PORTLAND, Ore. -- No matter how you do the math, it never adds up for Brandy Stroeder -- or Gov. John Kitzhaber, or Brandy's doctors, or the Oregon Health Plan.
Time is running out for 18-year-old Brandy, who needs a $250,000 combination liver and lung transplant her family cannot afford and the health plan refuses to pay for.
Without the procedure, the teen will die from cystic fibrosis, a genetic disorder that fills lungs with mucus and kills its victims just when they should be blossoming into young adults.
With it, the odds are that Brandy will still die young -- but, doctors say, it could buy her precious time, maybe even a few years.
Under a plan created by Kitzhaber, a former emergency room doctor, Oregon became the first state in the nation to combine state and federal funding to form a safety net for the sick who cannot afford medical care. The system supports about 350,000 poor, disabled and uninsured state residents.
The Legislature decided the only way it can afford to pay for coverage is by drawing up a list that ranks treatment according to the medical odds -- the best chances of recovery go to the top and the worst drop to the bottom.
Other numbers are factors, too, such as how many people would benefit. The more who would be helped, the better the ranking.
In Brandy's case, the cost is high and the benefits apply to just a tiny handful of people. The governor says the numbers don't add up.
''It is a tragedy brought about by the reality of limited public resources,'' said Kitzhaber, who has backed the decision of the state Office of Medical Assistance Programs to deny coverage for the double transplant.
''It's not as simple as one plus one equals two,'' said Hersh Crawford, the agency's director.
''When you get into multiple organ transplants, you get into a more complicated medical outcome,'' he said. ''Multiple organ transplant surgery is not being done at the level as single organ transplantation is being done today, and it does not have the long history of single transplant procedures.''
Brandy's family has gone to court to overturn that decision. A preliminary hearing is scheduled for June 15 in McMinnville, the teen's home town, where she graduates from high school the following day.
Her lawyer, Frank Weiss, is seeking an injunction ordering an evaluation at Stanford University Medical Center to determine whether she's a good candidate for the procedure. If Stanford, which has never performed the combined transplant, decides she qualifies, she could be placed on the organ recipient list.
If a judge denies the request, Weiss will have to turn to the Oregon Court of Appeals. He fears a decision may come too late to help Brandy.
''If it doesn't happen soon, it could be a hollow victory,'' Weiss said.
Brandy's mother, Karen Stroeder, who works two jobs to support her two children, said Brandy just wants a chance to start her dream of becoming a chef and maybe even run a bed-and-breakfast inn some day.
On the Net: United Network for Organ Sharing: http://www.unos.org
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