Thursday, June 6, 2013

The Unpleasant Case of Sarah Murnaghan

Sarah Murnaghan is the 10 year old girl who needs a lung.  She has been quite in the news this week, as Secretary of Health Kathleen Sebelius refused to intervene into an existing process intended to determine the optimum distribution of an exceptionally scarce resource: donated lungs. 

Through a roundabout path, I ended up at an insightful article by Ace of Spades on that encapsulates what bothered me about this whole incident.  You should read the whole thing.  (Thanks to Robb, I bounced through Popehat who does an excellent imitation of the Screwtape Letters, "Screwtape Embraces the Internet").

A federal judge has ruled that little Sarah can be put on a different waiting list; rather than waiting for a pediatric lung, Sarah can be put on the list waiting for an adult lung.  Adult lungs are about 50 times more available than pediatric lungs because, thank God, children rarely die of traumatic brain injury leaving behind most organs.

The problem is what this whole episode says of the coming of Obamacare and life in general.
Oh I don't mean to say I don't feel sympathy for this little girl.

But I mean this:  Her family will succeed in politicking on her behalf.  With ObamaCare coming, and bureaucrats patrolling for whether it's cost-justified to save your life or give you that new hip, our health care will increasingly consist of politicking -- going to our government to plead for special favor, enlisting the media and, for the well-heeled, even PR companies.

Our nation is no longer one of rights or ownership.  It is now one in which we merely plead to the courtiers of government for favors, or to keep something we have in our possession.
Sarah got her special place on the list because of a judge.  More to the point, Sarah  got onto this list by popularity contest.  Her parents worked the media and the public as deftly as any PR expert ever could.  Like the author of that piece, I don't mean to say I don't feel sympathy for Sarah or her parents.  I can hardly imagine the depths of their desperation at losing their daughter.  The public lobbying campaign they waged was a natural reaction. But what they really did was move to save their daughter's life at the expense of the life of another adult who needs that lung. With scarce resources, like lungs to transplant, it's inevitable that saving one kills another. 

What's coming is a time when exactly who gets a transplant is whomever polls better on Twitter, or who gets more Reddit Updings.  In an era when all resources are scarce (all single-payer health services are like this) the right diseases will get treated; the unfavored diseases, not so much.  If you have one of those rare diseases that only a handful of people get, especially if it has an expensive drug or surgical treatment, so sorry, you need to plan for your funeral.  Congress had a lobby full of women in pink T-shirts and ribbons when the budget was being set, so the money for your disease went to breast cancer.  (Or an lobby full of women lobbying for autism research - whatevs). 

This is what I can't stand about big government and big government health care systems.  To get what you should be able buy, you need to grovel and beg to the government.  You need to put on PR campaigns, and you probably need to be photogenic. I'm sure it would probably help to spread some donations around.  It aggrandizes them and diminishes us all.

As an engineer, I say the answer to the transplant problem is tissue engineering, and the solution to 10 year old girls needing lungs is genetically engineering a cure for cystic fibrosis.  Unfortunately, you can expect less medical research due to the Obamacare taxes.


  1. All entirely correct. The major problem underlying all of this is that because transplant organs are "scarce," the government has arrogated the power to allocate them.

    Why did we allow this? What isn't scarce, meaning limited in supply? The perception of an "important" scarcity in this case (and similar cases) arises from government intrusion: A market for transplant organs is not permitted.

    Many persons will blanch at the suggestion that transplant organs should be bought and sold like other goods. But in the nature of things, any desirable item will (omitting charity) either be traded in a marketplace or controlled by the State. No other arrangements are possible.

  2. We need involuntary organ donors. Molestors. Murderers, Rapists. Harvest their organs and use them on worthwhile individuals.

    If you've proven your incompatibility with society beyond a resonable doubt, congratulations! You're next on the donor list. The sick kid that gets your corneas, liver, marrow might be the one to give us room temprature semi-conductors, or functional ION engines.

    1. LFMayor, if you're there, I owe you a big apology. I hadn't noticed Google had stuck this in Spam for some unknown reason. I should check that folder more often.

  3. I will say "WTF?" for everyone.

    1. Thanks, Graybeard. That's exactly what I was thinking, only it came out as 'Huh?' when I said it.