Right now, a heart-breaking tragedy is unfolding in Philadelphia, where desperately ill 10 year-old Sarah Murnaghan is in a race against time as she waits for a lung transplant that is her only hope as she battles end-stage cystic fibrosis. But in Washington, Republican politicians and their media water-carriers are turning the Murnaghans' suffering into a cynical farce. After all, many of the same politicians and bloggers now denouncing the non-profit organ donor networks and HHS Secretary Kathleen Sebelius as "death panels" opposed the Affordable Care Act and its prohibitions on private insurers' lifetime benefits caps, "rescission" of coverage and pre-existing condition barriers that often meant financial ruin, death--or both--for Americans needing organ transplants. And when Arizona Governor Jan Brewer's 2010 cuts to Medicaid resulted in the deaths of patients subsequently denied transplant surgery, conservative propagandists came to her defense or simply said nothing at all.
That certainly wasn't the case Tuesday, when Sebelius came under withering criticism for her refusal to intervene in the policy of the Organ Procurement and Transplantation Network not to provide adult lungs to children under 12 until all adults and teens on the list have been offered the organs. (Unfortunately, the pediatric lungs for which Sarah Murnaghan currently qualifies aren't available.) Rep Tom Price (R-GA), a physician who famously claimed that "nothing has had a greater negative effect on the delivery of health care" than Medicare, told Sebelius she could save the child's life by "signing a paper." While Secretary Sebelius has ordered a review of the process, she argued that HHS lawyers stated she cannot personally intervene and take emergency action. And as Politico reported:

Sebelius, who would need to intervene in decisions made by a transplant panel, told a House panel Tuesday morning that she has spoken with Sarah's mother and "can't imagine anything more difficult." But she also said it isn't her job to pick and choose.
"I can't imagine anything worse than one individual getting to pick who lives and who dies," she said. Sebelius said putting Sarah next in line would disadvantage other young people who have also been waiting for transplants -- three of them at the same hospital.
"Unfortunately, there are about 40 seriously ill Pennsylvanians over the age of 12 also waiting for a lung transplant," she said.

In response, the execrable Gateway Pundit called Sebelius "pure evil" and wrongly described the tragedy as "Obamacare death panels in action." While the right-wing Ace of Spades rightly noted that "Sebelius' involvement doesn't seem to grow out of Obamacare," the blog nevertheless ominously warned:

But this little scene -- lobbying for the right to medical treatment -- will play out so many more thousands of times in the future thanks to ObamaCare.

Of course, that is exactly backwards. With its new curbs on the worst practices of private insurers and its expansion of Medicaid to millions of lower income Americans in states willing to accept it, the Affordable Care Act will help put decisions about life-saving care where it belongs--with patients and their doctors.
Just ask Jan Brewer. The Arizona Governor and Tea Party favorite outraged her GOP allies when she supported Obamacare's expansion Medicaid in her state. When she announced she would accept $1.6 billion in federal funding to provide health insurance to 300,000 of her state residents, Republicans called her a "traitor" and worse. But as in turns out, Brewer didn't just do the basic moral calculus. When she cut her Arizona's own Medicaid funding for transplants in 2010, people died.
As ABC News reported on January 6, 2011, "Two Arizona Medicaid recipients denied potentially life-saving organ transplants have died, even as Arizona doctors, transplant survivors and some lawmakers push to restore health care benefits slashed last fall." That same day, CBS News explained the impact of Brewer's decision to slice $1.4 million in funding for a host of previously covered transplant procedures in order to help close a billion dollar state budget deficit:

CBS News correspondent Ben Tracy reports at least two people have died since November. Mark Price, a father of six, died waiting for a bone marrow transplant. Now the University Medical Center in Tucson says a man needing a new liver died due to the cutbacks.
A hospital spokesperson said, "We believe that it's likely that they died because they were unable to get a transplant."
"There's absolutely no way you can justify killing people to save really a little bit over a million dollars," says Ariz. Rep. Chad Campbell (D).

Among those waiting for a double lung transplant was then 27-year-old Tiffany Tate, who like Sarah Murnaghan was failing in the late stages of cystic fibrosis. As she explained:

"If we all don't get our transplants, all 98 of us are going to die. We deserve a second chance. I didn't ask for this. I was born with this and I've fought my whole life."

Tate fought and won. But her victory came only after an anonymous donor came forward to pay the $277,000 cost of her surgery and the Arizona legislature restored funding for the hundreds of thousands of dollars of post-op care she'll need for the rest of her life.
But many others Americans haven't been so lucky. Even with insurance, the cost of organ transplants can be crippling as surgeries costing up to $500,000 are followed by years of follow-on therapy and expensive prescription drugs. That's why it so easy to find headlines about the mammoth bills and requests for donations to pay for care. (For examples, visit here, here, here and here.) Even those lucky enough to have insurance through their employer or the individual market (where it is estimated 22 percent of applicants are rejected), the staggering lifetime costs of treatment mean patients quickly hit lifetime benefits caps imposed by private insurers.
The case of 13 year old Chase McGowen, who received a rare lung-liver transplant provides a case in point. As the University of Texas web site reported in "Saving Chase":

Clinic visits, medications and medical equipment continued to eat away at Chase's insurance policy. Although the bills haven't yet been tallied, Carol McGowen figures the $1 million policy ran out sometime during the transplant...
Chase qualified for Medicaid, a federal-state insurance program that will cover at least some post-transplant expenses, because he lived apart from his dad, the family's sole wage-earner. Whether he will keep the coverage when the family reunites remains to be seen. They can't afford to lose Medicaid coverage, so perhaps, the McGowens say, Tom McGowen will have to move out of the family home. Perhaps they'll have to get a divorce. Everything is under consideration, they say, but there are no easy answers. "What we need is to win the lottery," Tom McGowen said.

Winning the lottery cannot be the basis for deciding who lives and who dies in the richest, most powerful nation on earth. As President Obama has said repeatedly, in the United States health care cannot be "reserved for the lucky." Under the Affordable Care Act; it won't. Starting in 2014, private insurers can't reject Americans due to pre-existing conditions, drop coverage when they get sick, or continue to impose lifetime benefits caps on 105 million Americans. Millions more Americans will gain insurance through the expansion of Medicaid and subsidies for private policies.
For her part, Secretary Sebelius has ordered a review by The Organ Procurement and Transplantation Network which sets policies for transplants and works with the nonprofit United Network for Organ Sharing to maintain waiting lists and implement the standards. As things stand, that won't come in time to help Sarah Murnaghan and other children like her. Due to the limited supply of organs, many other families will suffer heartbreak and loss. But for those Republicans who would reject the expansion of Medicaid, call for the repeal of Obamacare and still look for sinister "death panels" to decry, here's a little advice.
Look in the mirror.