Sebelius: I can’t suspend the lung-transplant rules for a dying 10-year-old

[eflatminor]

Oh I agree.

The thing is, you are painting this all or nothing scenario and it isn't. At the moment - organ transplant is not governed entirely by either approach - the market determines the cost of the surgery, but regulation is needed to ensure that organs are distributed to the most in need first - not those who can afford it first.

The market has no moral compass. And that is where your approach is lacking.

"The market" is an abstraction and cannot, by its very definition, have any sense of this subjective thing called "morality"...This is a good thing.

The one with no moral compass is the heartless ghoul bureaucrat who flippantly says "some people live, some die".

Competition does not always increase choice - that's a bit of a fallacy. After a certain point it decreases choice as fewer and bigger entities squash out competition.

Common anti-market myth...Please Google the "rule of three".

Here, I'll give you a start...Rule of three (economics) - Wikipedia, the free encyclopedia

do you think that if you were in need of heart transplant there would be three available matching donors at the same time represented independently that you would be able to negotiate a lower price with?

There would be companies competing with one another to supply the organs. The donors would have made their arrangements with the organ suppliers long before their death. So, yes, the guy in need of a heart transplant would not only have plenty of hearts from which to choose, he could pick the provider that gave him the right price/service he's looking for.

 

[MeBelle]

Sarah is eligible for adult donor lungs, but because of her age, she will only receive them after all adult candidates, regardless of how sick they are, have the opportunity to accept them.

This is a policy created by the Organ Procurement and Transplantation Network (OPTN), the nation's organ procurement, donation and transplantation system and enforced through United Network for Organ Sharing (UNOS) which manages US organ transplant system under contract with the federal government.


Based on a 2000 ruling by the US Department of Health and Human Services, which mandated that organ allocation policies must be based on medical necessity rather than waiting time, OPTN implemented a new allocation system based on the severity of a patient's illness (the Lung Allocation Score, or LAS), rather than the amount of time served on the wait list in 2005. This reduced the number of deaths among patients awaiting lung transplant, ensured lungs were allocated to those with less stable diagnoses, and dramatically reduced the average wait time from over two years, and reduced the wait list by half. This new approach only applied to patients over the age of 12.

This approach was not extended to children. Despite the fact that many pediatric patients can use a partial lobar transplant from an adult donor, these young patients are only offered adult donor lungs after all adult patients, regardless of the severity of the child's illness.

While Sarah has an LAS score over 60, which would normally place her as the highest priority for her blood type in region, all adults in region with her blood type will be offered the lungs first, even those with more stable diagnoses and lower LAS scores. Sarah will only be offered adult lungs if no adult candidates accept the organ.

This policy needs to change. The OPTN/UNOS Lung Review Board, a national group of transplant physicians and surgeons, can make an exceptional ruling for Sarah. And they can recommend new policies to OPTN. John Roberts is President of the OPTN/UNOS Board of Directors.
http://www.change.org/petitions/opt...nts-of-adult-lungs-based-on-medical-necessity
*****
Sebelius is 'reviewing' the rules?

BS

Based on a 2000 ruling by the US Department of Health and Human Services, which mandated that organ allocation policies must be based on medical necessity rather than waiting time...

This situation should be simple for Sebelius.
***************

Take out the emotion and look at freaking reality!

 

[Sunshine]

You have to read up on Complete Lives Systems to understand what is going on here. Anyone from 0-14 or over the age of 45 is on a bell curve and won't get treatment that would save their lives if the don't fit into the safe zone - 15 - 45 yrs of age. Why? Because they cannot produce for the State.

They don't need you if they can't profit from you. That is what it comes down to. - Jeri

That is one of the dumbest things ever posted on a forum, I have had many transplant patients over the years. Every last one of them has been on disability regardless of what their age was. Sheesh. Could you get any dumber! Don't answer that. I know you can and likely will.

 

[Coyote]

Bullshit. First of all, there would be far more organs available for transplant.

I don't think there would be, especially for children. What governs the availability of organs is a variety of factors not the least of which, a person (for many organs) has to die and die in such a way that the organ isn't damaged and can be quickly retrieved and is not diseased.

This is beside the point.

You're overlooking competition and choice, the only factors that drive costs down.

How exactly is it "beside the point"?

Competition and choice wouldn't work in organ transplants because you are dealing with a rare commodity that will remain rare due to it's nature and choice is always going to be limited by the "beside the points".

Wrong Comrade. The prices would decrease dramatically as the supply of organs increased and competition kicked in.

Comrade? You from the former Soviet Union or something?

Yes, profit that REQUIRES consumers willing to VOLUNTARILY pay for the service. No competition with central planners, no ability to choose a lower price.

Are we getting into Libertarian talking points here?

And a limited number of organs from which to choose...which would NOT be the case with a free market. There'd be PLENTY of organs because of that evil profit motive...

Do you have any proof to support there would be a huge increase in available organs? Remember, most of the time they have to die first and profit becomes far less of an interest.

There's never going to be enough organs that match up in tissue and size and condition - that's not going to change. [/quote

Strawman. There would be lots more organs. There would be competition and choice and the inevitable downward pressure on prices. That WOULD change.

Like I said, do you have any evidence to support this massive increase in availability? And, that that availability would become available as equitably as it is now?

The system we have now is the fairest and it's not determined by either corporate executives or government bureaucrats.

Which results in this girl's death. But hey, you and your central planners know what's best for everyone, right? Pass.

If this girl doesn't die, it would be someone else.

 

[Coyote]

If that were true, the Soviet Union would have been the most cost effective economy the world has ever known.

Central planning NEVER results in lower prices.

Oh I agree.

The thing is, you are painting this all or nothing scenario and it isn't. At the moment - organ transplant is not governed entirely by either approach - the market determines the cost of the surgery, but regulation is needed to ensure that organs are distributed to the most in need first - not those who can afford it first.

The market has no moral compass. And that is where your approach is lacking.

Hundreds of millions of consumers making voluntary choices is moral. Central planners suggesting they know what's best for everyone else is not. And let's not forget, my approach would assure the availability of lungs for this little girl. Your approach ensures she will die. You were saying something about morality?



If fewer entities control a market, it's because consumers have made that choice. Nothing stops new entrants into markets to ensure the bigger players remain competitive. Nothing expect government of course.

Stop thinking like a Marxist.

What exactly is Marxist in my thoughts

Everything you've stated. EVERYTHING.

Then I'm thinking you don't have a clue what Marxism is.

 

[Coyote]

Sarah is eligible for adult donor lungs, but because of her age, she will only receive them after all adult candidates, regardless of how sick they are, have the opportunity to accept them.

This is a policy created by the Organ Procurement and Transplantation Network (OPTN), the nation's organ procurement, donation and transplantation system and enforced through United Network for Organ Sharing (UNOS) which manages US organ transplant system under contract with the federal government.


Based on a 2000 ruling by the US Department of Health and Human Services, which mandated that organ allocation policies must be based on medical necessity rather than waiting time, OPTN implemented a new allocation system based on the severity of a patient's illness (the Lung Allocation Score, or LAS), rather than the amount of time served on the wait list in 2005. This reduced the number of deaths among patients awaiting lung transplant, ensured lungs were allocated to those with less stable diagnoses, and dramatically reduced the average wait time from over two years, and reduced the wait list by half. This new approach only applied to patients over the age of 12.

This approach was not extended to children. Despite the fact that many pediatric patients can use a partial lobar transplant from an adult donor, these young patients are only offered adult donor lungs after all adult patients, regardless of the severity of the child's illness.

While Sarah has an LAS score over 60, which would normally place her as the highest priority for her blood type in region, all adults in region with her blood type will be offered the lungs first, even those with more stable diagnoses and lower LAS scores. Sarah will only be offered adult lungs if no adult candidates accept the organ.

This policy needs to change. The OPTN/UNOS Lung Review Board, a national group of transplant physicians and surgeons, can make an exceptional ruling for Sarah. And they can recommend new policies to OPTN. John Roberts is President of the OPTN/UNOS Board of Directors.
http://www.change.org/petitions/opt...nts-of-adult-lungs-based-on-medical-necessity
*****
Sebelius is 'reviewing' the rules?

BS

Based on a 2000 ruling by the US Department of Health and Human Services, which mandated that organ allocation policies must be based on medical necessity rather than waiting time...

This situation should be simple for Sebelius.
***************

Take out the emotion and look at freaking reality!

I think there is more to the prioritizing then LAS score, according to KatznDog's article:

The problem is, Sarah is a child, and although based on her Lung Allocation Score (LAS) she would be ranked high the transplantation list, she probably won’t receive the transplant. Why? Children are grouped for children sized lungs, and there are very few to go around. She is lower on the list for adult sized lungs.

The Murnaghans seek to change those rules since they claim the existing system is based on ‘ageism’ and is discriminatory. They feel that since Sarah is a child, she should be placed above adults.

The OPTN network guideline do this not because of ‘ageism’ however. They set these strict rules based on medical conditions up so that transplantation candidates have reasonable chance of survival. Adult lungs are larger and more difficult to transplant into children, even if they are tissue matched. Keep in mind that transplantation of new lungs into cystic fibrosis patient will not cure Sarah; it will only postpone the inevitable. Lung transplantation into a cystic fibrosis patient has only a 50% chance of survival past 5 years — not counting the additional complications of mismatching the size of the lungs.

The issue of Sarah being essentially curable long-term is important, because another patient with another disease that might be more curable with lung transplantation will not get one.

Don’t forget, if we save Sarah that necessarily means someone else is left to die. Someone who might be saved. Someone who matches the donor lungs better. Someone else’s loved one.

The mother, Janet Murnaghan has taken it a step further than most bereaved mothers. She has petitioned HHS secretary Kathleen Sebelius personally for federal intervention in the case of her daughter, not only to save Sarah, but to change the rules set up by medical professionals.

 

[Oddball]

Oh I agree.

The thing is, you are painting this all or nothing scenario and it isn't. At the moment - organ transplant is not governed entirely by either approach - the market determines the cost of the surgery, but regulation is needed to ensure that organs are distributed to the most in need first - not those who can afford it first.

The market has no moral compass. And that is where your approach is lacking.

"The market" is an abstraction and cannot, by its very definition, have any sense of this subjective thing called "morality"...This is a good thing.

The one with no moral compass is the heartless ghoul bureaucrat who flippantly says "some people live, some die".

Competition does not always increase choice - that's a bit of a fallacy. After a certain point it decreases choice as fewer and bigger entities squash out competition.

Common anti-market myth...Please Google the "rule of three".

Here, I'll give you a start...Rule of three (economics) - Wikipedia, the free encyclopedia

do you think that if you were in need of heart transplant there would be three available matching donors at the same time represented independently that you would be able to negotiate a lower price with?

You clearly don't understand the rule of three, or you wouldn't have said that....Try clicking on the link to comprend what I'm saying

 

[Oddball]

Oh I agree.

The thing is, you are painting this all or nothing scenario and it isn't. At the moment - organ transplant is not governed entirely by either approach - the market determines the cost of the surgery, but regulation is needed to ensure that organs are distributed to the most in need first - not those who can afford it first.

The market has no moral compass. And that is where your approach is lacking.

Hundreds of millions of consumers making voluntary choices is moral. Central planners suggesting they know what's best for everyone else is not. And let's not forget, my approach would assure the availability of lungs for this little girl. Your approach ensures she will die. You were saying something about morality?



If fewer entities control a market, it's because consumers have made that choice. Nothing stops new entrants into markets to ensure the bigger players remain competitive. Nothing expect government of course.

What exactly is Marxist in my thoughts

Everything you've stated. EVERYTHING.

Then I'm thinking you don't have a clue what Marxism is.

Marxism relies on exactly kind of authoritarian central planner mindset that operates the organ donation apparatus in this country....And it's voice is that of the utterly heartless ghoul, Sebelius.

 

[Oddball]

this is your future...now where did we hear about DEATH PANELS?
Links in article at site

SNIP:

posted at 8:01 pm on June 4, 2013 by Allahpundit

Portrait of a bureaucratic nightmare: A little girl’s dying from cystic fibrosis and has three to five weeks to live unless she gets a lung transplant before then. The good news is that adult lungs can be modified for a child her age in a way that’ll save her life — except that, because she’s only 10, she’s not eligible for them. The “adult” list starts at 12; everyone younger than that goes to the children’s list, where lungs are much harder to come by. The question is, does Sebelius have the authority to suspend those age limitations and make the girl, Sarah Murnaghan, eligible for an adult transplant?

I honestly don’t know the answer. Murnaghan’s parents say Sebelius’s authority is clear; Sebelius herself claims that HHS’s lawyers have told her she can’t do it. A life hangs in the balance. On one side:


nder existing policy all adults in the region with her blood type will be offered the lungs first, her parents say, even those more stable and with less severe conditions. The girl’s parents called for a change in the policy after their appeal was denied…

United Network for Organ Sharing, also a nonprofit under contract with the government, said a committee would review the policy and the public would have a chance to comment on any proposed changes. But spokeswoman Anne Paschke said any changes most likely won’t come quickly enough to benefit Sarah or others like her.

“The policy development process is not fast,” she said in an email to The Associated Press. “Organ allocation policies are created to transplant as many people as possible overall, result in the fewest waiting list deaths overall and result in the best possible survival overall. In developing policies, committees and the board weigh data, medical evidence and experience, and public input.”

all of it here
Sebelius: I can?t suspend the lung-transplant rules for a dying 10-year-old « Hot Air

We should change the transplant list rules every time a 10 year old is dying.

Nah...Don't change the rules...Big Daddy Big Gubmint knows what's best for all his little peasants....A 10-year old kid is just a little bump in the road to progressive Nirvana!

Nope...No death panels....

 

[OohPooPahDoo]

this is your future...now where did we hear about DEATH PANELS?
Links in article at site

SNIP:

posted at 8:01 pm on June 4, 2013 by Allahpundit

Portrait of a bureaucratic nightmare: A little girl’s dying from cystic fibrosis and has three to five weeks to live unless she gets a lung transplant before then. The good news is that adult lungs can be modified for a child her age in a way that’ll save her life — except that, because she’s only 10, she’s not eligible for them. The “adult” list starts at 12; everyone younger than that goes to the children’s list, where lungs are much harder to come by. The question is, does Sebelius have the authority to suspend those age limitations and make the girl, Sarah Murnaghan, eligible for an adult transplant?

I honestly don’t know the answer. Murnaghan’s parents say Sebelius’s authority is clear; Sebelius herself claims that HHS’s lawyers have told her she can’t do it. A life hangs in the balance. On one side:


nder existing policy all adults in the region with her blood type will be offered the lungs first, her parents say, even those more stable and with less severe conditions. The girl’s parents called for a change in the policy after their appeal was denied…

United Network for Organ Sharing, also a nonprofit under contract with the government, said a committee would review the policy and the public would have a chance to comment on any proposed changes. But spokeswoman Anne Paschke said any changes most likely won’t come quickly enough to benefit Sarah or others like her.

“The policy development process is not fast,” she said in an email to The Associated Press. “Organ allocation policies are created to transplant as many people as possible overall, result in the fewest waiting list deaths overall and result in the best possible survival overall. In developing policies, committees and the board weigh data, medical evidence and experience, and public input.”

all of it here
Sebelius: I can?t suspend the lung-transplant rules for a dying 10-year-old « Hot Air

We should change the transplant list rules every time a 10 year old is dying.

Nah...Don't change the rules...Big Daddy Big Gubmint knows what's best for all his little peasants....A 10-year old kid is just a little bump in the road to progressive Nirvana!

Nope...No death panels....

Did it occur to you that providing the transplant to the 10 year old will likely kill someone who is not the 10 year old? That's big government death panel, too, right? There are a limited supply of lungs you moron. Who would you have deciding who gets the lungs? Wal Mart? The Koch Bros.? Maybe we can auction them off to the highest bidder and use the revenue to reduce the tax bills of the wealthiest Americans?

 

[Oddball]

We should change the transplant list rules every time a 10 year old is dying.

Nah...Don't change the rules...Big Daddy Big Gubmint knows what's best for all his little peasants....A 10-year old kid is just a little bump in the road to progressive Nirvana!

Nope...No death panels....

Did it occur to you that providing the transplant to the 10 year old will likely kill someone who is not the 10 year old? That's big government death panel, too, right? There are a limited supply of lungs you moron. Who would you have deciding who gets the lungs? Wal Mart? The Koch Bros.? Maybe we can auction them off to the highest bidder and use the revenue to reduce the tax bills of the wealthiest Americans?

Did it occur to you that it's none of your fucking business?

 

[Katzndogz]

The world does not permit the buying and selling of human organs because it would open up murder for profit on a world wide scale. Even so there are black market organs. In some of the most impoverished nations people are happy to sell one lung, a kidney, a lobe of liver for a price.

It isn't a matter of families being able to market the body parts of family members when they die. The person must be healthy at the time of death. They can't have cancer or hepatitis or any other disease. There is no market in human organs. The market is in healthy human organs. Perhaps someone at risk could be relieved of a few organs while they are still useful.

One family solved a transplant problem by producing a sibling for the child who needed a transplant. The spare parts child was a match. If this family wanted a lung for their daughter they could have made their own.

Or we could solve the problem like China does. Take them from convicted criminals.

 

[Katzndogz]

The government is not involved in the decision as to who gets a transplant on any level. The decision is made by a medical panel. A death panel. The decision is based on the evaluation of the transplant team following the individual case. After the initial evaluation is made, and that process takes a year or more, the panel decides placement on the transplant list. Your transplant team then monitors the progression of disease and can move someone up, down or remove them from the list entirely.

A judge just ruled in the 10 year old's favor opening a floodgate of litigation as to who gets a transplant.

 

[Trajan]

I think Sebelius got it right.


and for the reasons I hate obamacare and all it portends and pretends it will do or replace.

heres the point; under the bad old system in place now, an insurance co. very easily would have made this same call, nope sorry, its not in line with the agreed provisions etc. as in the coverage as written .........and they would have had the snot beat out of them for it.....so whats changed?


I love it how the left can use/create caricatures of po' folks or children ( and granny over the cliff) denied care under the same private ins. co., comparison with this Obamacare decision she just made, yet, they are 'bad' and supported by people (republicans) that just want to see people die and keep the good care to themselves....

another high water mark for lefty hypocrisy....



go ahead, prove me wrong lefty's, let me see you tear Sibelius up......I'll be back....

this has nothing to do with insurance. it has to do with rules in place for organ transplants. obamacare isn't a factor, and there was no 'obamacare decision'

and the rules are there for a reason.

thx for missing my point.

 

[MeBelle]

I think there is more to the prioritizing then LAS score, according to KatznDog's article:

Children are grouped for children sized lungs, and there are very few to go around. She is lower on the list for adult sized lungs.

The OPTN network guideline do this not because of ‘ageism’ however.
They set these strict rules based on medical conditions up so that transplantation candidates have reasonable chance of survival.

BS! It is about ageism or this situation would not be front and center.
Half a lobe...the other half could go to other pediatric patients in need of a transplant.

Adult lungs are larger and more difficult to transplant into children, even if they are tissue matched. Keep in mind that transplantation of new lungs into cystic fibrosis patient will not cure Sarah; it will only postpone the inevitable. Lung transplantation into a cystic fibrosis patient has only a 50% chance of survival past 5 years — not counting the additional complications of mismatching the size of the lungs.

The issue of Sarah being essentially curable long-term is important..
because another patient with another disease that might be more curable with lung transplantation will not get one.

Again, need is most important, not projected 'more curable'.
I had an uncle who had a heart transplant. He died 3 days later. Cause, unknown.

Don’t forget, if we save Sarah that necessarily means someone else is left to die. Someone who might be saved. Someone who matches the donor lungs better. Someone else’s loved one.

Sarah is not a loved one? Who decides who's worthy??
It's not about matching, it's about need. Period.

The mother, Janet Murnaghan has taken it a step further than most bereaved (= discount her by putting her in an emotional state) mothers. She has petitioned HHS secretary Kathleen Sebelius personally for federal intervention in the case of her daughter, not only to save Sarah, but to change the rules set up by medical professionals.

^^^ review above bolded sentence^^^​

 

[Katzndogz]

The first criteria is not about need. The first consideration is the success of the transplant.

Need is #3. First is a successful operation. Then it's the match. Out of the list of possible matches it will be need.

 

[Trajan]

Sibelius said that the rules had been made by a panel made up of medical specialists, and pre-dates obamacare. IF that is so, she made the right call.

I have seen folks right of center here say, that trotting out a singularity and using that person(s) and their particular situation as an emotional appeal to beat the crap out of some insurance co. that refuses to change its stance based on its contract and standing medical doctrine is wrong, (and add to that, those type of situations was used to gin up support for obamacare), so saying now that Sibelius got it wrong, is wrong.

We cannot have it both ways, if we are now going to start using emotional appeals to enact, change or fashion rules, we have lost the right to make the argument against it.

 

[Oddball]

Sibelius said that the rules had been made by a panel made up of medical specialists, and pre-dates obamacare. IF that is so, she made the right call.

I have seen folks right of center here say, that trotting out a singularity and using that person(s) and their particular situation as an emotional appeal to beat the crap out of some insurance co. that refuses to change its stance based on its contract and standing medical doctrine is wrong, (and add to that, those type of situations was used to gin up support for obamacare), so saying now that Sibelius got it wrong, is wrong.

We cannot have it both ways, if we are now going to start using emotional appeals to enact, change or fashion rules, we have lost the right to make the argument against it.

That's fine...Agreed....But central control over organ donation and distribution, in lieu of letting the marketplace handle the situation, is the root of the problem....That still makes Sebelius (or whomsoever is the HHS Sec. at the given time) the Death Czar(ina).

This is an issue of self-ownership more so than anything else.

 

[ogibillm]

thx for missing my point.

your point, as best i can see it, centered around an insurance company or the hhs secretary making the decision on who gets an organ.

that doesn't happen.

 

[Oddball]

The first criteria is not about need. The first consideration is the success of the transplant.

Need is #3. First is a successful operation. Then it's the match. Out of the list of possible matches it will be need.

Absolutely.

And a free marketplace in organs means that there will be more of them available from which to choose, ergo a higher possibility of a match.

This piece is as relevant and prescient as ever..

Who should decide?



<snip>

An organ market would eliminate the arbitrariness of doctors and bureaucrats sitting around like gods, deciding who will die and who will live. You say, "Williams, with market allocation of organs, only the rich would be served." Nonsense. I'd like to see the evidence for such a conclusion. Is it only the rich who have cars or homes or hotel rooms and are able to acquire loans? The great unappreciated advantage of market allocation of goods and services is that it reduces the potential for human conflict. Why is it that we see conflict in who gets what organ or what's taught in public schools, and no conflict in who gets what car, home or what's taught in private schools? The answer ought to tell us something.