At present, the state of Arizona is locked in a budgetary crisis for which there are no good choices. We have discussed this at some length in the past. While Medicaid (AHCCCS) cuts for transplant have been in the news a great deal lately— and have made it to the top of the legislative agenda largely on the heels of this attention– the daily loss of limb that is occurring as a consequence of the lack of podiatric services is arguably just as troublesome. This problem is no longer an abstraction. While we are working diligently to find other ways for them to be seen, we are failing more often than not. These are not patients who will die immediately. They won’t make headlines. They won’t make noise. Rather, they will wither away– limb by limb.