Just got devastating news - UPDATE

[Ms. Toad]

182. I absolutely agree about single payer -

but it is also more than just financial practicality. People die on the waiting list all the time. In August & September I lost three friends/acquaintances with the same disease my daughter while they were waiting for a livers. In 2009 (the last year for which I could quickly find data) 2723 people either died on the waiting list or were removed because they had become too ill to be candidates for transplant any longer. That same year 5975 received livers through transplant - which means there was a shortfall of 31% of the livers needed. (And that doesn't count all those eligible for transplant who just weren't sick enough to rise to the top of the list or die - another 7000 or so people.) There aren't enough organs available and the ones that are available need to be allocated to the people who (for a variety of reasons) are most likely to be able to put them to full use.

If you are unable to follow a rigid drug regimen your body will destroy the new liver. If you can't get access to the drugs in the first place your body will destroy the new liver. If you are an alcoholic who has seen the light and reformed only when you already needed a transplant, you may not have developed the new habits necessary to keep your alcoholism under control putting the new liver at risk. If you do not have a support system to help you during the approximately 6 month recovery period you may be unable to participate in the appropriate follow-up care necessary for you and your new liver to adjust to each other.

Even if we take money out of the picture, there are other factors which will keep people off the list merely because it isn't fair to the loved ones of the person who gave the gift of life - or the other similarly desperate individuals on the waiting list - to "waste" the liver. But we should absolutely take money out of the decision tree. The Affordable Care Act is a huge step in that direction because people who cannot afford insurance at all can get it for free and in many cases with no co-responsibility. Where the crunch comes still are those middle income folks who make enough money not to get subsidies - but for whom co-pays and co-insurance are still real money.