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Controversies in Internal Medicine
September 8, 2003

Should Liver Transplantation Be Made Available to Everyone?The Case Against

Author Affiliations

From the Liver Unit, Queen Elizabeth Hospital, Birmingham, England.



Arch Intern Med. 2003;163(16):1881-1883. doi:10.1001/archinte.163.16.1881

IN A UTOPIAN WORLD, every person would get all the medical treatment required to maintain the highest quality and length of life. However, utopiameans "no place," and the reality is that resources are finite, and tough decisions have to be made as to how these should be allocated. Even within the health budget, there are competing claims for scant resources. Despite the huge sums the United States spends on health care ($1.3 trillion in 2000—13% of the gross domestic product), resources are inadequate to provide for the needs of everyone. Even though liver transplantation is an expensive therapy (billed charges for a liver transplantation are about $290 000), it is highly effective in improving the length and quality of life.