There's an article on kidney donation in the New York Times Magazine today. The author is Sally Satel. She is a Scholar at the conservative think tank, the American Enterprise Institute.
Dr. Satel has written an essay on what it's like to be sick and need an organ transplant in the United States, where it remains illegal to pay for an organ.
Sally is a psychiatrist.
A couple of years ago, Sally was diagnosed with end stage renal disease. Sally was told she needed a kidney transplant.
In the essay in the New York Times Magazine, Sally describes in excruciating detail, how she got lucky and received a kidney.
Sally thinks our system for allocating organs isn't working. She believes there should be a "booming" market for organs. Hey, we all have two and we only need one, right? If the system were working, she argues, organs would be readily available. Sally believes if there were incentives, people would donate.
I'm going to tell you right in your face, what this woman is hinting at in this loathsome article. But like all of these cowards, she doesn't come right out and say what she really thinks. Actually, I'm being far too polite, she's more than hinting.
She thinks if we, as a nation, offer incentives, one of which she suggests should be "Medicare for life", people would line up to donate their organs.
This lady is talking about trading insurance and access to affordable and guaranteed healthcare for the 47 million uninsured, in exchange for their body parts.
Sally is free to write anything she damn well pleases. It's sad but not surprising that the New York Times would publish such garbage. The intersection of conservative free market hucksterism, and how to allocate scarce and desperately needed organs, is especially perilous territory for someone like Dr. Satel with a lunatic agenda.
Theoretically, kidneys should be in booming supply. Virtually everyone has two, and healthy individuals can give one away and still lead perfectly normal lives. Yet people aren’t exactly lining up to give. At the beginning of 2005, when I put my name on the list, there were about 60,000 people ahead of me; by the end of that year, only 1 in 9 had received one from a relative, spouse or friend. Today, just under 74,000 people are waiting for kidneys.
Donor's need to be motivated. Offering donors, um, health coverage, what she calls "lifetime Medicare coverage", would motivate people to become organ donors.
Well, we certainly have an army of 47 million uninsured Americans, middle class, low-income many of whom might jump at the opportunity to donate an organ in order to get health coverage. If Sally and her ilk had their way, this is what could happen.
Do you want to vomit?
Altruism is a beautiful virtue, but it has fallen painfully short of its goal. We must be bold and experiment with offering prospective donors other incentives for giving, not necessarily payment but material reward of some kind — perhaps something as simple as offering donors lifelong Medicare coverage. Or maybe Congress should grant waivers so that states can implement their own creative ways of giving something to donors: tax credits, tuition vouchers or a contribution to a giver’s retirement account.
In short, we should reward individuals who relinquish an organ to save a life because doing so would encourage others to do the same. Yes, splendid people like Virginia will always be moved to rescue in the face of suffering, and I did get my kidney. But unless we stop thinking of transplantable kidneys solely as gifts, we will never have enough of them.
I have no doubt despite her access to the healthcare so many of her fellow citizens can only dream about, Dr. satel suffered throughout her ordeal. But her heart, to say nothing of her medical training, certainly doesn't extend beyond her own personal drama. But this is the way these people behave. As Michael Moore said in SiCKO, as Americans we have a looming choice. Either our healthcare system is what Sally advocates, it's about me, or it's about all of us.
Sally has been writing about her health issues and her need for a kidney for some time. Most Americans who need organs, don't have multiple opportunites to write in the New York Times about their search for an organ donor as sally has.
But writing so much leaves Sally with a paper trail of hypocrisy.
Here's what she wrote in the New York Times in 2005.
At the time, she was appalled that an inmate would request payment for his kidney. And equally appalled that it's a felony to pay for an organ.
Most of the people who contacted me knew that they could receive no payment.
One exception was an inmate in a Kentucky penitentiary who wanted $900,000. In meticulous penmanship, he wrote: "What is life worth to you? If you do not have this kind of money, I am sorry. I cannot help you." It was as if he were holding his kidney hostage.
. . .I would also have gladly paid for a kidney, but that is a felony under the National Organ Transplantation Act of 1984.
Once Sally got her kidney--for free--from a libertarian-minded kindred spirit, she launched a new AEI sponsored campaign to make organ selling acceptable.
Here's what Sally wrote in an American Enterprise Institute publication after she received her kidney.
Organs for Sale
Don’t get me wrong. Altruism is a beautiful thing--it’s the reason I have a new kidney--but altruism alone cannot resolve the organ shortage. For that reason, more and more physicians, ethicists, economists, and legal scholars are urging the legalization of payments for organs in order to generate more kidneys for transplantation. One doesn’t need to be Milton Friedman to know that a price of zero for anything virtually guarantees its shortage.
Sally's solution is crafted, I would argue, right out of the AEI, George Bush, Mike Huckabee, Rudy Giuliani, Willard Romney play book. She's far more eloquent than me, these are her words.
The best answer is by creating a market arrangement to exist in parallel with altruistic giving. Within such a framework, any medical center or physician who objects to the practice of compensating donors can simply opt out of performing transplants that use such organs. Recipients on the list are free to turn down a paid-for organ and wait for one given altruistically. Choice for all--donors, recipients, and physicians--is enhanced. And it is choice in the greater service of diminishing sickness and death. Paradoxically, the current system based on altruism-or-else undermines the individual autonomy that is at the heart of the most widely held values in bioethics.
The rich can pay for their organs--supplied by the army of uninsured. The rest of us? Well, we can wait, and many of us will die.
This, of course, is how Republicans view access to healthcare. It's available to whomever can afford it, and
the free market tax cuts will solve all the remaining pesky problems.
The reality for many Americans who need life-saving organ transplants is bleak indeed.
Need an Organ? It Helps to Be Rich:
While Anyone Can Donate an Organ, Not Everyone Can Join a Waiting List, Especially the Uninsured, Report Says
Brian Shane Regions is dying.
Medications sustain the 34-year-old for now, but a heart transplant is his only hope of a cure for his congestive heart failure -- as is the case for the thousands of others who suffer from irreversible heart damage.
But Regions lacks health insurance and receives inconsistent care for his condition. He said some of his doctors have casually suggested that he should be on the waiting list for a new heart, but not one has helped him pursue it.
"There's really nothing I can do," said Regions, a freelance photographer in Campti, La. "I don't have the insurance to do it right now. They are treating the symptoms. I'm managing, but I know I'm slowly getting worse and it's not going to get any better."
It's the harsh reality of the organ transplant field: Patients who are uninsured or unable to pay are sometimes denied lifesaving treatment because hospitals can't afford to foot the bill for the surgery or the extensive recovery.
I'm sure the American Enterprise Institute provides Sally and her fellow conservatives with very good health insurance. This grotesque story reminds me how the wingers support the war. They love any war that requires no sacrifice--from them. They love any war that is fought by the less fortunate kid of their neighbor.
Imagine a winger
selling donating an organ to get health insurance.