Cost denies an undocumented immigrant a kidney transplant

You’re in your 30s. You work hard. You strive to master your craft. You support your extended family. You are liked by both your co-workers and boss.

Problem: You unexpectedly become unhealthy–you find out your kidneys are failing.

Solution: Regular kidney dialysis can keep you alive, by filtering toxins out of your blood.

Problem: Dialysis is time consuming (>3 hours/session, 3 sessions/week) and leaves you feeling tired and weak.

Solution: Your brother, who is a tissue match, offers you the gift of a lifetime–one of his kidneys.

Problem: Because you don’t have health insurance (you are covered under the Medicaid program for your “emergency” dialysis only) you are deemed ineligible for the transplant surgery.

Fact: The estimated cost of dialysis is $75,000 per year. The cost of the transplant surgery and care is $100,000, with an additional $10,000/year in anti-rejection medication costs.

Fact: Research shows that transplant pays for itself vs. the cost of dialysis at four years. Beyond that point, transplant is a tremendous cost saver overall. Patients feel better and live longer with transplant, too.

Solution: Surgeons at a medical center agree to waive their fees to perform the transplant.

Problem: The hospital still won’t allow the transplant to go forward.

Solution: Your kind boss offers to pitch in for health insurance.

Problem: You are denied because your kidney disease is a “pre-existing” condition.

Solution: Raise $200,000 to pay the hospital up front for the cost of the operation and any potential complications.

Any readers out there willing to step up?

You can read the full story of this patient’s plight here. Pay attention to the comments below the article to see the extremes of opinion.

The patient in question is an undocumented immigrant. His children were born here and are citizens. He meaningfully contributes to the community.

But because of his status, he’s out of luck in the sweepstakes world of health care.

John Schumann is an internal medicine physician who blogs at GlassHospital.

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  • Anonymous

    What about all the legal citizens of this country- we who were born here, we who pay taxes here, we who contribute to the society here, who require similar care but who have no other country to fly back to receive the care we request at far cheaper prices, if need be?

    What about us, the ones who don’t get write ups in the NYT, the ones whose bosses don’t go to bat for us, assuming we have bosses at all?

    What about us, the ones who are going to have to eat the cost of his anti-rejection medication should he receive the transplant, but who struggle to ensure we and our family will have enough food to eat?

    What of our plight? Who is going to step up for us?

    • Brian Curry

      I fail to read anything in your comment that directly addresses the problem at hand, and find myself wishing I had that minute I wasted on it back.

      • Anonymous

        I did address it- the NYT article states that he can receive the transplant in Mexico for far cheaper.

        Why are we duty-bound to provide this service to someone in this country illegally when he can go back to his own country and receive it? What about everyone else, people actually from here, in similar situations? No one’s talking about them, or fighting for them.

    • Naomi

      At least “we” get a minimum wage, don’t break our backs for 3$ an hour, and can’t be dragged off to detention centers where illegal immigrants are kept for one year even if they have been living here for 20 years and built a family. Much of these illegal’s problems are not entirely their faults.

      The US has, for too long, ignored the problem of illegal immigration – they are only reacting. The result is that many of these hard laboring immigrants have been living among us for 20 years without the benefits that we are entitled to – and now they must leave instantly. BTW. 48 % of Americans don’t pay income tax (and it sounds like you don’t either).

      • Anonymous

        I do pay income tax; I have a well paying job in the medical industry.

        They absolutely do work in deplorable conditions, with little-to-no protection, that much is true. And it’s shameful. Most in this country never realize just how much we rely on them, or what would happen if they were all to be deported.

        The point is this: they chose to be here. I realize Mexico is far from an ideal place to live, and I see why they’d want to make a better life for themselves and their descendants, but our resources aren’t unlimited, and I fail to see why we are bound to provide the transplant when, as the article states, he could return to his home country and receive it for far cheaper.

        It’s sad. I’m not arguing otherwise. But so is what is happening to people across the country in similar situations who are actually citizens of this country and require similar care. No one’s mentioning them. No one is fighting for them. The original poster asks if anyone will step up for the illegal immigrant, but who is stepping up for everyone else in similar situations to this who were actually born here?

        • ninguem

          The illegals working in the “deplorable” conditions (by our standards) are there because the conditions, bad as they are, are still a step up from where they came from. Pretty much a tautology; if worse than where they came from, they never would have come here.

          If you could snap your fingers and magically make those illegals working under deplorable conditions……..LEGAL…… you think they’d stay at those jobs?

          As fast as you snapped those fingers, they’d leave those arguably deplorable jobs, in favor of jobs with better pay or working conditions.

          As far as I’m concerned, they’re a slave class.

      • ninguem

        Except for the people who DON’T get a minimum wage because they aren’t hired in favor of illegals. The illegals have those jobs because they don’t have legal standing to defend themselves against even minimum employment standards for pay and safety.

    • Lata Potturi Schaedler

      I agree with you. It’s not that I don’t sympathize with the plight of this unfortunate man, but I do wonder when we will write about our underinsured American citizens, even veterans, who are unable to get similar life saving treatments and surgeries. It seems odd that an illegal immigrant is getting so much press.

  • ninguem

    Undocumented means you left your driver license at home.

    The individual in question is not undocumented, he is in the country illegally.

    I would not expect Mexico or Canada or the UK or Germany or China or anywhere else to do surgery on me for free if I were in tieir country illegally.

    • Anonymous

      Interestingly enough, I have read many stories of just that -Americans visiting England or Germany, for example, and getting free medical care in an emergency.

      • Lata Potturi Schaedler

        This case is not an emergency, and we do plenty of that here as well. We also deliver millions upon millions of babies to illegals, paid for by the taxpayer. Do not argue that the US is not generous with its medical care!

        • ninguem

          Exactly, this is NOT an emergency, and I’m sick and tired of people who conflate the two…..deliberately. The idea is to demonize people as wanting to let acutely ill people die in the streets.

          The same thought pattern that gets people opposed to ILLEGAL immigration demonized as “against immigration”, or opponents of the Obama health plan as “against healthcare”.

          We provide the emergency care…….always…..without regard to citizenship status. And the Brits, Germans, etc., are not about to provide chronic care to an American, apart from…..maybe…..highly unusual circumstances preventing the individual from getting repatriated.

  • Anonymous

    This person should inquire of his state insurance dept whether there is a high-risk insurance pool, for people who have been denied health insurance because of a previous condition. This is funded by the health insurers in his state who are obligated to contribute money to it. There is also a federally funded high-risk pool in some states. The coverage is high, but if his employer is helping, it’s a lot cheaper than paying out of pocket for dialysis or a transplant.

    Also, call public attention to this hospital’s actions. Hospitals typically brag about their “charity” care (the cost of which in reality is passed on to people with health insurance through higher fees).

    As a last resort, if his country of origin has universal health care, go home for treatment – it’s a matter of life or death.

    Meanwhile, consider some milkthistle for liver health.

    • Anonymous

      whoops, not liver, kidneys, sorry.

  • Anonymous

    Just to hihack this thread a little.  I’m in California and we now have what’s called the “Dream Act” which is a set-aside of $50 million a year specifically for illegals (or their children) to attend the Univ. of California. 
    The only requirement for this grant, besides being illegal, is that they be in the state for at least 3 years. At the same time, our governor is proposing a massive tax hike, because we are so broke, which includes a second 10% increase in university fees for the rest of the population. When you add this to the publically funded extreme medical care proposed for this group, no one should be scratching their heads when citizens who don’t share in these privileges, voice their resentment.

  • Margalit Gur-Arie

    This person has been working since he was sixteen, supporting a family and, according to the article, he was PAYING TAXES, which is more than some corporations do, and more than some citizens do.

    This may not be an emergency, but since, under current regulations, we are providing for his dialysis and will continue to do so until he dies, wouldn’t it be cheaper (as the author points out) to pay for his transplant?

    In other words, if we won’t provide help to save a life, could we provide help to save a dollar?

  • Anonymous

    The lack of health insurance and/or the cost of an operation denies many people needed medical services.
    This individual is in a very difficult and life threathening situation. I hope he finds a way to return to his native land for treatment and fully recovers.

  • ninguem

    I think foreign-trained foreign-national doctors might be a reasonable comparison.

    None of this is meant to disparage FMG’s, IMG’s, whatever term we use these days.

    Foreign physicians do not solve the problem of access to underserved areas. Foreign physician demographics match the demographics of USA physicians. It’s shown time and again, you want doctors in rural areas, you train physicians FROM those areas, and even better, TRAIN them in those areas, and they are more likely to go to the rural area that’s their home.

    You get the foreign docs in the rural areas on the J-1′s because they’re forced to go there if they want to stay in the USA. As soon as they have served their obligation, they find more desirable locations to practice…….and I don’t blame them.

    ILLEGAL immigrants (sorry, not “undocumented”), work these undesirable jobs because they have no choice if they want to be in the USA. So they work jobs where their rights are compromised because of their illegal status.

    Snap your fingers and make them legal, and in a heartbeat they will leave those jobs to something that pays better and gives them basic workplace rights. Same as the foreign docs do, the instant they are freed from J-1 obligations.

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