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More Medicare Will Fix Medicare (Pt 1)

More shameless disinformation from the New York Times:

U.S. Cost-Saving Policy Forces New Kidney Transplant


September 14, 2009

SAN DIEGO — Melissa J. Whitaker has one very compelling reason to keep up with the health care legislation being written in Washington: her second transplanted kidney.

The story of Ms. Whitaker’s two organ donations — the first from her mother and the second from her boyfriend — sheds light on a Medicare policy that is widely regarded as pound-foolish. Although the government regularly pays $100,000 or more for kidney transplants, it stops paying for anti-rejection drugs after only 36 months.

The health care bill moving through the House of Representatives includes a little-noticed provision that would reverse the policy, but it is not clear whether the Senate will follow suit. The 36-month limit is one of several reimbursement anomalies — along with inadequate primary care payments and incentives that encourage unneeded care — that many in Congress hope to cure.

Ms. Whitaker, 31, who describes herself as “kind of a nerd,” has Alport syndrome, a genetic disorder that caused kidney failure and significant hearing loss by the time she was 14. In 1997, after undergoing daily dialysis for five years, she received her first transplant. Most of the cost of the dialysis and the transplant, totaling hundreds of thousands of dollars, was absorbed by the federal Medicare program, which provides broad coverage for those with end-stage renal disease.

Despite that heavy investment, federal law limits Medicare reimbursement for the immunosuppressant drugs that transplant recipients must take for life, at costs of $1,000 to $3,000 a month.

Once Ms. Whitaker’s Medicare expired, she faced periods without work and, more important, without group health insurance, which disregards pre-existing conditions. Struggling financially, she soon found herself skipping doses of anti-rejection drugs.

By late 2003, her transplanted kidney had failed, and she returned to dialysis, covered by the government at $9,300 a month, more than three times the cost of the pills. Then 15 months ago, Medicare paid for her second transplant — total charges, $125,000 — and the 36-month clock began ticking again.

“If they had just paid for the pills, I’d still have my kidney,” said Ms. Whitaker, who shares an apartment in the La Jolla neighborhood with her boyfriend, Joseph D. Jamieson. “I’d be healthy, working and paying taxes.”

Currently unemployed, Ms. Whitaker is nervous that in two years she will again find herself without health coverage. She and Mr. Jamieson, who have been together five years, said they would marry if necessary so he could insure her under the group policy provided by his employer, the drug manufacturer Pfizer. But nothing is guaranteed.

“If Joe were ever to lose his job or medical coverage, I do feel it would be possible for me to find myself without insurance again,” said Ms. Whitaker, who reads lips to compensate for her hearing loss. “I’m extremely nervous about whether I’m going to be able to afford my medications once my coverage runs out.”

Bills have been introduced in Congress since 2000 to lift the 36-month limit and extend coverage of immunosuppressant drugs indefinitely. They have never made it to a vote, largely because of the projected upfront cost; the Congressional Budget Office estimates that unlimited coverage would add $100 million a year to the $23 billion Medicare kidney program.

But the cost-benefit analysis would seem obvious. The most recent report from the United States Renal Data System found that Medicare spends an average of $17,000 a year on care for kidney transplant recipients, most of it for anti-rejection drugs. That compares with $71,000 a year for dialysis patients and $106,000 for a transplant (including the first year of monitoring).

“It doesn’t make any sense at all,” Ms. Whitaker said. “Somebody’s not looking at the numbers.”

A provision to cover the drugs is in the sweeping House health care bill, which has cleared three committees. It is uncertain whether the Senate Finance Committee will include it in its bill…

The couple gets by on Mr. Jamieson’s paycheck and Ms. Whitaker’s Social Security benefits. With the help of financial aid, she recently completed two years at a community college and will soon start classes at the University of California, San Diego. She said she hoped a degree would help her find a job with health coverage, perhaps as an addiction counselor.

But her bigger hope is that Congress will eliminate the 36-month limit so she can pursue any job, without concern for insurance.

“My whole life is dictated by my illness, and it’s such a waste,” Ms. Whitaker said. “If the government is going to spend all that money to help people get a kidney, they should help you keep it.”

Somebody’s not looking at the numbers, all right.

But if this isn’t a typical New York Times report, we don’t know what is.

Ms. Whitaker’s kidney transplant was required because here pills were denied by Medicare for being too expensive.

And the New York Times pretends (and Ms. Whitaker somehow seems to believe) that a nationalized healthcare system, which will really just be an expanded Medicare system – will somehow miraculously avoid such idiotic choices.

Won’t it be just the opposite? Won’t expanding Medicare through nationalizing the healthcare system have exactly the opposite effect and mean that more people will have to go without?

Also, we can’t help but note that once again (as is so often the case in these tear-jerking stories) it would seem that Ms. Whitaker, her fiance and her family and friends would rather she lose a kidney than pay for her pills out of their own pockets.

This article was posted by Steve on Monday, September 14th, 2009. Comments are currently closed.

19 Responses to “More Medicare Will Fix Medicare (Pt 1)”

  1. proreason says:


    Bureaucracies are stupid. We need more bureaucracies.

    If Medicaire was a private business, it would have been driven out of business decades ago by other businesses that offered better service, higher quality, and cheaper prices…..just like every other private business in the world.

    But since it’s government run, it is allowed to get worse and worse, until finally, it will bankrupt the entire country.

    Unless Obamy gets us there faster through another of his schemes.

    • proreason says:

      And by the way, doesn’t it seem that the reporting in the msm is becoming increasingly and pitifully stupid.

      Even given that their goal is to brainwash the country, wouldn’t you think that they would want to do it with smart people.

      Does being brainwashed yourself blind you to stupidity?

      The MSNBC guys are even worse. Can they even feed themselves?

  2. snickerdoodle says:

    You are assuming that her family could afford the $1000+ a month medications.

    • SinCity says:

      You freakin kidding me snickerdummy! You ever been to San Diego? She lives in La Jolla, which is the most expensive place to live in San Diego. All they would have to do is move south a few miles, while it wouldn’t be as nice, it would still be decent and she’d save $1,000 in just rent easily.

      Or better yet, why doesn’t she marry her boyfriend to get private insurance? You mean the taxpayers have to pay for her lack of commitment in her relationship with her boyfriend? They already shack up and pretend to be married, they might as well do the deed and reduce the load for the taxpayers.

    • catie says:

      Sin is exactly right. I can’t afford to even walk into LaJolla. And why don’t these two get married is an excellent question. Trash, plain and simple.

    • Colonel1961 says:

      Thank you snickerdoodle for exposing several holy grails of leftist fallacies (is that redundant?): everyone is a victim and no one can afford the necessities, but the luxuries are readily ‘affordable’, i.e., owning a house in La Jolla, for Pete’s sake, but can’t afford their medicines!

      Better call the Whaaambulance!

  3. GetBackJack says:

    Yeah, ask an Indian how he likes the feds’ Indian Health Service.

    4 million native Americans
    15,000 total employees of IHS (that includes clerks, etc)
    Just 900 physicians
    2,000 nurses, 300 dentists, 400 pharmacists, etc. For 4 million people, a majority of whom are chronically ill.

    In 35 states, 557 recognized Tribes. Just 33 ‘hospitals’ and 59 ‘health centers’, I suppose that means what we term a clinic.

    I’m sure any Navaho or Chippewa would say “Mmmmm – mmmmm gimme some more of that good government loving, yes sir.”

    It’s only the defeated who get government health care, Free People make their own choices.

    • proreason says:

      But it sounds cost effective.

      It may be a wee bit tight on the allocation of resources, but there should be no need for grannie to worry.

      President Obamy has assured us that not only will nobody under Obamycare need to give up their insurance, all caps on medical care will be lifted.

      Everybody will have infinite medical care. and with higher quality,a t a lower cost than today, with all of the other problems taken care of. For example, no pre-existing conditions, no interruptions in service, 30 or 47 million more people covered. And it will be done without a tax increase, and what you pay today won’t go up either. And the curent shortage of doctors won’t be a factor either.

      And that 39 to 50 Trillion shoftfall for Medicare? Don’t worry about that. Heck, we’re even gonna cut medicare costs by half a trillions.

      That’s how good Obamy is.

      Looks like the Indians are in for some happy times.

  4. Liberals Demise says:

    See what happens when they play with that Home Lobotomy kit…..duuuuuh!!

  5. VMAN says:

    Oblabby says that if we don’t do something about medicare it will balloon out of control. So what is his solution? Create more bloated government bureaucracy.

  6. MinnesotaRush says:

    “She and Mr. Jamieson, who have been together five years, said they would marry if necessary so he could insure her under the group policy provided by his employer, the drug manufacturer Pfizer.”

    Marriage counselor to ignoramus’s: “So why did you and Mr Jamieson get married, Ms Whitaker?”

    Ms Whitaker: “For the insurance coverage.”

    Marriage counselor: “Excuse me while I go slap myself silly .. I dont think I heard you right.”

    “But nothing is guaranteed.” I got news for ya’ chickie. Some dame I’m thinkin’ of marrying tells a MSM outlet she’s marrying me for the insurance .. I guarantee ya’ .. I’m outta here!!!

    “She said she hoped a degree would help her find a job with health coverage, perhaps as an addiction counselor.”

    Great idea! Another lame brain who wants to be a counselor!

    Good grief!!!

  7. wardmama4 says:

    Well here’s a telling statement, if I ever read one –

    perhaps as an addiction counselor

    Which given the fiberal penchant to hide the umm, how to say this, less savory aspects of the sob-story of the day – so maybe, just maybe Ms Whitaker might want to be an addiction counselor because it was an addiction that got her to the point of kidney failure?!?

    And yes – I’d move home or rent before I’d stop taking medication. Hell just yesterday (after being assured that my wonderful, perfect and free (NOT) government insurance was going to cover 100% of a ‘surgery’) I ended up flashing that plastic (the one with a bit of ‘rainy day’ savings in it) to pay in full the surgery because one little itty bitty question wasn’t asked by either of the ‘insurance’ experts and that little itty bitty t wasn’t crossed properly. I did what I needed to do by asking before going ahead – because hubby works part-time during the summer so we don’t have extra play money lying around. And alas like all honest and hardworking Americans – we got screwed. Sucks to be me. But it worked – so now I don’t have to use the medication daily.

    And that is the lesson to be learned by doing for yourself rather than sitting around lying (or at least leaving out key details) and whinning because you opt not to do what needed to be done – and suffer because of it. It’s as bad as an alcoholic getting a new liver and then going out to toast it. I don’t care if you are chronically stupid – why should I be forced to pay for it – or cry about your miserable life?

    Guilt for being stupid – wow what low levels of ‘compassion’ the fiberals have been reduced to.

  8. snickerdoodle says:

    Hey kids! Reading comprehension is fun! Look up Alports syndrome and you’ll find it is a genetic disorder. The article states that Ms. Whitaker lives in an apartment (not a house) near UCSD, where she is going to attend college. It mentions she did not have electricity around the time that her kidney failed and that she did not live in La Jolla at the time.

    While I may agree with you on many points in this health care debate, kicking sick people is not something I agree with.

    • SinCity says:

      Snickerdummy… you truly are a dim bulb. Allow me to lay this out for you, maybe you can practice some of your reading comprehention. Nobody said that her affliction was a result of behavior. That wasn’t even brought up and personally I don’t give a crap about her sob story anyway. However, there are many lifestyle changes that could be made that would allow her to pay her own way, including marrying the boyfriend that donated a kidney anyway, that way she can get on his insurance. Which would take her off the public dole.

      Now, a little map reading skills. The UCSD main campus is well south of La Jolla. While a satellite campus does exist in La Jolla, the campus where she will be attending classes is not so near. UCSD, because it is a part of the University of California system rather than the Cal State system, is UBER expensive to attend. Where is this money coming from? It wouldn’t shock me that yet again it is the taxpayers that is footing the bill.

      Don’t give me your nonsense about compassion and feeling sorry for others. I have a good place where you can stick that rhetoric. I have compassion for the cart pullers as much as those riding in the cart. Millions of Americans, like myself, face adversity and overcome it while paying our fair share and then some. Ms. Whitaker needs to make some sacrifices herself before holding her bowl up high and asking, “More please”. When I was living down there, I couldn’t afford UCSD, but I sure as heck wasn’t going to saddle my fellow taxpayers with the bill either. I attended a good school that I could afford, while working full time.

    • proreason says:

      Snickerdoodle’s head is going to explode.

      They don’t want to deal with facts and reality and responsibility and being grown-up.

      They just want your money.

    • snickerdoodle says:

      UCSD is actually north of La Jolla. But you’re probably right about everything else. Take care!

    • proreason says:

      “said Ms. Whitaker, who shares an apartment in the La Jolla neighborhood with her boyfriend, Joseph D. Jamieson”

      damn my lying eyes.

      We shudda known she really lives where she “will soon” go school.

    • SinCity says:

      Damn, he got me on that one. It has been a very long time since I lived in San Diego. Somehow I remember it being in Mission Valley. Oh well, I stand behind everything else I said. He is right about another thing too… I am right about everything else I had said.

      I am sick of the media dragging out all of these slobbering sob stories that don’t even come close to passing the smell test. Since when does MORE government involvement makes things better?

  9. Rusty Shackleford says:

    Cheapest rent I could find in La Jolla was $1050 a month. http://www.forrent.com/search-apartments-by-area/CA/San-Diego-County/LaJolla

    In-state tuition for UCSD runs between 15k to 25k per year….so she has to have an income of 35K a year to cover that and include utilities, food, gas, clothing, etc.

    I do not kick people when they are down and any illness is unfortunate. But certain priorities must be met. If she’s going to go to college, is the money for tuition already spent? Is she on scholarship? My god, if I had to go to college now there is NO WAY I could afford that kind of rent. Not with student loans, or even a part-time/full-time job. Assuming they split the rent, I’m still not seeing it.

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