Couple Weigh a Heart-Rending Act

After nearly 25 years of marriage, Jeff and Rosemarie Litoff are considering a divorce. But not because of the usual problems that break up families.

Their fight is against a degenerative disease that is gradually weakening Jeff Litoff’s heart.

Last month, the 50-year-old appliance repairman was told by his doctors that, without a heart transplant, he had less than a year to live.

But at a cost of about $200,000 for the surgery and the first year of postoperative care--and with insurance covering only $50,000--the family cannot afford the transplant.

Short of a massive fund-raising campaign, divorce may be the only way to come up with the money, the couple say.

On Friday, an attorney explained to the couple how, by divorcing, they can transfer all their assets into Rosemarie Litoff’s name. Litoff can then declare himself indigent and apply for Medi-Cal, which covers the cost of organ transplants.

“I may have to divorce to live,” said Litoff, a quiet man whose rosy cheeks belie his illness.

After consulting an attorney who specializes in Medi-Cal law, Rosemarie Litoff seemed pleased to learn that divorcing in order to qualify for Medi-Cal is legal. “It is finding a way to use the law the way it is written,” she said.

The divorce would take place on paper only--Jeff would not have to move out of their Newbury Park home.

Sitting at the kitchen table last week with their 19-year-old son, Brett, the couple said that although they consider divorce a bad option--an unethical stab at “beating the system”--it is a step they are willing to take.

“It stinks,” said Rosemarie. “It is basically taking it out of the taxpayers’ pocket, but if we can’t do it any other way, it is a possibility.”

Stuck in a system where only the very rich, the very poor or the well-insured can afford the lifesaving transplant surgery, they are not the only ones to consider the option, said Andrew Prislovksy, a patient coordinator for Tennessee-based Organ Transplant Fund Inc., a national nonprofit organization that helps patients raise money for transplants.

“It is one of those things that people have to do,” he said. “We are sometimes raising money just to help people stay together.”

Prislovsky will help coordinate fund-raising efforts to enable the Litoffs to afford the transplant without divorcing.

“We are going to do everything we can so they don’t have to exercise [the divorce] option,” said Alan Greenbaum, a rabbi at Temple Adat Elohim in Thousand Oaks, where the couple worship.

The Litoffs’ problems began in November 1991 when Jeff Litoff was hospitalized after a major heart attack. During surgery, doctors discovered that he had four blocked vessels and that a degenerative heart disease had weakened 80% of his heart muscle.

Litoff’s heart was pumping less than half the normal amount of blood, said Dr. John Hess, his cardiologist at Westlake Medical Center.

After unblocking two of his four clogged arteries, doctors prescribed a medication and a no-salt diet.

But his heart has continued to deteriorate. A once-active scoutmaster, he had to give up hiking with the group. Now he only attends meetings.

“I look after him a lot now,” said Brett, a sophomore at Moorpark College. “If he starts to lift something, my mom and I yell at him.”

When it became clear that medication wasn’t stabilizing his condition, Hess sent Litoff to the UCLA Heart and Lung Transplant Program for tests. Last month, he became a candidate for a transplant.

Not only did he qualify, UCLA doctors said, Litoff was also told that the waiting list for a heart of his blood type is very short.

But there was a catch: To be put on the list, he had to prove that he could pay for the operation. And with a dwindling income and skyrocketing bills, the Litoffs didn’t qualify.

“They have to be prepared to support the organ,” said Ruth Irwin, manager of financial counseling at UCLA Medical Center. “It is a very scarce resource, and you don’t want a patient to lose it because they can’t pay for it.”

The family used to have a plum package of insurance benefits but lost them last year when Rosemarie Litoff lost her job at a small mail-order company because of downsizing.

The only private insurance they could find will pay only $50,000 a year for Jeff’s medical costs, a fraction of the estimated $200,000 bill for the first year of transplant care.

Meanwhile, Jeff’s income has dropped by 75% since his illness began. And although Rosemarie has started her own mail-order business, she had to take out loans from family members to do it, further restricting the family’s finances.

“We are trapped,” Jeff Litoff said. “In order to get a heart, we have to be financially secure or . . . “

“Or he has to become indigent,” Rosemarie Litoff concluded.