How the Organ Transplant System Is Stacked Against the Most Needy

The original title of this article is "How the Organ Transplant System Is Stacked Against the Most Needy, and Why You Should Be a Donor".
But they never give a reason someone who cannot themself afford to receive a transplant, should offer to be a donor. I note that to do such a thing for the sake of some stranger is a liberal thing to do. Frankly, I do not want my organs going to save the lives of some conservatives who don't care about others.

http://www.alternet.org/health/152074/how_the_organ_transplant_system_is_stacked_against_the_most_needy,_and_why_you_should_be_a_donor?utm_source=feedblitz&utm_medium=FeedBlitzRss&utm_campaign=alternet

August 19, 2011

Being an organ donor is simple and can save lives; conceivably, eight lives. But the system is very much in need of reform.

Ever see the bumpersticker, “Don’t take your organs to Heaven, Heaven knows we need them here!”?

Regardless of whether you believe in God, these stickers make a good point: Why are we taking our organs to the crematorium, or burying them six feet underground, when we could use them to avoid someone ending up in the same situation? And by same situation, I mean dead.

More than 100,000 Americans are waiting for lifesaving operations. Unfortunately, organ donation rates do not match organ demand. Each year 6,000 or more people die waiting for organ transplants. What’s more, because the organ transplant system operates with a built-in bias against the poor, minorities are nearly half as likely to receive organs, even though they are more likely than whites to need them. In 2008, 7,182 people died waiting for organs; 4,638 people died waiting for kidney transplants, and 1,542 of them were black. In other words, 64 percent of deaths on waiting lists are for kidneys, and 33 percent of deaths on the kidney waiting list are black patients.

Blacks in America donate organs (13 percent of donors) at about the same rate they make up the population (14 percent), but they represent a disproportionate 35 percent of the kidney waiting list. More problematic is the fact that many in need of an organ do not even make the lists, or not in time, stymied by a complex patchwork system that discriminates against poor and minorities in any number of ways, many of which can be fixed.

[...]

During dialysis, patients deemed to be physically, mentally and economically able to undergo a transplant receive a transplant referral. However, the amount of time dialysis demands makes many poor people unable to make all of their appointments. Health providers then label the poor “non-compliant,” as opposed to “disadvantaged,” and assume that they will not keep up with the after-care necessary to maintain a successful organ transplant.

The problem is not that minorities choose to stay on dialysis, but that they struggle to meet the demands of the system. “We often require multiple tests or procedures to be done for patients right before they are perceived to be appropriate for the waiting list. If you take patients who are, broadly speaking, financially disadvantaged -- many significantly so -- all are also time-disadvantaged because they’re on dialysis, which is taking up three days a week,” said Norman.

Disparity in time from dialysis to wait list would not end, however, with incentivizing referrals. The reality is that those who cannot make it to dialysis regularly would probably not be able to keep up with vital transplant after care, but not due to lack of compliance. According to Callender, Medicare covers about 80 percent of expenses in the first three years following an organ transplant. After three years, patients must come up with the annual $10,000-$20,000 necessary to take the medicine vital to preventing organ rejection. While transplant centers and organizations work with patients so that most can afford the medication, some cannot find another health insurance plan to take over where Medicare left off. If they cannot come up with the cash, the organs will actually be taken back, and the patient must go back on dialysis, which, at $50-60,000 a year, costs a whole lot more than the transplant medication, but is covered by Medicare. In the words of Callender, the policy “makes no sense.”

[...]

Another possibility is making organ donation part of an “assumed” process -- requiring people to opt-out of organ donations, e.g. when they get drivers' licenses and denying families the opportunity to prevent their kin from giving organs upon death.

[I consider this proposal immoral as long as people who need organs cannot get them because of lack of money.]
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