As the Supreme Court begins deliberating the healthcare reform law it’s important to remember how we got here. And there is no more perfect example of our flawed, inequitable healthcare system than the fact that Dick Cheney got a heart transplant last week. This troubles bioethicists because of his age and his extremely poor health:
It is concerning that a 71-year-old got a transplant. Many of those who manage to even make the waiting list for hearts die without getting one. More than 3,100 Americans are currently on the national waiting list for a heart transplant. Just over 2,300 heart transplants were performed last year, according to the United Network for Organ Sharing. And 330 people died while waiting.
According to UNOS, 332 people over age 65 received a heart transplant last year. The majority of transplants occur in 50- to 64-year-olds.
Most transplant teams, knowing that hearts are in huge demand, set an informal eligibility limit of 70.
Cheney is not the first person over 70 to get a heart transplant. He is, however, in a small group of people who have gotten one. Why did he?
Cheney has an advantage over others. It is not fame or his political prominence. It is money and top health insurance.
Heart transplants produce bills in the hundreds of thousands of dollars. The drugs needed to keep these transplants working cost tens of thousands of dollars every year. Organ donations are sought from the rich and poor alike. But, if you do not have health insurance you are far less likely to be able to get evaluated for a heart transplant much less actually get a transplant.
I wrote about this last October when I reminded everyone that Steve Jobs used his wealth and mobility afforded by a private plane to “game the system” and fly to Memphis for a liver transplant. Two years later he was dead.
The wealthy and powerful will always pull out all the stops when it comes to their healthcare needs; the healthcare law is not designed to address that, nor should it. But there are millions of people in this country with failing organs who never even get in the door of a hospital, let alone find their names on the transplant list. Millions of people without health insurance and therefore without healthcare for whom getting on the national organ transplant registry is never going to happen. But we’ll happily take their healthy organs when they die.
It really makes me wonder what kind of society we have where the poor are so expendable. Texas’ women’s health clinics have been shut down over a wholly misguided ideological battle, that’s thousands of women who aren’t going to see a doctor for a variety of needs now. Sorry poor people, sucks to be you, too bad we didn’t catch that cervical cancer sooner, but if you die can the former Vice President have your heart?
This country is seriously fucked up. The greatness of a nation is judged by how it treats its most vulnerable citizens, not its most powerful. Right now the status quo which conservatives are bizarrely fighting to maintain is an unworkable, expensive, ineffective system. Once upon a time they loved the very healthcare reform legislation they’re now spending millions of dollars trying to dismantle. It is truly strange.
I don’t know how SCOTUS will rule on healthcare reform but I do know that our existing system is completely unworkable and gets moreso every year. If parts of the Affordable Care Act are ruled unconstitutional and other parts are shredded by Republicans in Congress, what we’re left with is a system in utter tatters. I just don’t see that standing for very long. We might end up with that “Medicare For All” everyone has been clamoring for.