"We can't afford to pay for everything for everyone," acknowledged Shapiro, a member of the ethics panel for the United Network for Organ Sharing, a private, nonprofit organization under contract with the federal government to manage the nation's organ transplant system. "Sick people need medical care and it's all of our responsibility to help them get that care. Doctors can't do it themselves."
Jennifer Carusetta, chief legislative liaison for AHCCCS, said Arizona Medicaid patients were notified on Aug. 27 of the impending changes, prompted by a 30 percent increase in enrollment during the recession and a federal requirement that the program maintain its eligibility requirements despite receiving fewer federal matching dollars.
The state is facing a $1 billion deficit in the program come July 2011, she said. Although Arizona's fiscal year began July 1, the state opted not to implement the cuts until Oct. 1, when it estimated they'd affect about 100 people on transplant lists. However, Carusetta said the state anticipated that only a fraction of them were likely to feel direct effects of the policy change. "We believe that only about 15 percent of those individuals would be able to get a match and secure an organ."
One of the patients who has felt the budget ax is Francisco Felix, 32, of Laveen, Ariz., whose liver has been damaged by hepatitis C. According to an account published in The Arizona Republic, Felix was admitted to Banner Good Samaritan Medical Center in Phoenix on Monday night after learning that a dying family friend wanted her liver to go to him. But when Felix couldn't come up with $200,000 to pay for the procedure by Tuesday morning, the hospital wouldn't operate on him and the liver went to another patient.
In a prepared statement, Banner Health spokesman Bill Byron apologized for the disappointment and stress the family was feeling. He said that if Banner had absorbed the costs of giving Felix the liver, that action "could have committed the organization to providing the same service to the other 22 patients in the same situation as Mr. Felix. Costs for liver transplants can exceed $500,000, so it is not feasible for Banner to absorb the $12 to $15 million in costs associated with 23 procedures."
Byron said he hoped that a solution could be found for Felix "who we believe will need a transplant within the next 12 to 24 months."
Felix's family has begun working with the National Transplant Assistance Fund in Radnor, Penn., to raise the needed money, the organization's executive director, Lynne Samson, confirmed Wednesday.
"We work with families from all over the country who are referred to us by their transplant social workers when they find out that they either do not have insurance for the particular transplant, or the insurance is severely capped, or there's gaps in medication co-pays that they cannot pay for," Samson said. The fund then helps the patients raise money in their communities "in a way that is tax-deductible and doesn't jeopardize their eligibility for medical assistance."