Medicare Funded Organ Transplants
Keller Graduate School of Management
Health Rights and Responsibilities HSM 542
Medicare Funded Organ Transplants: Ethical Issues
“Ethical issues are the branch of philosophy that defines what is good for the individual and for society and establishes the nature of obligations, or duties, that people owe themselves and one another. In modern society, ethics define how individuals, professionals, and corporations choose to interact with one another.” (Ethics, Legal legal definition of Ethics, Legal. Ethics, Legal synonyms by the Free Online Law Dictionary.) The ethical issue with Medicare funded organ transplants is who it should be eligible and the problem that the needed immunosuppressant drug is only available for a limited amount of time through Medicare funding. The value of a person’s life has been fragmented down to if they have worked long enough, have enough wealth and/or resources to deserve an organ transplant; and the required drugs. This is troublesome in the regard to should everyone have an equal shot to a prolonged life and quality of care. Only those who have the ability to pay will be put on the waiting list for an organ.
How can Medicare better handle the ethical issues faced with funding organ transplants and the medication needed? “Since 1973, end-stage renal disease has been the only condition specifically covered by Medicare regardless of age. In 1988, coverage was extended for 12 months to anti-rejection drugs, which had recently been developed. Congress gradually lengthened the cutoff to 36 months, and then in 2000 made the benefit unlimited for those who are at least 65 or disabled. The rationale for leaving out younger transplant recipients was simply that the money was not there.” (Medicare Covers Transplants, But Limits Payments for Anti-Rejection Drugs - NYTimes.com) There are cases where the government has actually paid more money because the organ was rejected after the patient was unable to pay for the immunosuppressant; and a second transplant was needed which is extremely more costly than the drugs itself. “Iimmunosuppressant drugs, which are also called anti-rejection drugs, are used to prevent the body from rejecting a transplanted organ.” (Immunosuppressant Drugs - blood, pain, time, infection, medication, pregnancy, heart, cells, risk, cancer, nausea, Definition, Purpose, Description, Recommended dosage, Precautions) This drug must be taken throughout the duration of the patients’ life. It poses a major problem if the patient cannot afford the drug required to stay healthy. “The story of Ms. Whitaker’s two organ donations — the first from her mother and the second from her boyfriend — sheds light on a Medicare policy that is widely regarded as pound-foolish. Although the government regularly pays $100,000 or more for kidney transplants, it stops paying for anti-rejection drugs after only 36 months.” (Medicare Covers Transplants, But Limits Payments for Anti-Rejection Drugs - NYTimes.com) An added problem is who Medicare covers for organ transplants. Someone without the correct economic standings will not even be spoken to about the option of a transplant because hospitals cannot take on the burden of paying that bill themselves. “For those who have End-Stage Renal Disease (ESRD), you are eligible for Medicare if your condition requires a kidney transplant or dialysis treatment. In order to qualify for Medicare eligibility, you would also have to either be the spouse or dependent of someone who is eligible for Social Security or RRB benefits or have to have worked long enough to receive these benefits.” (Medicare Eligibility - Medicare Consumer Guide) That means a person; their spouse or sponsor will have to have earned 40 credits which is the equivalent of working 10 years; if they are not receiving RRB benefits. This can be problematic since the cost of a transplant is extremely high and some private policies do...
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