Healthcare Rationing Affects the Alcohol, Drug Dependent

One of the big concerns about national healthcare reform is the prospect of government rationing of care, but a pair of recent stories shows that such decisions are already made in the U.S. as well as in Europe when it comes to caring for alcohol-related illnesses.

The Hawaii Tribune Herald reported Aug. 8 that a resident of Waimea suffering from hepatitis and cirrhosis was denied a liver transplant by her insurer, the Hawaii Medical Service Association (HMSA), and died on July 27. The family of Kimberly Reyes claims the denial stemmed solely from the fact that toxicology tests revealed traces of marijuana in Reyes’ system.

The insurer refused to comment or provide its criteria on drug use and transplant approval. Previously, Reyes had been denied a transplant based on technical violations of HMSA policy, such as missing Alcoholics Anonymous meetings. On July 17, HMSA approved a transplant, but withdrew permission three days later after the toxicology reports came in.

In Great Britain, a 22-year-old man who began drinking at age 13 and was suffering from severe cirrhosis was refused a liver transplant and later died, the Sydney Morning Herald reported July 22.

Doctors reportedly denied the transplant because they believed Gary Reinbach could not stay sober for six months after the operation.

“They told him to stop smoking and he did. They told him to stay in bed and he did,” said Reinbach’s mother, Madeline. “All he wanted to do was prove that he was serious, and that he wouldn’t drink again. But he never had the chance to prove himself properly because he was too fragile to be sent home. He couldn’t go against the doctors, but because of that he couldn’t have the second chance he wanted so much.”

Britain’s National Health Service (NHS) said the case demonstrated the impact of a shortage of donation organs for transplant. “They have to make tough decisions about who is going to get the benefit and who is going to take best care of this precious gift,” said the NHS’s Blood and Transplant office.

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