U.S. Aides Back Medicare in Some Heart Transplants

Top health officials of the Department of Health and Human Services have recommended that the government begin paying for heart transplants for a limited number of Medicare patients--those under about age 55--and Secretary Margaret M. Heckler is “favorably disposed” to the idea, sources said Friday.

In addition, the Public Health Service is recommending that the new multimillion-dollar Magnetic Resonance Imaging machines, which provide far better pictures of the central nervous system and of the soft tissues inside the human body than X-rays or CAT-scan devices, be approved for use on Medicare patients generally.

Sources said that the department is likely to adopt that recommendation also.

Huge Costs Involved

Approval of the recommendations would be a watershed in introducing some of the most advanced new technologies--capable of producing enormous health improvements but also of generating huge costs--into the nation’s largest medical program, which now totals about $70 billion a year.

Although immediate costs for transplants would be small because of the age-55 limitation, many politicians and health specialists fear that political pressure would eventually lead to a higher age limit to include far more patients.

Heckler has made no decision on the transplant recommendation but previously made clear that she would favor Medicare transplants if costs could be curbed.

Decision Postponed

In May, she appeared ready to signal a go-ahead but postponed a decision and ordered the Public Health Service and the Health Care Financing Administration to study the issue further.

Those two agencies have now developed a plan for Medicare coverage of heart transplants that would limit eligible recipients to those whom medical specialists consider the best candidates--generally people under their “mid-50s with adequately young physiologic age to permit successful transplantation,” and in most cases, free of other serious conditions.

The memorandum estimated that only 500 people by 1990 would be eligible for the Medicare heart transplants, adding that by then costs would run to no more than $50 million.