Ethical Issues with Medical Funded Organ Transplants Using Medicare Angela K. Bettis
Mountain State University
This paper is going to focus on the importance of getting a better way for Medicare to handle the needs of transplant patients. The current situation isn’t a good one. The patients are the ones that suffer while the medical insurance companies and centers keep making more and more money. This is showing to me how much of the healthcare has turned to be about that. The transplant centers are needed but there is so much red tape that they have to go through to be approved by Medicare it makes it hard for them to open. What seems like should be an easy fix sure isn’t when you look into it.
The ability to keep someone alive by replacing one of their major organs is an amazing achievement of this century of medicine. Unfortunately, the current supply of transplant organs is much lower than that need or demand for them, which means that many people in the United States die every year for lack of a replacement organ. When a person gets sick because one of his or her organs is failing, an organ is damaged because of a disease or its treatment, or lastly because the organ has been damaged in an accident a doctor needs to assess whether the person is medically eligible for a transplant or not. If the person is eligible the doctor refers the patient in need of an organ to a local transplant center. If the patient turns out to be a transplant candidate a donor organ then must be found. There are two sources of donor organs. The first source is to remove the organs from a recently deceased person, which are called cadaveric organs (Potzgar, 2007). A person becomes a cadaveric organ donor by indicating that they would like to be an organ donor when they die. This decision can be expressed either on a driver’s license or in a health care directive, which in some states are legally binding contracts. The second source is from a living donor. If a person does not have a living donor he or she is placed into a waiting pool for an organ from a cadaver by their transplant center (Centers, 2007). Deciding who gets a transplant most often is a decision about who lives and how dies. The primary ethical dilemmas surrounding organ transplantation arise from the shortage of available organs and the criteria on who should receive an organ first and why. Not everyone who needs an organ transplant gets one. But not just that, Medicare funded organ transplants add another set of ethical issues to the equation. Medicare is a federally-funded health insurance program available to retirees over the age of sixty-five, disabled people and other qualifying individuals. There are two parts to Medicare: hospital insurance and medical insurance. Medicaid is state-funded health insurance program for low-income individuals. Many patients cannot afford to pay for the full cost of an organ transplant, or even a small insurance deductible amount, using their personal funds. Most people waiting for an organ transplant have financial difficulties, as most of the time their illness has caused them to be placed on disability. In 1965, Title XVIII of the Social Security Act created Medicare under the principle of beneficence. This title was to contribute actively to the health and well-being of the people mentioned above. In 2007, The Secretary of the Department of Health and Human Services signed the 42 CFR Parts 405, 482, 488, and 498 otherwise known as “Medicare Program; Hospital Conditions of Participation: Requirements for Approval and Re-Approval of Transplant Centers To Perform Organ Transplants” giving Medicare responsibility for the quality of care that the patient received during organ transplants. This regulation placed Medicare in a controlling position where Centers for Medicare & Medicaid Services dictates the rules regarding transplant centers participation with Medicare. If the centers fail...
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