If I were the parent of a child who might be kept alive -- if only for a few more years -- by a lung transplant, I would move Heaven and Earth to get it done. It's completely understandable that the parents of 10-year-old Sarah Murnaghan have made her an Internet and cable news celebrity in a desperate effort to get her on the adult list for a lung transplant. No one with a particle of human sympathy can fail to be moved by the family's situation.
The story, however, has loosed a torrent of demagoguery -- some of it coming from the very people who should be most alarmed about the politicization of cases like Sarah's and of health care generally.
Talk radio and TV have been ringing with strident and even hysterical accusations that HHS Secretary Kathleen Sebelius is "letting this little girl die," or "choosing who will live and who will die." Some are linking Sebelius's supposed callousness to the terrible, politicized rationing of care that Obamacare will inaugurate.
This is all backwards. The people calling upon Sebelius to intervene and grant a waiver from the usual rules regarding children and transplants are the ones urging the politicization of medical care -- at least in this case. They would be the ones responsible for setting a terrible precedent. The lesson would be this: If you can muster public pressure through social media, the press, and politicians, your loved one can gain an advantage over others waiting for a lung or kidney or liver. Photogenic patients or those with media-savvy or even politically well-connected relatives would go to the head of line. That is exactly what conservatives ought to fear.
It may well be that the rules about eligibility for lung transplants need an overhaul. But the laws of economics dictate that when a commodity is scarce, there are two ways of allocating it -- by price or by rationing. Organs are scarce. As Sebelius noted in response to a congressman demanding that she change the rules, 222 people are waiting for lung transplants in Sarah's region alone, including six children aged 10 and younger. Nationally, about 1,700 people are waiting for lung transplants, including 31 children 10 and younger. Lung transplants are very high risk -- only 50 percent of recipients survive longer than five years.
Deciding who among the desperately sick should get a lung or other organ when they become available is managed by a nonprofit group called the United Network for Organ Sharing. UNOS has developed a complicated scoring procedure for those seeking a lung transplant that takes many matters into account, including how sick the patient is and how long he or she would be expected to survive post-transplant.
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