Word: medicaid
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Dates: during 1980-1989
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...spending that the White House will ask. Current plans are to whack outlays a total of $169 billion below earlier projections over the next three years-$34 billion in fiscal 1986 alone. That would involve freezes on such programs as food stamps and welfare, reductions in popular programs like Medicaid and veterans' health benefits and complete elimination of general revenue-sharing grants to states and cities, among other activities...
...proposed budget cuts, which they feel could wipe out state reserves in one swoop. Reductions in the federal contribution to state and local governments would force states to scale back many popular programs. In New York, officials say the Reagan budget proposal could cost the state $170 million in Medicaid funds, $458 million in revenue sharing, $271 million in sewage-system construction grants and $67 million for child-nutrition programs. That would turn a modest surplus into a deficit of about three-quarters of a billion dollars. The shortfalls would also be severe in California, where federal dollars amount...
...enough organs to go around; how do we decide who benefits from the limited supply? Second, the transplant costs on the order of 10 times what a normal operation costs, around $300,000 for a single liver transplant. Since this money comes from insurance companies or from state Medicaid, the status quo is not a free market, but it threatens to become one, given the high financial incentives for doctors and hospitals. Clearly a laissez-faire scramble for pieces of human bodies in which the stakes are immediate life or death for the patient is an indigestible alternative; this does...
...consider better or worse ways of deciding how to allocate organ transplants. The strongest negative implication of the "limited capacity" scenario is an increased possibility that a patient who might benefit from a transplant could be denied one through lack of funds. The task force has decided that other Medicaid programs are more important; perhaps they are, though it should be noted, for example, that the kind of heart defect suffered by Baby Fae kills a substantial number of infants. The committee has implicitly decided that not all patients who might benefit from a transplant have an inalienable right...
What the task force wants to do is pull up on the reins of a technology that saves lives and is on its way to saving more. The limiting of organ transplants to a small scale effort solves the problem of monetary drain on Medicaid. It does not, however, solve the overall problem. This ultimate resolution of expanding transplant availability, the only resolution that satisfies the strongest ethical implications of the problem, would be delayed, perhaps indefinitely, by the group's plan. What is missing is an assessment of what the constraining effects of the task force-advocated policy would...