See title. In a thread discussing opti,g out/opting in systems for organ donations, an American posters stated so.
It has been my understanding that in the USA, hospitals will treat you for life-threatening conditions, eve if you’ uninsured. Needing a new heart or liver fits pretty much the definition of life-threatening condition.
So, is this poster right? And if she is, on what basis is such a life-saving treatment denied? And finally, are there others life or death situation where you can nevertheless be denied a treatment by hospitals if you’re uninsured?
Yes, organ transplants can be denied if you cannot show the financial means (insurance or independently wealthy) to pay for the procedure and necessary follow up care.
Hospitals are only required to assess and stabilize patients in an Emergency Department without regard for ability to pay. They can then discharge stable patients or those who leave of their own volition. Or they can transfer the patient to a hospital better suited to meet the patient’s medical need.
Specifically hospitals are not required to provide medications which may be prescribed. A typical drug regimen for a transplant patient is very costly. An organ will not be offered to a patient who lacks the ability to comply with the post-transplant medication regimen.
It’s not like some procedures where it’s merely a matter of being expensive. There are only a limited number of organs available and all of the money in the world won’t get you one if there isn’t a match available.
If you need a new organ, you go on a regional waiting list that is Federally controlled. You aren’t going to get high on the list if they don’t think that you’re a good candidate to survive. One if the many factors is ability to be able to afford the upkeep.
Some patients with insurance might be denied a transplant for financial reasons if the procedure is considered an experimental treatment for the patient’s medical condition. Insurance companies often deny coverage for experimental treatments. Due to the extremely high cost of transplant procedures insurers tend to be slow to regard a transplant as non-experimental in some instances.
Keep in mind, too, that even with the most comprehensive universal health care not everyone who needs an organ gets one because the supply of organs is very limited. But at least in those places one is not condemned for lack of money.
But remember that in a universal, single payer system like the NHS, costs are a LOT lower than they are in America’s massively inefficient health care system…
The sad, unfortunate reality is that we have such a system in the U.S. It’s called medicaid, and it has been my very uncomfortable position, more times than I care to remember, to deny applications because the applicant wasn’t poor enough … yet.
At least I could advise them, within the letter of the law, as to how to get to that point. All while thinking, “… there but by the grace of tenuous circumstance.”
Understood, we’ve got a terribly inefficient system.(*)
But, the reality of organ transplantation is that it’s expensive and resource intensive.
Would somebody with no fixed address and no job be offered a transplant?
Remember that it takes effort, time, and money after the operation, every day of the rest of their life.
Somebody with no car, calendar, or watch isn’t going to be able to handle the task. So why waste an organ?
(*) ETA- I worked in a hospital, I’ve seen how broken our system is.
Such a person would not be denied a transplant based solely on how much money they have, no. Of course, other factors may affect the decision - a lot of people who are homeless have drug or alcohol problems, for example.
In most of Spain (heck, most of Western Europe), a car isn’t necessary for daily life - it may make it easier, but it’s not needed and note the may (my cousin didn’t bother get a license until her early 40s and doesn’t have a car; my mother has never had a license). Calendar or watch? That homeless person, once transferred to social services and if they’re willing to play the game, will have a home and caretakers, and the caretakers will dispense meds. Someone who’s put-together enough mentally to qualify for that transplant they need (alcoholics for example will be considered very low-priority) will be able to play the game.
I would never have thought of it in terms of “offering” a transplant. You’re told you need one; if an organ is found, you’re called in to get it. I guess “offer” is the right term, since you can reject it… but short of JW’s I can’t imagine who would.
There are many inefficiencies in the NHS; bloated bureaucracy (the blight of any government organisation) and some greedy consulats, to name but two.
The great thing is that it is universal. That is not to say that there are not differences around the country, but if you get wheeled into A&E on a stretcher (even if you are an American tourist) you will get the best care that the unit can provide, and in many cases that is world class. For a tourist they would try to recover costs from insurance, but that would only happen after treatment.
BTW - if you are suffering from a gunshot wound you are better off in Belfast (because of the troubles) or Birmingham (where the war wounded end up).
There was a story, I think it was real, about a Tea Party meeting shortly after the Health care act was passed and the speaker asked the audience just that question. What should happen if a poor uninsured person needed some treatment. The answer, accompanied by wild cheering: “He dies”.
A congressman from, I think, Kentucky, arguing to end the food stamps program (it provides food for people in poverty and has had bipartisan support for 40 years) quoted–or claimed to quite–something from the bible that said, “He who will not work, shall not eat.” I am not familiar with the bible, but I would like to know the context. Does that imply that an infant with an unemployed father ought to starve to death? That could be the effect of ending the program.
You do realize that the uninsured are NOT just the homeless? Someone working 40 hours a week at a job that offers no insurance might need a transplant, but would be denied simply because they don’t have insurance or be sufficiently wealthy to pay for it out of pocket. Not just the working poor - an entrepreneur might have a middle-class income but no insurance. You can have a home, great family/support network, be mentally stable, no addictions, and a full time job but if you don’t have medical insurance (or millions of dollars in your bank account) you’re screwed if you need a transplant.
