A national task force recommended yesterday that all public and private health insurers, including the Medicare and Medicaid programs, pay for heart and liver transplants for beneficiaries meeting appropriate medical standards.
For heart patients, such standards generally require the patient to be otherwise in good health and under age 55.
The task force, appointed by then-Secretary of Health and Human Services Margaret M. Heckler in January 1985 under a law sponsored by Sen. Albert Gore Jr. (D-Tenn.), also recommended that the government pay for heart and liver transplants for Americans who do not have health insurance.
Some state Medicaid programs and private insurers do pay for heart or liver transplants. HHS Secretary Otis R. Bowen announced June 27 that Medicare will start paying for heart transplants but not for most liver transplants, because officials still consider them experimental.
Task force Chairman Olga Jonasson, a professor of surgery at the University of Illinois, said the task force recommended that for any transplants it finances, the federal government pay for outpatient drugs to prevent the body from rejecting the transplanted organ; these may cost up to $5,000 a year. Bowen, in his June 27 decision on Medicare heart transplants, had excluded such drug payments.
The task force proposed that the government set up a national network for organ sharing, with uniform standards for organ procurement and distribution to help guarantee fairness. "No one should be able to reach the top of the waiting list by influence or by money," Jonasson said.
The report was released at a Senate news conference convened by Gore. Jonasson said HHS had claimed that it could not find a room to hold it. Gore said a room was "denied" because the Reagan administration wants to "bury" the report for fear of the costs of expanding transplants along the lines suggested by the task force.
HHS said later that it had expected the report to be released in Chicago, and had not received an official request for a room here.
Referring to reports that well-to-do foreigners are coming to the United States and obtaining transplants ahead of Americans, the task force recommended that nonimmigrant aliens be eligible for no more than 10 percent of the kidney transplants from deceased persons, and that they be eligible for other organ transplants "only when no suitable recipient who is a resident of this country can be found."
Although between 17,000 and 26,000 brain-dead bodies annually have organs potentially suitable for transplant, a variety of barriers, particularly lack of family consent, limited heart transplants to only 730 last year. The task force said it is essential that states require hospitals and agencies to identify cases where organs might be available.
The report estimated that its recommendations would cost up to $62.5 million a year.