Apocalypse R’ Us


 Healthcare Armageddon begins in Arizona

I talked briefly in a previous article about the coming days of reckoning in the health care biz due to the growing gap between ever increasing costs and ever decreasing funds. Among the first victims will be high dollar procedures that benefit a small segment of the population. Consider the following an early mortar shot in this war. . .

An article in the New York Times describes the struggles to balance the medicaid budget in Arizona by cutting funding for certain procedures. Together the Governor and the legislature reviewed statistics on success and survival rates of various transplantation procedures and made the decision to stop  funding certain solid organ and bone marrow transplants, effectively taking several people off the transplant list.

Did the Arizona legislator make a fair judgement? Probably not, however, their position is not one that I envy. One thing these legislators can say however is that, by looking at cost and survival data, at least they made it LOOK like there was a modicum of science to their process. The process they are using is just the beginning of what state legislators around the country will be doing  . . . reviewing mortality and cost data to make decisions on what they are willing to pay for. And fueling their antacid consumption is the fact that they will be using this data to justify their decisions in an increasingly politically charged environment. Their job is made even more difficult by the fact that they have no training on how to interpret this data and essentially no guidance from medical professionals. Indeed the only input they will likely hear from medical societies will be something along the lines of “you can’t cut that, I make money off that people will die!”

Predictably, their decision to cut transplantation funding was opposed by the president-elect of the American Society of Transplantation, who felt that it was “inappropriate that life-saving care has the potential to be withheld based solely on budgetary issues”

Ultimately this decision may be revisited by the Arizona legislators, depending upon how many news stories there are depicting dying patients deprived of their transplants. But regardless it is going to be an issue that will be visited many more times and in many other state capitols.