she could use to save these lives.  She says the money is spoken for but won’t say where it’s going.  In the meantime she found $2 million to conduct algae research and another nearly $2 million to fix a roof. 

 

Steven Daglas a 30-year-old Republican from Illinois studied the Arizona budget carefully and found 26 ways to cover the cost of the transplants without raising taxes and without negatively affecting other programs.  Respectfully he offered his findings to Governor Brewer and the legislature.  He, too, has been ignored.

 

Now Arizona wants to cut almost 300 thousand people from Medicaid which will cause a hike in the cost of healthcare and insurance while penalizing hospitals at the same time.  If this legislation is passed and spreads to other states and a flood of patients of Noah’s Ark proportions hits hospital emergency rooms the death toll will mount  into the hundreds of thousands if not millions and health care and insurance costs will rise until only the ultra-rich will be able to afford them.  That’s the scenario friends.  You can deny my hypothesis, you can call it exaggerated and sensationalized but the fact remains that cutting Medicaid to the bone or eliminating it altogether as Texas would like to do, will cause a major financial and health disaster unlike anything America ever seen. 

 

Other state legislatures are meeting now, too, and most of them are watching Arizona very carefully to see what the Grand Canyon State is going to do.  If we allow Arizona to balance its budget by refusing to treat the first 98 critically ill patients and then cutting another 300 thousand from Medicaid roles, the green light will be seen from California to New York and the disaster will have begun.

 

Many of us in Organ Transplant Initiative and other organizations believe that allowing the critically ill to die in order to balance a budget is wrong.  This is a civil and human rights issue and no elected official(s) should have the right to decide who lives and who dies.  In the case of Medicaid those who die will be mostly poor who have exhausted all other alternatives.  We can find absolutely no justification for this cruel and unconscionable action.  Politicians who pander to base selfishness and allow people to die are really no different from the street thug who maims and even kills an innocent citizen for their money.

 

Please view our 7 minute video “A Promise Broken” on www.savethearizona98.com.  Also…there is more information on this blog site about other donation/transplantation issues.  We would love to have you join our Facebook pages, ORGAN Transplant Initiative  and The Dream of Life Coalition  The more members we get the greater our impact on increasing life saving organ donation

Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the immediate need for more organ donors.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.

Posted on February 7, 2011, in Assault on Medicaid and tagged , , , , , , . Bookmark the permalink. 3 Comments.

  1. Ashley Tenczar Curran

    I am a member of the Organ Transplant Initiative, a group that Bob Aronson created about two years ago, and he took the “ARIZONA 98” cause on with a fierce loyalty of someone who is “family”. You see, we in the “Transplant Community”, despite our differences in opinion, cultures, types of transplants, and emotions ARE a “family”.
    My husband is waiting for a liver transplant in Boston, MA, and has been on the UNOS list for about 19 months now. He is not even CLOSE to being at the top of the list, and yet, he suffers deeply at the loss of his life, his soul has been robbed of it’s bright colors, and the strange thing is that if 1,000 New England Residents were to sign up to be Organ Donors every week, he prob would be close to the top of the list within a year.
    That makes me very sad. I can say that because as SOON as I turned 16 I was excited to do two things: get my Driver’s Liscense, and become an Organ Donor. I was many years away from even knowing my husband, but something about organ donation made me feel very grown up, and I signed up with PRIDE.
    We at the OTI are trying to instill that same pride within all human beings, to show them that we are all going to pass some day, and to leave a legacy of saving up to 7 people’s lives as you pass on is nothing short of heroic, and proof that humanity is alive and well.
    But, every day, thousands of people in the world have their funerals, and go into the ground with those precious organs that could save a little girl who is on a machine keeping her alive, bravely, until she gets her chance at “The Gift of Life”.
    I visit this particular cemetery several times a week to see “my buddy”, a shooting victim who was just 11 years old when she was gunned down by 4 gunman as she left a playground to go home, 3 houses down.
    Senseless violence became compassionate and loving though, when her Mom made the ultimate in courageous and loving decisions, to donate her organs.
    Over the last two years I have met several parents who have done the same. They have taken tragedy and through the bleary eyes of a shocked and heart broken parent, given freely of their child’s organs so that another parent does not have to suffer, another child does not have to die in a senseless way.
    Please consider becoming an organ donor.
    I am APPALLED at the atrocity that Gov Jan Brewer has literally committed when she condemned 98 INNOCENT AMERICAN CITIZENS to death.
    No “trial”, unless you call a committee of non-medical “experts” who made the blundering conclusions that “transplants don’t work”.
    The Author of this Blog, my friend, Bob Aronson is LIVING PROOF that yes, Governor, they DO WORK. In his “spare time” you would not BELIEVE what Bob does! I could never keep up with him, and I am a 37 yr old woman!
    Yet, her decision has withstood the test of time, because, in my opinion, there are people who fear her, and so they lay down their thoughts and arguments.
    If they did NOT FEAR HER, then they would have RECALLED her for such an act!
    IMAGINE if she did this to CANCER PATIENTS?
    IMAGINE if she told one of the SHOOTING VICTIMS in the Tucson Massacre, like Gabby Giffords for one, “Sorry, we know you need a transplant, but we cannot give you one because you cannot pay for it”.
    It just further proves that some people matter, and some people don’t.
    Well, Governor Brewer, MY HUSBAND MATTERS.
    That is why I will NEVER step foot in your “Wild West” state until you yourself are out of that state.
    Personally? I think Mommy Brewer did not give enough love to little Jan.
    (ok, that was my one immature joke)
    Please support us at the OTI (on FB, ORGAN TRANSPLANT INITIATIVE), and help us help those in AZ that cannot help themselves.
    We welcome you to our group!
    Thank you Bob for another well written and truly meaningful post that we can all learn from. If you want the facts, come to “BOBSNEWHEART”.🙂
    Ashley Tenczar Curran
    Boston, MA USA

    Like

  2. It’s even worse here in Arizona. A Russell Pearce ally (Lori Klein of Anthem) is pushing a bill, formally SB 1433 that would allow the legislature to appoint a 12 member committee to determine which federal laws to follow and which to ‘nullify.’

    The thinking is that if/when the waiver AZ has applied for is denied, Pearce (as the ultimate power in the state) will push through a budget that dumps all those people off of AHCCCS anyway and use his committee to ‘nullify’ whatever federal law that would be breaking in the process.

    Like

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