What makes you think lower class people get fucked over? Are you just repeating the typical propaganda regarding this issue or do you know anything about the issue at all?

About 53 million people in this country are already covered by Medicaid. That's government provided insurance if you didn't know.

That's better than one out of six people and counting. A few states even allow you to enter the Medicaid program with an income of about $60,000 for a family of four, and still be eligible. That's almost three times the so-called poverty level income. That's a pretty generous system that the taxpayers are paying for.

There are options here for poor people. Are we supposed to fuck up the entire system just for a few people?

There is no doubt the system here has some problems and is expensive. Most of these problems are directly due to government and government regulations and interference. The system needs reform, not more government involvement. The current levels of government involvement have already created a lot of waste. For every doctor and patient, there are about 3 or 4 other people involved doing paperwork.

The system here is still far better than the system in that runaway socialized garbage dump that you come from. Healthcare is "rationed" in the UK. People here don't have to wait 6 months for a TB test. That includes people with no health insurance at all. We don't let our old people die from lack of care because they are just too expensive to keep treating in their advancing years.

In England, even former members of Parliament can't get good healthcare and are allowed to go blind because of the crappy government healthcare system. If former MP's don't have a chance in the shitty English system, the average person has even less.

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After I make my wealth here in the US I probably will go back to England, when I can afford to live there. Not sure how my friends manage - At least they don't have to worry about the bill for getting treatment at a Dr / Dentist or a hospital in the event of an accident.

Those are the key words..."when you can afford to live there". They take all of your money and in exchange you get to wait in line 6 months or a year for crappy healthcare.

Good luck when you get old over there. You are going to need it.

You can't even purchase a television set in that country without paying an expensive "television tax" to the government every year.

It's good to hear you will be moving back to England. That will be one less ingrate immigrant living here.

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This country doesn't need law-abiding, tax paying immigrants eh! Nice. May as well just let all the illegals in who don't pay taxes or obey the laws - That would be a nice place for you citizens to live in!!!!

I never said we don't need tax paying law abiding immigrants. What we don't need is immigrants who come here complaining that our systems suck and should be changed to the even far worse socialized systems in the dumps they decided to leave.

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Was thinking about this some more on my drive home. So what you are really saying NY is that you are communist and that everyone should agree with the government and not have our own opinions about things. If I disagree with the way the US health care system is run, then I should be repressed and my freedom of speach taken away?

Is the US not based on freedom of speach and the right to maybe once and a while have our own opinions about such things as say - Sucky healthcare for the poor?

Ya know I thought you were Republican through and through, but you're sounding more and more like a communist the more you argue. Maybe it's you who should move to North Korea or somewhere where speach is repressed and the people are forced to act like Zombies and not have their own opinions. I think you'd be right at home! Although I think they might have a government paid healthcare system too, so you might have to just put up with that.

Yeah sure, I'm a communist.

Where have I ever said that everyone should agree with the government? Don't put words in my mouth or say ridiculous things and attribute those things to me.

I'm advocating for the government to get out of the healthcare business. Almost everything government touches they fuck up and make worse. We have enough government dependency in this country. I certainly don't want to see a system where all citizens become complete slaves to government from cradle to grave. Europe is crumbling because of that mindset.

You have all the freedom of speech that you want. What you don't have is the freedom from someone else calling you on your bullshit.

X2.

Here's my slant. Everybody that's born is going to die, someday. If you're rich enough to prolong your life, then good for you. If you're not, nothing was "taken away" from you; you just couldn't afford the luxery of expensive healthcare. Oh well.

I don't know why there are people that think "helthcare" is in the Bill of Rights... Last time I checked, there is no unalienable right to have a $50,000+ medical procedure done on your broke ass. If you can pay, then great!

If not, then great! There are plenty of things in this world that if you can afford it, you can have it. Health care is a luxury, not a necessity, and most definitely not a right. It's no different than real estate, cars, or any other luxury items people pay.

Caveat: I think there ought to be some form of basic health care available to all children under the age of 18, as it's not they shouldn't miss out of the opportunity of health care just because someone else can't afford it (their parents). I know, I know, that sort of goes against my overall line of thought on the whole thing, but still, that is my thinking, anyhoo. Deal with it.

I knew it.

Okay, let's get back to the meat and potatoes of the post; transplant recipients who are HIV positive.

Each organ transplant program has their own patient selection process that every potential transplant candidate must complete. The staff members at these hospitals want people who receive transplants to get better and have an improved quality of life. The intent of the procedure is not to make a transplant recipient, who by their underlying organ failure is critically ill, sicker or start a series of events that result in their death.

Someone who is HIV positive would have to have a very low viral load, high CD-4 count, and be pretty well off from an infectious disease stand point to even survive the transplant and massive immunosuppression that will be required post operatively.

As of 5:10 PM today, there are 96,534 persons on the transplant waiting list in the US. The number of persons on that list who are also HIV positive is very low. Stop the immature ranting people...

Be a donor, save several lives, be a hero.

Hey I feel bad...i started this mess as a public service announcement to see what others thought now it is a mess about all health care.

X2 on the organ donor issue....my DL and my Military ID both have me as an organ donor...if it helps another person who needs it then so be it!!!!

Tim

takes 10-20 years for a patient to go from HIV positive to full blown AIDS.

with new treatment (and treatment compliance!!), this patient, even though he has HIV now, can look forward to theoretically living another 20+ years. With possible new advances in the coming years, maybe more.

say the guy is 50 years old right now...then that means his life has now "theoretically" been prolonged another 20 years...up to 70...

btw...remember what the treatment is following transplants in normal patients?? they get their immune systems nuked to prevent host-vs-graft reactions....

i think someone said it already on the first page...this guy is probably a 'better' candidate for transplants due to his already-deficient immune system.

Lots of interesting posts here. Obviously an ethical dilemma for some. Even more good discussion on the public health system.

I suppose you could call me an expert in both categories. One, this weekend marks the one year anniversary of my liver transplant. I had a genetic disease, so there weren't the same ethical issues that surround this case, but the organ transplant experience did teach me a lot about the process. The process works as it is designed. It certainly was interesting.

UNOS (United Network on Organ Sharing) changed the Liver criteria in 02 or 03 for how patients wait on "the list", which is the actual list of persons waiting for organs. The list is broken up into regions, and organs are allocated state, regional, and then nationwide. This means that the donor's organs go to the state they are in (in my case, Oklahoma), then if no match, go to the patients waiting in the region (in our region, its Oklahoma and Texas).

The change made the wait time change from "time" waiting, to acuity, or how sick the patients are. The old way had patients dying from how sick they are, rather than treating the sickest. The liver list now goes by what is called a MELD score (Measurement of End Stage Liver Disease), which uses lab work to indicate who is sickest, and the sickest move to the front of the line.

In my opinion, as a nurse, a health professional, and a patient, this is the correct method, and if the criteria are followed, it shouldn't matter what the patients background is. Clinically, this should be the end of it, but these hospitals make a lot of money on transplants as well. The only distasteful part of the process was having to work with the financial people to get "clearance" for the surgery. They made it clear they would not "list" me until the finances were in order. I believe this is wrong. I believe we need to morally take care of the patient, and then send them to collections if they do not pay. All that being said, now try to wrestle with a convicted criminal, murderer, child abuser, etc, getting a liver transplant. It could happen. There are lots of inmates in prisons with liver failure from hepatitis.

The payment comment, I believe, also comes from where I work, and our philosophy on taking care of patients. I work in an Indian Health Service facility, and we take care of Native American patients regardless of ability to pay. We do not offer everything, only the basics- primary care. We do some surgery, have a screening cardiologist, and do some basic orthopedics. We do bill patients if they have insurance, medicare, medicaid, etc. We also do all labs, radiology (no MRI), and dispense lots of drugs (few new medications, primarily generics), for the patients needs. Its as close to the socialized medicine that the country offers. We have been to a lot of VA hospitals, and ours is more similar to a community hospital and clinic due to OB and peds, things the VA does not routinely offer.

Is it perfect - No, we can do lots of things better. Does it work for our population ? Absolutely.

So, in closing, I suppose I would say this:
1. Transplants for HIV patients. If UNOS set the criteria, and they were going with the sickest patient first, then I would be OK with that.

2. A socialized medical system is not perfect by a long shot. It leaves most of the specialty care out. However, I do feel it works in the right setting with the right people running the show.

Comments from the 'Donor. Thanks for playing!

Kaiser Johnson is right!