Bureaucracy is the art of making the possible impossible.
-- Javier Pascual Salcedo --
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-- Javier Pascual Salcedo --
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Dick Cheney got a heart transplant, at age 71, after only 20 months on the wait list. Authorities insist that there was no favoritism.
You know, the rest of us simply don't believe that. We might be more inclined to believe that rich and famous people don't get organs faster, don't jump the line, if once, just once, somebody rich or famous died while waiting for an organ.
There are thousands of ordinary people every year who die waiting for livers, kidneys, lungs, hearts. If it's really fair, at least one of them had to be rich or famous.
Anybody know of any?
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If you're here for info on how transplant lists work, see the comments, especially my second (long) one. When I originally wrote this, I assumed everyone knew how the lists work and why rich people don't wait, but it became obvious from the other comments that they didn't. So I explained it. Read the comments.
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4 comments:
I know that availability of organs varies by locality, and wealthy people can afford to travel and to get tested in multiple centers, and can afford emergency travel (like private planes, hello?) if an organ becomes available across the country, so they can go on multiple lists, whereas ordinary people have to be satisfied with hoping for an organ close to home. And that's why wealth gets you organs, and that's what Cheney did.
But that's also unfair!
Instead of giving the organ to the person who can afford the fastest transportation to the organ, why not give the organ fast transportation to the person? Perhaps airlines and private pilots will carry it free? That way people can be tested only once. too, in one center.
Robert Goulet died waiting on a lung transplant at age 73. Personally I think there needs to be a cutoff age for that sort of thing and if you abused yourself and that was the cause of needing the transplant it should be off the table as an option. Sorry Larry Hagman. Keep them comfortable and bid them adieu.
Heard a story about this on NPR on my way to work this morning.
Re: Keeping the patient close to home, there may not be a competent staff with a great deal of experience in transplants at the nearest facility. Do you really want them to start working on you?
The person (a dr?) being interviewed said normally the cut-off age is 65 or 70, but it all depends on the person's health. If the patient is otherwise healthy, the transplant team takes that into consideration, 70 is the new 60, etc.
I, for one, am glad David Crosby got pushed ahead of the line for the liver transplant. 1) Nobody had to die for him to get it. 2) Elton John footed the entire bill. 3) Find me someone else who sings like that and needs a liver transplant and I'll do the best I can to talk up the cause.
"Close to home" doesn't mean your local community hospital.
This is my understanding:
There are designated transplant facilities, some specializing in particular organs. Every state has at least one, many associated with universities, or there's one just over the state line.
Lists of people who need transplants are kept by the transplant centers. They examine and test you for suitability and if you are approved by their board, you are put on the list for that state and that center.
Organs are are doled out within the state of origin (where the donor died) first, going to the nearest transplant center, then to other centers in the state, then within the region, then it spreads out nationally. So if you are on the list in Pennsylvania, you'll get first dibs on organs in Pennsylvania. You'd get one from Virginia only if there was no match in Virginia.
Some states tend to have more patients on wait lists than organ donors. Other states have more donors than patients on the waiting lists. Since each center wants to do their own testing and records review, the more money you have, the more center's lists you can go on. It's to your advantage to find the states where donors outnumber patients, and get on their lists, and to get on as many as possible. Obviously, it is best to be on lists at centers all over the US.
In order to actually GET the organ, you have to be able to get to the center within X hours of notification. That's why people who need an organ will actually move to the city with the transplant center to wait. When a match is found, the best and neediest match who is on the center's list AND shows up at the door soonest gets it. Having access to a private jet to get to centers in far-flung states makes that a lot more feasible.
And that's why rich people get organs before poor people. They have been approved by more centers, are on more center's lists, and they can get to the centers quickest.
(Um, also, they can positively or negatively affect the center's fundraising, but, um, we won't mention that.)
When a very wealthy person doesn't get an organ in time, it's frequently because either they didn't make the effort, or they have a rare genetic makeup.
Re the age cutoff being based on overall health - Cheney has a VERY bad health record. It's a miracle that he's made it this far. Perhaps the age of the heart he was given (60?) was a factor. You don't put a brand new motor in a 15-year-old junker, nor a 200K-mile motor in a 2-year-old car.
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