I'd say this is truly the limit, but we always seem to be finding new limits to the shame of our healthcare system.
But this is really awful and it's going to break your heart.
What follows comes from Class and Race Inequalities in Health and Health Care: INSURANCE STATUS OF U.S. ORGAN DONORS AND TRANSPLANT RECIPIENTS: THE UNINSURED GIVE, BUT RARELY RECEIVE by
Andrew A. Herring, Steffie Woolhandler, and David U. Himmelstein
This is from the introduction. It's about an uninsured patient. Andrew Herring, one of the authors of the study, encountered this uninsured American as a young medical student.
"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. 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. This tragedy inspired us to examine data on the participation of the uninsured in organ transplantation, both as recipients andas donors."
Make sure you read this carefully. "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."
You scratch your head and ask why? Because in our country, healthcare is a privilge not a right. This is why we intend to hold President Obama to his oft repeated campaign pledge to deliver guaranteed and affordable healthcare to all Americans.
Returning for a moment to the chilling account you just read, it's from a new study from a team of Harvard University researchers, writing in the current issue of the International Journal of Health Services.It reports that a representative sampling of U.S. patients in 2003 shows that at least 16.9 percent of organ donors had no health insurance at the time of their hospitalization. In contrast, only 0.8 percent of the transplant recipients were similarly uninsured; in other words, almost all recipients had some kind of health coverage at the time of their procedure.
Among the transplant recipients, equal proportions (44.2 percent) were covered by private insurance and by Medicare, a public program that serves seniors and some of the disabled (including virtually all patients needing kidney transplants). Medicaid, a government program for the poor, covered another 9 percent. About 2 percent were covered under other programs.
Among organ donors, however, insurance coverage was much less extensive.
The finding that most transplant recipients were insured at the time of their transplant had previously been known. However, the authors state, "our finding that uninsured patients frequently serve as organ donors is both new and poignant."
"The U.S. health care system denies adequate care to many of the uninsured during life. Yet, in death, the uninsured often give strangers the ultimate gift."
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).
The authors emphasize that the asymmetry of who donates organs and who receives them does not reflect "the values or intentions" of the medical transplant community, whose members avow a "commitment to equal access for all patients."
I'll add my own observations. About two years ago, I was privileged to witness an organ retrieval surgery. My friend who is a cancer surgeon, was for a time, a volunteer in the local New York City organ harvesting network.
I went with him to a very poor public hospital in Brooklyn and I watched as surgeons from all the major medical centers descended on this small, needy hospital to harvest the organs of a young woman. It was quite apparent she from a very low income family.
Did she have insurance? I don't know. If I had to guess, I'd say, probably not. I watched in tears as her family said a final farewell. She was placed on a gurney and wheeled to the operating room. Then her body was prepped by an army of nurses to give life to others. A body which undoubtedly was not entitled to healthcare or worth insuring when she was alive.
Shame on us.