It helps to be rich if you need an organ:

To find matching donor organs, transplant centers rely on the United Network for Organ Sharing, or UNOS, a nonprofit organization that maintains a nationwide patient waiting list. Organs are then typically dispensed to the sickest patients or to those who have been waiting a long time.

UNOS maintains the list, but it’s left up to 256 organ transplant centers across the United States to decide who gets on the list. Each center sets its own criteria, which often include the patient’s ability to pay.

Laura Siminoff, a bioethicist, called this the “wallet biopsy,” during which a person’s financial standing comes under scrutiny.

“Every transplant center can do what they want,” said Siminoff, who directs the bioethics program at Case Western University and is a board member of the Minority Organ Tissue and Transplant Education Program in Cleveland. “Centers have different practices. And if you’re a well-to-do patient, you can shop around to centers. But if you don’t have any money, you will go wherever is closest, and their policies are what you are stuck with.”