Let’s give credit where it’s due: Transplant surgery, in popular lore, has become one of modern medicine’s most miraculous practices, not only saving individual lives but also blazing new frontiers about the functions of organs in the body and providing insights of large significance into the workings of the human immune system. This progress hasn’t come without considerable cost to health care as a whole — and recent developments should prompt some deep thinking on how transplants work now.
First, let’s look at the disturbing study that suggests that wealth gives patients needing a transplant an edge when it comes to getting an organ. As the Associated Press notes in describing the research just presented to the American Heart Association, “You can’t buy hearts, kidneys or other organs but money can still help you get one. Wealthy people are more likely to get on multiple waiting lists and score a transplant, and less likely to die while waiting for one …[This work] confirms what many have long suspected — the rich have advantages even in a system designed to steer organs to the sickest patients and those who have waited longest. Wealthier people can better afford the tests and travel to get on more than one transplant center’s waiting list, and the new study shows how much this pays off.”
Who is to blame for this seeming inequity or gaming of the system? The United Network for Organ Sharing, or UNOS, has a government contract to run the system that decides who among 100,000 Americans waiting for various organs will get one suitable for transplant. The independent body “considers medical urgency, tissue type, distance from the donor, time spent on the waiting list and other factors.” Despite criticism of its practices, such as occurred when Apple tycoon and California resident Steve Jobs got on the liver transplant list in Tennessee, UNOS allows patients to traverse the country seeking the optimal situation for themselves and possible procedures. To even get on the lists, however, the patients–each time–must fork over, depending on the organ the need, anywhere from $23,000 to $51,000 for various suitability tests. Ouch.