In Spite of Myself

Its Hard Out There for a VP

I’ve long been very interested in organ donors and transplants.  In fact, I think about it almost every time I use my ID to damage some of my organs (not too much though, I promise).  Organ donation is the gift of life and there are so many stories of how much good a deceased person’s organs can do.  They give people a new lease on life.  That’s tangible.  That’s real.  That’s why I’m an organ donor and you should be too!  Take the diagram below.

Pretty incredible.  These stories happen all over the country.  What got me first interested to learn more about organ donor-ship and transplantation was the death of Chris Henry.  As an avid Cincinnati Bengals fan since middle school, I remember watching the up and down career of this player on a team of players that I rooted for and cared about each Sunday.  When he died unexpectedly, I was shocked when I heard about the good that his organs continued to do even after his passing.  Every day, someone’s life is changed by a selfless gift.

What brought the issue to mind more recently was this story about former Vice President Cheney’s 20 month long wait for a heart transplant.  How could a man of his stature have to wait that long for a heart?  It made me think:  “Was it possible that others with the same predicament had to wait much longer for such a gift?”  It turns out, its true:

Mr. Cheney’s wait for a new heart was not unusual, though it appeared to be longer than the average wait, which has varied in recent years from six months to a year, according to several studies. In June 2010, 3,153 patients were on the waiting list for a heart transplant, and 80 were awaiting a heart-lung transplant, the American Heart Association’s journal Circulation reported last year.

Patients on the list generally have to be ready to rush to the hospital when a suitable donor is found, so there is little notice before a transplant takes place. It is not unusual for recipients not to know the identity of their donor; notification is determined by the rules of organ donation networks and the wishes of the donor’s family.

I wish I had the ability to study this special gift.  However, I’m neither a bio-statistician nor a health economist.  However, I agree with the premise that we should be doing more to increase the pool of organ donors in our society.  There are so many moral and ethical issues at play here, or for that matter in any issue about life or death or what happens after it.  Whether its redesigning the market for organ donations or discussing compensating people for organ donations, I think its worthwhile discussing what else can be done without taking the decision out of a family’s hand regarding a loved ones.  Organ donation is a gift.  If you aren’t an organ donor, I would strongly ask you to consider or reconsider it.  It could mean the world to somebody out there.

Go to www.donatelife.net or www.organdonor.gov/index.html for more information.

Further reading:
Kessler, Judd B. and Alvin E. Roth, ” Organ Allocation Policy and the Decision to Donate,” American Economic Review, 2011.

Leider, Stephen and Alvin E. Roth, ”Kidneys for sale: Who disapproves, and why?” American Journal of Transplantation , 10 (May), 2010, 1221-1227.

Sure, Graphs Can Be Fun…

It never gets old.  The Commonwealth Fund’s Annual survey of health care costs and conditions across the world came out today and once again, in a few words, the U.S. comes out on top!!!  (Cue Hulk Hogan’s “I Am A Real American”)…In costs.  Yes, we have the most costly system of delivering health care in the world.  In addition, the survey finds that, in the U.S., more than 40% of people went without care because of these high costs.  That’s no way to run a country, rich or poor.

A Lesson in Universal Health Care

I was reading a post from one of the New Republic’s great blogs, the Spine, about Israel’s Universal Health Care…The blog post references an article from the Jerusalem Post which provides an overview of the effectiveness and desirability of the Israeli Health Care system.  I don’t think Israeli’s are 10 times smarter than us Americans…so how do they do it and by it I mean cover all their citizens, even those who don’t acknowledge their existence.  Here’s a couple glimpses/references from the article:

The link to the article is here:  http://www.jpost.com/Home/Article.aspx?id=175612

In fact, a study that the Pittsburgh Regional Health Initiative (PRHI), a consortium of medical, business and civic leaders in Pennsylvania, commissioned in the autumn of 2009, concluded that the US and other countries might do well to learn from the Israeli health system. “Israel’s healthcare system has significant relevance and important lessons to lend to healthcare reform efforts in the United States,” says Bruce Rosen, director of the Smokler Center for Health Policy Research at the Myers-JDC-Brookdale Institute, who participated in the PRHI study.

“US health reform debates have been about the best ways to move toward a more integrated model, through which payment is aligned with care delivery and that targets safety, efficiency, access, and quality. Therefore, as the US moves to strengthen primary care, contain costs, and require multi-provider accountability for coordinated high-quality care, there is much to learn from Israel, where these concepts are already at work.“

Despite widespread misconceptions, the country’s health care system is not a socialized, single-payer system. Israelis generally accept as almost axiomatic that there should be universal health coverage, with a significant acceptance of government involvement in regulating health care for the sake of redistribution, accountability, and preventing competition from leading to uncontrollable cost overruns. At the same time, there is also recognition of the benefits of keeping a strong measure of competition in the system. This has led to what Glazer describes as “regulated competition”: universal state-financed insurance coverage is provided through four competing health-maintenance organizations.

An outside perspective on rationing, the price society must pay (larger in some systems than others) for greater access and an end to coverage denials among a host of other things.

Glazer agrees. “National health works in every advanced country in the world,” he says emphatically, “and it can work in the US just as well.” Given the widely held assumption in Israel that universal health coverage should be guaranteed by society, and the success of 15 years of national health, many Israelis find the fierceness of opposition to health reform expressed in the US bewildering. “Americans are paranoid about changing their health system, to their detriment,” opines Glazer. “Of course, under the Israeli system there is rationing – you don’t have complete freedom to be treated by any doctor you want, and sometimes you might need to wait a couple of weeks for an appointment.

“But any health system will include some aspect of rationing. There is health care rationing in the US right now, in various ways, such as the number of people who are entirely uninsured, and people who have paid for health insurance for years and then discover their coverage disappears as soon as they get seriously ill,”Glazer notes.

I like reading stuff about these international comparisons of Health Care systems…If anybody wants a really good primer about this kind of stuff, they should read T.R. Reid’s book, “The Healing of America”, its a great introduction to other health care systems with a lot of first hand information directly from the people who work and are served within the systems.

Thanks for reading this far!!! Glad you made it!/?