What We're Reading: Indian Health System Failures; Crowdfunding for Transplant Care; LePage Rebuffed Again

Policy Failures, Underfunding Cause Errors Leading to Unnecessary Deaths in Indian Health Service

Fundraising for Post-Transplant Care Is Common, Experts Say

Maine GOP Governor Denied Last-Ditch Effort to Delay Medicaid Expansion on His Way Out the Door

An investigation by the Sioux Falls Argus Leader in South Dakata has found that dozens of patients have died needlessly due to errors made in Indian Health Service (HIS) hospitals in the state. Thousands more have limited access to primary care providers, long wait times for basic medical treatments, and outstanding medical debt for necessary care sought outside the federally-funded facilities. The paper said the federal government has ignored the conditions on reservations, and the state’s Congressional delegation has failed to make a difference. The newspaper cited a combination of state and federal policy failures, underfunding, geographic remoteness, and extreme poverty for the healthcare catastrophe.A recent case of a Michigan woman resorting to crowdfunding to pay for post-transplant care in order to get on an organ transplant list sparked outrage, but requiring proof of payment for organ transplants and post-operative care is common, transplant experts told California Healthline. Arthur Caplan, a bioethicist at the New York University Langone Medical Center, said patients get what he calls a “wallet biopsy.” Virtually all of the nation’s transplant centers require patients to verify how they will cover bills that can total $400,000 for a kidney transplant or $1.3 million for a heart, plus monthly costs that average $2500 for anti-rejection drugs that must be taken for life, Caplan said. Coverage for the drugs is more varied than for the operation itself, even though transplanted organs will not last without the medicine.A judge in Maine denied a request by the outgoing GOP Governor Paul LePage to stay an order that the state implement Medicaid expansion, which was approved by voters last year. The Hill noted that the issue is somewhat moot, since incoming Democratic Governor-elect Janet Mills takes office next month. About 70,000 people are expected to gain health coverage from Medicaid expansion.