Most Americans probably realize that our healthcare system is broken. With health insurance largely paid for by employers so that patients rarely see the cost of their healthcare, or with the government paying through Medicare or Medicaid, costs continue to climb while quality of service continues to spiral downward. Thus it shouldn’t be any surprise to find out that in the United States tens of thousands of people have died while waiting for kidney transplants, while at the same time tens of thousands of perfectly usable kidneys were thrown away.
There are a number of factors that go into this scandal, among them the fact that doctors are under an incredible amount of pressure to provide a satisfactory outcome. No one wants to receive a kidney and then die because the transplant failed to take. So doctors naturally try to choose only the highest quality kidneys for transplants. That leaves thousands of kidneys that could still be used with only one destination: the garbage can.
Hospital administration plays a role too, as it often costs more to transplant a lower quality kidney, yet hospitals aren’t always reimbursed for the full costs of those lower quality transplants, they just get a lump sum per transplant. Thus the incentive is to choose kidneys that will get patients out of the hospital faster. Once again, perverse financial incentives lead to suboptimal health outcomes.
Compared to countries in Europe, the United States uses much higher quality and younger kidneys. Yet the success rate of transplants is much higher in Europe than in the US, which suggests that there are significant problems with the US organ donation system. For the sake of those waiting for kidney transplants, let’s hope that there’s some real healthcare reform soon so that those who are currently at risk of dying in vain will get the help they deserve.