MATTERS OF LIFE AND DEATH: DEFUNDING ORGAN TRANSPLANTS · A CASE ANALYSIS
In the spring of 1987, Arizona state government came face-to-face with a controversy partly of its own making and partly cause by national health policy in the United States. Regardless of the sources of the problem, however, it was the state government (the legislature primarily, but also the governor) who had to respond to public pressures over a state policy that rationed health care services in such a way that (a) Diana Brown (a 43 year old) died because the Arizona Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS) denied coverage for a transplant operation that was required for her survival, while (b) state-funded health care access for pregnant women and children aged six through 13 was extended to families with household income levels above that were higher than the AHCCCS qualification maximum but which were below the official federal poverty income level.
The public controversy centered on a woman's probable preventable death and assuring basic health services access to pregnant women and children in indigent households. The real policy issue (the big policy question), however, involve the appropriate use of state assets to fund health care services in Arizona. The evaluation of this issue involves the analysis of the case Matters of Life and Death: Defunding Organ Transplants in the State of Arizona (Varley, 1988).
Relevant Issues (Big Issues Surrounding the Question)
A number of relevant issues were associated with the question of health care rationing in Arizona in the spring of 1987. These issues included the concepts of (a) distributive justice, (b) equity theory, (c) social justice, (d) cost-benefit analysis, (e) economic efficiency, (f) the status of health care in a society, and (g) the role of government in a society.
Within the context of both the big policy question involved in this case and the bi...