Tuesday, December 30, 2008

Government Inefficiency

There are many social programs, funded by the taxpayer, and mismanaged by government administration. The story of Sabrina Holloway is just one of those.

Sabrina is a 39 year old mother of 8 covered by Medicaid. But "covered" isn't exactly true.

Therein lies the story.

Holloway is covered by Medicaid, the insurance program for the poor and disabled. But unlike other states’ Medicaid programs, Georgia’s does not cover an intestinal transplant for patients 21 years old and older.

Such transplants are covered for younger patients, but not someone older. Wonder why?

Without the surgery, Holloway likely would have died within two to three years, Katz had said.

Is the Medicaid system heartless?

The federal government gives state Medicaid programs leeway on which transplants to approve. Other states’ Medicaid programs —- which have their own coverage rules —- approve intestinal transplants for people Holloway’s age.

So federal health care programs allow each state to decide the level of treatment. So much for "universal" coverage.

Without the surgery, Holloway was fed intravenously at an estimated annual cost of $150,000.

So how much does the surgery cost?

The operation generally costs $200,000 to $400,000, doctors said recently. But Dr. Douglas Farmer, head of the intestinal transplant program at UCLA, said in June that a transplant could be less expensive for the state in the long run. He added that intestinal transplants can cost less than $200,000.

So how was it that she received the transplant?

It seems she relied on the charity of others at the Cleveland Clinic.

The Cleveland Clinic last week declined to disclose the cost of Holloway’s surgery and postoperative care. Officials there said they “made every attempt to obtain coverage from Georgia Medicaid.”

It begs the question.

If government run health care is so great, why do patients have to rely on charity?
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