Editorial: Difficult decisions

Thursday, Oct. 26, 2006 | 7:58 a.m.

Heart transplants are not performed in Nevada. Anyone who needs one must go to another state.

For adult Medicaid patients who need heart transplants, the situation is even worse. According to a story by the Las Vegas Sun's Marshall Allen, Nevada's Medicaid program doesn't pay for heart transplants for Medicaid participants 21 and older. They must go without - unless they somehow move to another state where Medicaid covers such procedures.

Heart transplants are procedures of last resort. People who need them generally will die without them. But Medicaid resources are limited. Medicaid provides health insurance to low-income people through a federal-state partnership. The federal government reimburses the state for half of its Medicaid services and requires that any treatment necessary be provided to people younger than 21. Nevada could choose to provide better benefits but it doesn't.

Some states, such as California, do provide heart transplants to adults, the Sun reports. But such procedures just don't fit into Nevada's $1.3 billion Medicaid budget. So Nevadans with low incomes go without. One such person is Troy Shaw - a 32-year-old Las Vegas man, profiled by the Sun, who will die without a new heart. At 32, Shaw is still a young man.

Republican conservatives who say Nevada already is spending too much on Medicaid need to know more about such people as Shaw, for whom being poor is a death sentence.