Study: Rural patients get fewer organ transplants

I feel rural patients get bumped out of liver transplant lists because they do not know how to raise hell. It is not uncommon for someone who has remotely used alcohol and has no history of current alcohlism for years to be referred to expensive and unnecessary alcohol rehab after a million dollar pre-transplant work up and if the patient refuses to be quitly dropped from transplant listing. Insurance companies should include the payment for pre-transplant workup and post transplant medical therapy as a bundled fee to reduce casual referral for very expensive pre-transplant workup. Patients should be clearly told why they are not being included in a transplant list in writing. The most vocal and savvy patients go to multiple transplant centers and get listed. Often they get transplanted in a unit remote from their location. Sometimes the reason for not including a patient in a transplant listing can be as silly a reason as not being able to raise $3000. Insurance companies also play games. Once patients are transplanted they need to be covered for the post transplant treatment without any additional hassles or questions. This is one hellish area of Medicine. No easy answers as the cost of treating these kinds of hellish illnesses can bankrupt even our insurance companies. Even nationalized healthcare will not help as our country's exchequer is empty and we are living on borrowed money!