It's hard to think of any political similarities between Washington’s Democratic Gov. Chris Gregoire and Arizona's Republican Gov. Jan Brewer. But there is one. Both governors want to cut off funding that affects people needing transplant operations.
Brewer caused a national furor last month when she defended her state's budget-saving termination of Medicaid coverage for certain types of transplant operations, which has placed about 100 patients on transplant waiting lists at risk of imminent death. Critics have called it Brewercare, the real-life version of the bogus death panels dreamed up by foes of President Obama's health reform legislation. Even some Arizona Republicans — though not Brewer — have begun backing away from the transplant cuts.
Now, Gregoire, an advocate of universal health coverage, has proposed eliminating the state’s 17-year-old Basic Health Plan, an affordable health insurance program for working-poor families with incomes at 133-200 percent of the federal poverty level. Zeroing out the program as of March 1 would save $219 million over the next two years, as part of her proposal last week to slash nearly $4 billion in spending and close the state’s huge budget deficit.
The proposed termination of the Basic Health Plan (BHP) came as a shock to a man I’ll call Jim, a 34-year-old Spokane electrician and father of seven whose kidneys are failing. I’m not using his real name because his unemployment benefits could be jeopardized if the state learns he can't work due to poor health. Jim’s BHP coverage will end if the Legislature approves the governor’s plan, which appears likely. As a result, he may not receive the kidney transplant he’s waiting for at Providence Sacred Heart Medical Center. And his wife, who’s also on BHP, wouldn’t be able to afford the care involved in donating a kidney to him.
"Gregoire proposed that?” Jim said when I talked with him last month. "I don't even know why they would try to do something like that. It would leave a lot of people in a lot of hurt. I’m a union worker. I voted for her."
A kidney transplant costs tens of thousands of dollars for the operation and the anti-rejection drugs, which must be taken for years after the surgery. Like other transplant centers, Sacred Heart won’t perform transplant operations on patients who don’t have the means to pay for the operation and the drugs, because kidneys and other organs for transplant are scarce resources.
“Our purpose is providing patients access to life-saving transplants,” says Dr. Okechukwu Ojojho, the surgical and program director at Sacred Heart’s kidney transplant program. “But they have to be able to afford the medications which help keep the body from rejecting the new transplant. So financial issues will have to be a consideration in deciding whether to transplant (Jim).”
Jim is not the only Washington resident who may lose access to a transplant if Gregoire’s budget passes. BHP paid for eight transplant operations in 2009 — a kidney, a liver, two lungs, two bone marrow grafts, one heart, and a liver/intestinal transplant. While state officials couldn’t say how many BHP patients currently are waiting for transplants, Dr. Ojojho says Sacred Heart has at least a couple of other BHP patients waiting for kidneys. Another hospital official said Sacred Heart does four to five heart and kidney transplants each year on BHP patients.
State officials are well aware of the harsh impact that terminating the program would have on patients in need of transplants. And, of course, it also would have major consequences for the rest of the 66,000 BHP enrollees who may have serious if less critical health care needs —not to mention the 138,000 people on the program’s waiting list. “We understand and shared those impacts with the executive and the Legislature,” said Preston Cody, BHP’s director. “If the program is eliminated, we’ll make every effort to communicate with the entire population and send them information on other resources to see what their other options are.”
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