Rationing

 Updated 3/2017-- all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Do you recall the severe rationing of food and water the Chilean miners had to endure to survive?   The rationing was done to stretch their limited resources.

I would argue the state of Arizona’s new policy to not cover organ transplants for patients on Arizona Health Care Cost Containment System (AHCCCS) or their version of Medicaid is a similar form of rationing.

AHCCCS, as many Medicaid programs, is underfunded.  They are trying to operate on a limited budget.  Something has to give.

Sadly in this case, many (NPR reports 98) had already been granted approval for organ transplants which they may not receive.  Francisco Felix, 32, who due to Hepatitis C needs a liver transplant, is reported to have made it to the operating room, prepped and ready for his life-saving liver transplant when doctors told him the state's Medicaid plan wouldn't cover the procedure.  The liver he was to receive went to someone else.

In this prolonged economic downturn, I wonder how many parents have had to tell their children who were accepted into their dream college they will not be able to go, the family income has changed and it is no longer affordable?

In a perfect world, everyone would have health insurance.  Health insurance companies (private, state, and federal) would have unlimited resources so that all “evidence-based” medically necessary care/procedures/medications would be covered.

Hell, in a perfect world, we wouldn’t need health care.

It isn’t a perfect world.  There are limited resources.  Tough decisions must be made in doing the most with the available resources.

Is this the sort of rationing of medical care we will be seeing more of in the future?

It Costs How Much?

Do you remember this splint that I was told to wear (and did for a week) when I had acute olecranon bursitis? Well, I got my bill recently and was shocked by how expensive the splint was! If I had been told how much it was going to be, I swear I would have left without it. I would have used the "soft" elbow pad and made myself a plaster splint to protect my elbow from being bumped for that week. Here's the breakdown of the medical bill. For some reason, all of the charges had been billed to insurance EXCEPT the splint charge. I asked that it be submitted.

Service	Description of Service	Charge	Insurance Allowed	Patient to Pay
99204	Office/New Patient	$229.02	$140.38	$140.38
73070	X-Ray Exam	$73.92	$33.12	$33.12
97760	Orthotic (OT)Management	$40.00	$36.00	$36.00
L3763	Rigid Elbow Splint	$773.33	???	???