Channel 4 News Correspondent Sarah Smith reports from the US where people are being told that a massive budget deficit mean they have to find the money themselves for life-saving operations.
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Travel to Arizona at this time of year and you find both 80 degree sunshine and an almost abnormal amount of Christmas decorations. Some houses are so lit up they look like they have been transplanted from Vegas. It is all terribly festive and jolly - unless you are one of the 98 state residents who have just been told they are no longer eligible for potentially life saving operations. So much for the season of giving and goodwill.
The state is facing a budget deficit of over a billion dollars so everyone accepts that some pretty severe spending cuts do have to be made. But a lot of voters were shocked to discover that one of the things the state will no longer pay for is organ transplant operations.
In Phoenix, I went to meet Randy Shepherd; a young man in his 30s with three children. His weak heart means he really struggles to keep up with them. He doesn't have the strength to carry on working as a plumber and in the US, no job generally means no health insurance. That is why he has to rely on the state Medicaid fund which covers healthcare costs for people who can not afford any other kind of cover.
He has been waiting for a new heart for about 18 months and he had just got to the top of the transplant list. The next suitable heart would be his - or would have been if the state hadn't suddenly decided to stop paying for any transplant operations. He got a letter starkly informing him that he was off the list and the decision could not be appealed.
The only thing he can think of doing is start trying to raise the money for the operation himself, through charitable donations. But it will cost in excess of $600,000, so he must realize his chances of finding that kind of money before his heart gives out are pretty slim.
The Republican Governor of Arizona, Jan Brewer, is notorious both for her right wing views and her aversion to answering questions from the press. I managed to "doorstep" her as we call it in TV - i.e. I caught her at a public event and just started asking questions, uninvited.
"How many people have to die before you are prepared to reverse your decision on the transplant operations?" seemed like the obvious question.
She said she thought that was unfair and started to explain how dire the state's financial situation is. If people are so worried about the transplant patients then they should ask the federal government in Washington to send us more money, she said. But she would not explain to me, or to any Democrats in the state capitol, what she has done with the nearly $200 million she was already given in 'stimulus funds' to spend on anything she liked.
There are nearly 100 patients in total, who had already been accepted into the transplant programme, who have now been told that they are no longer eligible for treatment. Some are waiting for hearts, others for kidneys, livers or lungs. One man, Francisco Felipe, was prepped for surgery and awaiting a liver that was being donated by a dying friend. But he was suddenly told the operation could not go ahead unless he came up with $200,000 immediately. The surgery was cancelled instead.
Doctors in Arizona are furious because they know they are going to see organs that could have been perfect matches for their very ill patients either go to waste or go to people further down the transplant list. All because some patients can afford private medical cover and some cannot.
This situation has nothing to do with the controversial health care reforms President Obama introduced nationwide. Those relate to people who buy their own health insurance or get it through their employers. The patients who are being denied transplants in Arizona are only those who have to rely on state health coverage. But isn't it ironic that during the debates about "Obama-care",as the Republicans called it, the right wing kept repeating the lie that Obama wanted to set up "death panels". Bodies that would decide who was to get treatment and would die instead. It wasn't true then, but in Arizona now it seems that Gov. Jan Brewer has effectively set up a death panel of her own.
- Countdown with Keith Olbermann Arizona contemplates more death panels - msnbc.com