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Bad (or no) finances can be a deal breaker for transplant

Posted By Pierre Charland     December 10, 2018    


The topic of "only the rich" can get a transplant resurfaced and it made me cringed a little bit.  What I have read in the media does not tell the whole story obviously.  It makes all the transplant centers look bad and greedy.  Some are but most are not.  Most transplant recipients have some type of government insurance like Medicare, Medicaid, and ACA or what is known as Obamacare.  It is true that not all hospital accepts all Medicaid plan but they all "like" Medicare. 

These insurances have lower reimbursement rates than private insurances, especially Medicaid.  I have heard stories of insurance not paying their bills despite a single case agreement signed before the transplant.  A single case agreement is when a hospital and an out of network insurance agree on financials before a transplant evaluation can begin.  This behavior, of not paying, by that insurance company only penalized the other patients who might need a transplant. Every transplant hospital will take patients from all walks of life and all of them are asked about their finances.  A transplant center wants to make sure the patients will be able to have access to their medications after the transplant.  Transplant centers can’t be liable for paying the medications.


Once a hospital commits to perform the transplant surgery, the relationship between the medical team and patients becomes like a marriage: for the better and the worst.  Transplant centers can't give up on non-compliant patients, especially during that first year.  Doing so could endanger the survival of the program if not enough patients survive the first year after transplant.  Therefore, most transplant programs do a thorough screening of the patients prior to accepting their candidacy.  Financial screening is one of them.  There is a difference between being poor or having no money.  The poorest usually have heavily subsidized insurances who have very low copay on drugs.  Other patients are really underinsured.  The transplant financial specialist should be able to guide you in the right direction if your condition can be improved.  Some patients are asked to fundraise for one reason or another, but the media often don't relate all the facts.  We don't know the whole story for the transplant candidates who must fundraise; maybe they have huge financial debts or poor insurance with high medicines copays. 


But one thing though, a patient that can raise some money for their future medical bills is showing some real serious about having a successful transplant outcome.  Fundraising done right will assure the money will go towards the medical bills and not towards buying a new TV.  In kidney transplant, most patients have time to fundraise but not in heart, liver, and lung where patients can become acutely ill quickly.  Remember, transplant centers "don't have" to transplant everybody.  They can pick and choose the patients that will give them the greatest balance between quality and quantity.  Organ transplantation is a privilege, not a right. 


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