One for All and All for One: Moving Toward a Single Payer for Heart Transplant.
One for All and All for One: Moving Toward a Single Payer for Heart Transplant.
复制标题
一为所有人，一切为一：走向心脏移植的单一付款人。
DOI：
10.1016/j.jchf.2018.10.019
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Breathett,Khadijah
中科院分区：
文献类型：
--
作者：
Breathett,Khadijah
在美国，医疗保险是心脏移植的先决条件（1）;仅凭医疗需要不足以进行心脏移植。还需要财政手段。由于10%的非老年美国居民仍然没有保险（2），许多患者在考虑心力衰竭的高级治疗时面临着限速步骤。在被保险人中，决定是复杂的免赔额水平和保险类型的充分性，包括移植评估，手术，免疫抑制药物，和后续护理。虽然《患者保护和平价医疗法案》禁止限制对既存疾病的覆盖范围（3），但并非所有保险公司都覆盖心脏移植。所有美国居民都应该平等地获得涵盖心脏移植的医疗保险吗？在本期《JACC：心力衰竭》中，DeFilippis等人。(4)使用器官采购和数据网络来检查65岁以下成年心脏移植受者的保险支付者组合的全国趋势。这是一个重要的焦点，因为> 80%的成年心脏移植受者在列表时年龄小于65岁（4）。从1997年到2017年，公共保险覆盖的成年心脏移植受者比例出现了显著趋势。医疗补助的比例，
Health care insurance is a prerequisite for heart transplantation in the United States (1); medical necessity alone is not sufficient for heart transplant listing. Financial means are also required. With 10% of nonelderly US residents remaining uninsured (2), many patients are faced with a rate-limiting step when considering advanced therapies for heart failure. Among the insured, decisions are complicated by level of deductibles and adequacy of insurance type in covering the transplant evaluation, operation, immunosuppression medications, and follow-up care. Although the Patient Protection and Affordable Care Act prohibits limiting coverage for pre-existing conditions (3), not all insurance carriers cover heart transplantation. Should all US residents have equal access to health care insurance that covers heart transplantation?In this issue of JACC: Heart Failure, DeFilippis et al.(4) used the Organ Procurement and Data Network to examine national trends in insurance payer mix for adult heart transplant recipients younger than age 65. This is an important focus because> 80% of adult heart transplant recipients are younger than age 65 at the time of listing (4). A significant trend was observed in the proportion of adult heart transplant recipients covered by public insurance from 1997 through 2017. The proportion of Medicaid and