A nurse is adjusting one of the 1,200 butterflies at Providence St. Joseph Hospital in Orange, CA on Wednesday, April 12, 2023. These butterflies symbolize the total number of organ transplants conducted over the past five decades at the hospital, coinciding with National Donate Life Month.
The ongoing deliberations in Congress over successive budget bills, frequently skirting government shutdown deadlines, reflect the challenges of achieving consensus in a divided Congress with slim majorities in both chambers.
Despite the current political landscape, lawmakers from all parties should rally around a crucial area of reform that promises both cost savings and improved health outcomes: enhancing kidney transplants and encouraging living donations.
Various reforms targeted at enhancing the kidney transplant system have the potential to not only save taxpayer funds but also enhance healthcare results. Presently, there is a notable absence of substantial federal backing for living kidney donation. While numerous non-profit organizations and numerous transplant centers are making commendable efforts, there is a lack of significant federal resources to aid individuals in need of a living donor and to support those willing to donate a kidney and save a life.
Legislation is imperative to establish a comprehensive national support system for living organ donors, comprising three fundamental components.
Firstly, Congress should approve the deployment of kidney transplant navigators for both transplant recipients and donors, building upon the recent Medicare initiative. Secondly, it is essential for Congress to affirm that living donors are entitled to reasonable cost reimbursement, expanding on existing guidelines instructing Medicare to cover all justifiable expenses for living donors. Lastly, the adoption of a national program for educating living donors is crucial. Together, these foundational elements constitute a pragmatic legislative framework.
The escalating healthcare costs associated with programs like Medicare and Medicaid underscore the urgency for strategic allocation of resources. Billions are annually expended on necessary (albeit preventable) care aimed at enhancing and prolonging lives. However, it is imperative to shift the focus from conventional program expenditures towards prioritizing living donors over long-term dialysis treatments, presenting a significant structural reform that benefits patients and taxpayers alike.
Supported by a private report commissioned by the Kidney Transplant Collaborative, the potential savings are substantial. By substituting the annual dialysis expenses of roughly \(150,000 per patient with a one-time transplant cost of \)165,000 and ongoing immunosuppression drug expenses of \(27,000, savings exceeding \)6 billion could be realized. With even modest growth in living donor transplants, these savings would accrue rapidly, resulting in substantial financial benefits for Medicare.
While the implementation of these changes and the ensuing benefits may not materialize immediately, they hold the promise of saving lives. In 2023, over [ppp1] kidney transplants originated from living donors, contrasting with more than 16,000 sourced from deceased donors. Simultaneously, [ppp2] individuals were on the waiting list for a kidney transplant, with tens of thousands more requiring transplants but not yet listed.
Presently, the average wait time stands at [ppp3], and [ppp4] individuals succumb daily while awaiting an organ transplant, with tens of thousands more in need of transplants but not yet included on the waiting list.
Despite the rise in deceased donors, the waiting list continues to expand at an alarming rate. Without intervention, an escalation in waiting times and fatalities can be anticipated.
As Congressional deliberations persist on healthcare reform, these provisions present a pragmatic, uncontroversial blueprint for addressing the nation’s health and financial future.
Max N. Rose, former member of Congress from New York (2019-2021) and senior advisor to the Secretary of Defense, and Thomas Reed II, former member of Congress from New York (2010-2013), contributed to this piece.
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