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Author Topic: Why More Than 120,000 Americans Can’t Get The Organ Transplant They Need  (Read 3050 times)

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Offline Clark

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http://thinkprogress.org/health/2014/11/20/3595088/organ-transplant-issues/

Why More Than 120,000 Americans Can’t Get The Organ Transplant They Need
BY SAM P.K. COLLINS
 
A single organ donation — including that of the heart, kidney, liver, and bone marrow — can save eight lives and potentially improve the health of 50 people.
High health care costs, however, often prevent many people from carrying out the altruistic act. That’s part of the reason why the number of patients in the United States in need of a healthy organ currently stands at more than 120,000, according to the National Kidney Foundation.
In the upcoming weeks, the American Society of Transplant Surgeons, in conjunction with the American Renal Society and the American Society for Transplantation, will release white papers calling for studies on compensation for organ donation, which the National Organ Transplant Act of 1984 outlaws.
Since the Department of Health and Human Services (HHS) carried out the law, the organ donation waitlist has increased by more than 1200 percent. Medical officials haven’t been able to meet the increasing need for organs. As a result, more Americans have died in the process of waiting for an organ than in World Wars I and II, Korea, Vietnam, Afghanistan, and Iraq combined.
“When it comes to transplant organs, the United States unfortunately is not as progressive, liberal or free-market as Iran or Riyadh,” Thomas A. Firey, senior fellow for the Maryland Public Policy Institutes, wrote in the Herald-Mail Media last month. “As a result, another 6,500 Americans will die this year because they didn’t receive a transplant, and the waiting list will top 125,000 suffering souls. It’s well past time to reform one of America’s deadliest laws.”
Lawmakers on both sides of the aisle worry that compensating organ donations would encourage poor people to sell their organs for a quick dollar. But Dr. Sigrid Fry-Revere, founder of Stop Organ Trafficking Now, told Medical Daily that failing to provide medical coverage for the practice has made it so that only a wealthy few can donate organs, which has exasperated the supply gap.
“If we just covered people’s funds to donate, it would increase the flow of donors significantly and this is not creating a market for organ donations,” said Fry-Revere. “A market is not the way to go…but we have created a model where only the rich can donate.”
Fry-Revere has some cause for concern. Donating organs can cost anywhere between $5,000 and $20,000 and six weeks out of work, which doesn’t bode well for 90 percent of American households that wouldn’t be able to shoulder those expenses without going into debt. Before the passage of the Affordable Care Act, volunteers often couldn’t afford follow-up care because their insurers designated organ donation as a preexisting condition, despite studies showing that people could lead healthy lives after the procedure. That’s part of the reason why only 30 percent of Americans sign up for organ donation.
Supporters of organ donor compensation cite Iran’s success in eliminating its kidney donation wait list with its legal organ market — funded by the government and local charities — that has been in existence since 1982. While different than what many Americans have expressed support for, Iran’s efforts have compelled officials in Australia and Singapore to at least consider following suit.
In the United States, however, efforts to increase the organ supply in the last 40 years — including the creation of computer registries — have focused on the deceased and the consent of their families. Facebook has also recently allowed users to disclose their organ donation status on the social network as a means of compelling others to join the registry. But even the use of cadavers — which account for more than two out of three organ transplants — can’t help close the increasing organ gap.
In recent years, a growing chorus of health care providers have argued that lawmakers should revisit the National Organ Transplant Act and create some kind of system that will protect organ donors from egregious medical costs. The American public seems to agree. According to a poll conducted by NPR and Thomson-Reuters Health in May, nearly 60 percent of respondents supported compensation in the form of credits for health care needs, while nearly half wanted tax credits. More than 80 percent also expressed support for the practice when it involved the transfer of kidneys, livers, and bone marrow.
“It’s clear they’re saying there is a difference,” Dr. Ray Fabius, chief medical officer for Thomson Reuters’ health unit, told NPR. “Any living donor should be recognized, and it should be handled by insurance companies.”
For a large portion of the American population, however, organ donation may not be a possibility, even if HHS puts methods of compensation in place. A recent study presented at the American Society of Nephrology found that preventable health conditions — including obesity, alcoholism, diabetes, skin cancer, high blood pressure, HIV, coronary artery disease — disqualifies a majority of Americans from donating.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
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Offline Clark

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Opinion: It's past time to reform organ transplant act
« Reply #1 on: November 21, 2014, 10:30:05 AM »
http://www.heraldmailmedia.com/opinion/guest_editorials/tom-firey-it-s-past-time-to-reform-organ-transplant/article_21ff6b07-0acd-5b2b-a5ed-8c5279ca4765.html

Tom Firey: It's past time to reform organ transplant act

Thirty years ago this month, Congress approved and President Ronald Reagan signed one of the most well-intentioned but disastrous laws in American history. The 1984 National Organ Transplant Act (NOTA) formalized a nationwide organ transplant system and — more importantly — prohibited compensating organ donors or their estates. Lawmakers reasoned that money should not be a deciding factor in who gives or gets a vital organ.
Under the law, hundreds of thousands of dollars are spent on each life-sustaining transplant of a kidney, lung, liver or heart, but not one cent can be used as incentive to secure a healthy organ. As a result, the national transplant list has swelled from 10,000 in 1982 to nearly 125,000 today. Some 6,500 Americans die each year awaiting transplant, roughly equal to the total number of American troops killed in Afghanistan and Iraq. Yet every year, thousands of other Americans’ bodies with transplantable organs are lowered into the earth — organs intact — to become food for worms.
Some ethicists and doctors defend NOTA, saying it protects people from the temptation to sell their organs for money. That’s a strange argument in a country where conservatives favor “individual liberty” and liberals defend a person’s “right over his or her body.”
But put that concern aside; enough organs could be harvested from the recently deceased to dramatically reduce — if not completely eliminate — the current organ donor list. In return, the donor’s estate could receive credit toward funeral expenses or a cash award; economists have estimated that awards of as little as $1,350 could be enough to address the need for donor kidneys.
NOTA supporters also claim that compensating donors would reduce the total number of organs available for transplant because some current donors might hold out for money or else think donation is “tainted” by the incentives. Perhaps that’s true, but that would mean transplant organs are unlike every other good. Farmers are paid for their crops, yet people donate food to the needy and there’s no U.S. food shortage.
Builders are paid for houses, yet Habitat for Humanity has volunteers and there are plenty of homes. Teachers are paid, yet people volunteer at schools and no one calls for pay cuts to solve a teacher shortage. For that matter, no one claims that transplant surgeons should be unpaid to ensure an adequate supply of those doctors.
NOTA supporters offer one more argument: compensating donors just feels wrong. Yet they struggle to justify that feeling in ethical theory. For instance, the late medical ethicist Benjamin Freedman wrote, “That which cannot be bought and sold is by definition priceless. By removing human life and health from the marketplace, we affirm this principle.”
That’s a moving statement — but it’s clearly wrong. When something can’t be bought and sold, despite the owner’s willingness to part with it, then it isn’t priceless — it’s worthless. Yet donor organs aren’t worthless to the tens of thousands of people who now suffer while on the transplant list. They certainly merit $1,350 for a kidney or the few thousand dollars it might take for a heart — amounts that are less than 1 percent of the cost of transplant surgery.
Some NOTA supporters seem to realize their arguments are unconvincing and claim to be willing to consider evidence that incentives might improve organ donation. But when shown that incentives encourage the supply of other goods, they say other goods are not like vital organs. They want specific evidence that incentives will increase organ donations, but they won’t consider easing NOTA — even for a pilot program — until they have such evidence. Obviously, it’s hard to provide such evidence when it’s illegal to collect that evidence.
And yet, there is such evidence — if NOTA supporters would only consider it. For instance, though NOTA prohibits incentives for organ donations, a 1968 federal law allows financial incentives — such as covering funeral expenses — for donations of whole cadavers for research purposes. There is a steady supply of research cadavers, and even an overabundance in states where incentives are more generous.
More compelling evidence comes from overseas. In 1988, Iran adopted an incentive system for living kidney donors in an effort to reduce that country’s lengthy kidney waiting list. Today, Iran’s wait list is retired. In 2006, the Saudi province of Riyadh began an incentive system for organ donations from families of the recently deceased. The supply of transplantable organs immediately tripled and has remained at that level ever since, while donation levels in other Saudi provinces remain unchanged from the years before 2006.
When it comes to transplant organs, the United States unfortunately is not as progressive, liberal or free-market as Iran or Riyadh. As a result, another 6,500 Americans will die this year because they didn’t receive a transplant, and the waiting list will top 125,000 suffering souls. It’s well past time to reform one of America’s deadliest laws.
Thomas A. Firey is senior fellow for the Maryland Public Policy Institute and a native of Washington County.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

 

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