Eitan Neidich, Alon B. Neidich, David A. Axelrod, MD, and John P. Roberts, MD
Geographic disparities in availability of organs for transplant have spawned for-profit companies that help patients get on waitlists in more than one region and arrange travel for them if an organ becomes available.
We really can't promise both more transplants and better outcomes. The controversies over organ allocation really represent intellectual exhaustion in the face of a long series of inadequate policy responses to the decade-long trend of the kidney supply increasing only at the expense of organ quality and patient outcomes.
Bruce C. Vladeck, PhD, Sander Florman, MD, and Jonathan Cooper, JD
The United Network for Organ Sharing’s geographic allocation system is outdated and inequitable, particularly in light of improved ability to transport organs. Allocation should be based on common medical criteria, not accidents of geography.
Daphne C. Ferrer, MD and Peter M. Yellowlees, MBBS, MD
Telepsychiatry extends access to psychiatric treatment to those who might not otherwise get it, but licensure problems and the risk of boundary violations between patients and physicians need to be worked out.
The organ transplantation system is viewed as one of our most equitable health care services, but poor patients are effectively excluded by policy that denies Medicaid coverage of post-transplant immunosuppressant medication.
The Patient Navigator Outreach and Chronic Disease Prevention Act of 2005 supports entities that provide counseling and health care coordination to low-income patients who suffer from cancer or other chronic diseases.
The implementation of breakthrough quality improvement initiatives has been successful in closing the gap between the number of organs that are available and the number of patients who need them.