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Penna. Reimbursement Plan
Medical Ethics
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Pennsylvania's proposed funeral
reimbursement plan
Press Release -
Pennsylvania Department of Health
JUNE 9, 1999
ACTING HEALTH SECRETARY ZIMMERMAN DIRECTS DEPARTMENT REVIEW OF
PROPOSED ORGAN-DONOR FUNERAL-REIMBURSEMENT PLAN
Advisory committee today recommended voluntary pilot program to provide $300 stipend to
funeral homes
HARRISBURG (June 9) – Acting Secretary of Health Robert S. Zimmerman Jr. today
announced that the Pennsylvania Department of Health will conduct a thorough review of a
proposed $300 voluntary funeral-reimbursement pilot program for families of organ donors,
including exploration of the ethical and legal implications of the plan.
The proposed plan will not go into effect unless approved by the Secretary of Health.
The Organ and Tissue Donation Advisory Committee proposed the plan to the Health
Department at a committee meeting today.
The proposed plan would create a pilot program to defray part of the funeral expenses for
a donor’s family by reimbursing the funeral home up to $300.
Zimmerman thanked the committee for its efforts in putting together the plan, and stressed
the need for increased public awareness of organ donation.
"The single-largest problem confronting organ donation is the shortage of suitable
organs for transplant," said Zimmerman. "Each donated organ can mean the
difference between life and death for someone awaiting a transplant.
"But the recommended $300 reimbursement also has raised legal and ethical issues, and
it is very important that we consider these issues, too. That’s why I’ve asked
Pennsylvania’s Physician General, Dr. Robert Muscalus, and the Department of
Health’s Office of Chief Counsel to review, respectively, the medical ethics and
legal issues involved."
The Organ Donation Advisory Committee was created under Act 102 of 1994, which sought to
increase organ donations in Pennsylvania by supporting organ-procurement organizations,
increasing public awareness; providing for voluntary contributions; and encouraging people
to become donors.
Act 102 established a trust fund for voluntary contributions and empowered the committee
to advise the Health Department on how to use the fund to increase organ donations.
In addition, the law provided for the possibility of using 10 percent of the fund to
reimburse the families of donors indirectly for funeral or medical expenses and directed
the advisory committee to develop procedures, including a pilot program to implement the
provision.
According to Organ Procurement Organization statistics, from Sept. 1, 1996, through July
31, 1998, in Pennsylvania, a total of 2,267 organs were transplanted; 72,245 tissue grafts
were produced; and 3,536 eye tissues were transplanted.
The Delaware Valley Transplant Program, which serves Eastern Pennsylvania, reported a 43
percent increase in organ donations from 1995 through 1998. The Center for Organ Recovery
and Education in Western Pennsylvania reported a similar increase during the same time
period.
The Department of Health promotes organ donation through various activities.
Pennsylvania’s minor-league professional baseball teams join with the Health
Department, organ-procurement agencies and other groups to promote organ donation at
certain "Mickey Mantle Day" games.
Pennsylvanians may make a $1 voluntary donation when renewing their driver’s license
or on their state income tax return. As of July 1, Pennsylvanians may make a $1 voluntary
donation when registering a vehicle or renewing their registration.
Annually, more than 2 million "Greatest Gift" brochures are provided to
Pennsylvanians who renew their driver’s license to inform and encourage their
decision to become an organ donor.
# # #
COMMONWEALTH OF PENNSYLVANIA
Department of Health
Commonwealth News Bureau
Room 308, Main Capitol
Harrisburg, PA 17120
CONTACT:
Evelyn Tatkovski
Richard McGarvey
(717) 787-1783
[click here to
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June 9, 1999 SWING!
by Casey J. Lartigue Jr.
Casey J. Lartigue, Jr. is a staff writer at the Cato
Institute.
Could there be a better means than altruism for organ donation? A recent
proposal from Pennsylvania plans to pay the relatives of organ donors $300 toward funeral
expenses. Such a plan acknowledges, finally, that altruism isn't enough.
Hearing about that plan brought back memories of a college friend who was
from Pennsylvania. Terri Mullin, a self-described "country girl from
Pennsylvania," was a fantastic reporter at my college newspaper. But as good as she
was, she never had a legitimate shot at an executive position on the paper. She had cystic
fibrosis. The senior editors were worried because she was often in bad health, missing
days at a time.
Because she acted as if she didn't have the disease, I wasn't surprised
when she asked me if I could teach her how to play softball. Softball was the sport that
everyone on the paper could play. Everyone, that is, except for Terri.
I really regretted that Terri and I never found a time for softball. The
following autumn, she checked into the hospital for an extended stay.
Worried that she might be dying, several of us made the trip to the
hospital to see her. Between coughs, she assured us that she would be back, soon. She
later told me that she was happy to see me because I enjoyed her rants about animal rights
groups who opposed medical testing on animals. She blamed those groups for the deaths of
many of the "invisible victims" of diseases. A former poster child for cystic
fibrosis, Terri had memorized the names of diseases that had been cured as a result of
animal testing.
There she was, sick in the hospital, and she wanted to ... play softball!
She asked me if I would still teach her how to play. I reluctantly agreed to do so after
she got healthy.
She did return a few weeks later, upset because she knew that her long
stay in the hospital had ruined her chances for a top spot on the paper. She was even more
upset because I was hesitant to play softball with her.
Spring came and it was softball season. Terri seemed to be much healthier.
One day, she just showed up at one of the games, without even a day of practice. There she
was, trying to figure out how to hold the bat.
Before the game started, she came to me, nervous: "Coach, quick,
teach me how to play." She took a couple of weak practice swings behind the batting
cage. Suddenly, she was up next. She was frantic.
"What should I do?"
"Swing."
She was livid. "That's it? Swing? That's what you call
coaching?"
She walked up to the plate. The pitcher tossed the world's slowest pitch
right down the middle. Terri did swing; late, badly. Strike one. Another pitch, a swing,
and contact! If it had been a movie, she would have hit a home run or a triple. Instead,
she hit a weak dribbler that dropped right in front of home plate.
I had forgotten to teach her one other thing:
"Run!"
Glaring at me and holding the bat the whole way, she lumbered down to
first base. She was halfway there when the ball arrived.
She played in several other games, even getting a "hit" in an
intrasquad game. She had managed to actually hit the ball past the pitcher and directly to
me at shortstop. Although I could have outrun her to first base, I ended up tossing the
ball at least 10 yards over the first baseman's head. I will never forget the big grin on
Terri's face later as she awkwardly leaned off second, taunting me for making the error:
"Those who can, do. Those who can't, play shortstop."
That is my best memory of my three years of working with her. About two
years later, I happened to see her picture as I was thumbing through the Boston Globe. It
was in the obituary section. Shortly after she had started working at the Boston Globe,
she had taken a leave of absence. She had died in England, apparently waiting for a
transplant that never came. I can't help thinking that Terri might be alive today if we
didn't rely solely on voluntary organ donations.
There are numerous appeals to get more people to sign up to become organ
donors. Sporting events are held to raise donor awareness. Celebrities, including Michael
Jordan, have acted as spokespeople for the cause. The U.S. Post Office has issued an
"organ donation" stamp to raise awareness. But the reality is that during Donor
Awareness Week, observed in late April, at least 80 people will die while waiting for an
organ. On National Donor Day, observed on February 13, another dozen people will die while
waiting. Those efforts will continue to fail as long as we continue to rely on altruism as
the sole motivation for organ donations.
The National Organ Transplant Act of 1984 explicitly prohibits the
purchase or sale of internal organs. It is time to repeal that law. The free market isn't
a utopia: The rich may still get the "best" organs, but an increased supply of
organs would benefit everyone.
© 1999 The Cato Institute |
Organ donor funeral aid
scrapped
Health department fears conflict with federal law
Friday, February 01, 2002
By Christopher Snowbeck, Pittsburgh Post-Gazette Staff Writer
A controversial plan to help pay funeral costs for organ donors has been
scrapped, and a state legislator says the state Department of Health's
replacement program is an insult to donor families.
Starting last month, the new Expense Benefit Plan for Organ Donors and
Their Families offers a $300 benefit per organ donor to pay for food and
lodging costs incurred by a donor or the donor's family.
That's a significant change from the recommendation made by an advisory
committee in 1999 to provide that sum to defray funeral expenses for a
donor's family.
But the Department of Health concluded last year that the funeral benefit
strayed too close to violating a federal law that prohibits offering "valuable
consideration" in exchange for organs, said Steve Curovie, a deputy secretary
at the Department of Health.
Department officials felt covering the costs of food and lodging was not as
risky because the National Organ Transplant Act specifically allows for such
reimbursements. As would have happened with the funeral benefit, the new
program directs the money to the service providers, not to families or donors.
But the state legislator who first proposed the funeral benefit, Rep. William R.
Robinson, D-Hill District, said donor families generally need more help paying
funeral expenses than covering the costs of meals or lodging.
The idea for the funeral benefit grew partly from the heart-liver transplant of
then-Gov. Robert Casey in June 1993. In that case, the donor's parents had
trouble raising funds to bury their son, Robinson said.
Robinson said the law passed the following year was a way to make sure
other families didn't meet that fate.
The meal-lodging benefit "is so far afield from what I was originally trying to
do that it's insulting to the families who really need help," he said.
Organ recovery experts aren't thrilled with the health department's plan either,
although they think the program could be helpful for living donors, who
provide a minority of all organs used in transplants.
The problem with the new benefit program, they say, is that families who
agree to donate organs from brain-dead relatives don't usually go to a
restaurant or hotel right after making the decision.
"They say their good-byes and go home," said Brian Broznick, executive
director of the Center for Organ Recovery and Education, which coordinates
organ recoveries in Western Pennsylvania, West Virginia and part of New
York. "We think that this [benefit is] a viable option for individuals who are
living donors, but it's probably not a viable option for cadaveric donors."
The money for the benefit payments comes from the Governor Robert P.
Casey Memorial Organ & Tissue Donation Awareness Trust Fund.
Pennsylvanians make voluntary contributions to the trust fund through driver
license and vehicle registration renewals, state income tax checkoffs and
direct gifts.
The 1994 law stipulated that 10 percent of the trust fund be used for medical,
funeral and incidental expenses incurred by the donor or donor's family in
connection with donating an organ. The payments were not to exceed $3,000
per donor and would be made directly to the funeral home, hospital or other
service provider.
The organ donation committee that advises the Department of Health on trust
fund expenditures recommended in 1999 that this "funeral benefit" be
voluntary and that the benefit's value be reduced to $300 so that it would not
appear to be coercive.
Howard Nathan, executive director of the organ procurement organization in
Eastern Pennsylvania, said the Department of Health changed the plan to a
meals and lodging benefit on its own and presented it to the advisory
committee as "a fait accompli." Both Nathan and Broznick are members of
the advisory committee.
"The two organ procurement organizations didn't agree with this, but we
basically said we're not going to stop it," Nathan said.
Broznick said the Department of Health never got a ruling from the federal
government on the legality of the funeral benefit. Curovie responded that
federal officials seldom respond to such requests, so health department
lawyers relied on their own judgment.
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