The uninsured give more ... organs

The transfer of vital organs from the have-nots to the have-mores doesn't just play out in cinematic goings-on in seedy London hotels, but also in the humdrum precincts of the American health (couldn't) care (less) system. In a recent press release, the Physicians for a National Health Program (PNHP) reveal that "People who lack health insurance are about 20 times more likely to donate their liver or a kidney for a lifesaving transplant than to receive one".

The press release summarizes a research paper published in the International Journal of Health Services, written by Andrew A. Herring, David U. Himmelstein, M.D., and Steffie Woolhandler, M.D. Perhaps the most quotable item is this, which you may want to include in the letter I'm sure you're going to write to Senator Ted Kennedy and/or your local newspaper:

Strikingly, lack of insurance was a stronger predictor of organ donation than was any hospital characteristic or demographic factor other than age (older people’s organs are more often diseased and unsuitable for transplantation).

And this in spite of the fact that "special protocols, including guidelines adopted by Congress, have been developed to improve equity in the transplantation of organs."

PNHP is working extra hard right now because this is a critical moment for health care legislation. They ask us to write to Senator Kennedy and to President-elect Obama, asking them to support single payer; to speak out by writing to your newspaper or any other publication you have access to; to set up a meeting with your Representative asking for their support or thanking them if they are already a cosponsor; and to send a donation to PNHP.

Comments

How does lack of insurance

increase the number of donors?

I would hate to think it's what I think.

Most donors are dead,

(or "cadaveric", as the authors charmingly put it) it would appear from the paper. But there's no proposal of a causal chain that would explain why such a large proportion of donors are uninsured. We can just draw our own unpleasant conclusions.

OTOH the paper opens with a story that appears to stand in for an explanation of why few uninsured people receive donated organs:

In September of 2005, one of us (Herring), then a third-year medical student, cared for a previously healthy 25-year-old uninsured day laborer who arrived at the emergency department with rapidly advancing idiopathic dilated cardiomyopathy. The patient was ultimately deemed unsuitable for cardiac transplantation. The decision on transplantation was driven, in part, by realistic concern about the patient’s inability to pay for long-term immunosuppressive therapy and to support himself during recovery. Absent such resources, the likelihood of a successful outcome is compromised (1–4). The clinicians caring for him faced a wrenching dilemma: deny the patient a transplant, or use a scarce organ for a patient with a reduced chance of success. He died of heart failure two weeks after his initial presentation.

It's not explained why this happened in a system where "many patients who were uninsured at the onset of organ failure acquired coverage through programs such as the Medicare End Stage Renal Disease Program, as well as through the concerted efforts of transplant teams’ social workers and financial coordinators."

Policy not party!

Comment viewing options

Select your preferred way to display the comments and click "Save settings" to activate your changes.

Health Care House Parties, Corrente Style

Monroe/Seattle, WA (December 27, 2:00PM

Philadelpia, PA (December 29, 6:30 PM)

A reality-based survey for your party (as opposed to Daschle's)

Who else wants to host a House Party in real life? NY? CA? FL? Post on it!

We'll also be holding Virtual House Parties here -- with special guests!

Previous Virtual House Parties

Festivus, December 23 (roundup

Feed the hamsters...

... that work the wheels that keep the Mighty Corrente servers turning. Help us cover monthly hamster kibble anxiety:

...or provide temporary relief:

Thank you!

I support Americans United for Separation of Church and State.