Economic Inequity in Organ Distribution

This month’s theme is to #MakeTransplantsFair by addressing the economic inequity within the current organ transplant system. There’s no simpler way to put it: the more money a patient has, the easier it is for that patient to receive a transplant. Every candidate for a life-saving transplant should have an equal shot at getting one, regardless of where you live and how much money you make.

The status quo creates an unfair divide between wealthier patients in regions with superior access to organs and those who will continue to wait – even if they may have a more pressing need – and don’t have the necessary economic means.  Experts within the transplant community generally agree that factors such as socioeconomic status, race, gender, and where you live should not determine your access to a transplant.
For poorer patients, Medicaid is not portable. Therefore, patients with Medicaid cannot even consider getting a transplant in another state if they are disproportionately affected by the geographic barriers set up in the current system. Additionally, travel is an expensive option.  Often times, only those with great means can afford to get on the waiting list in another state or leave their jobs to live somewhere else.
If the implementation of an organ transplant model results in a significant mortality gap between men and women, or between people of different racial identification, or between the wealthy and the poor, then it must be adjusted accordingly. Sadly, the current system does not reflect this line of thinking, leaving the roughly 120,000 men, women, and children who are waitlisted in the current transplant system on an unlevel playing field that values wealth over need.
CODE has long advocated for reasonable and measured approaches that would ease the challenges presented by these inequities, The Liver Committee’s own analysis has demonstrated that sharing livers within a reduced number of zones would save hundreds of lives and bring overall health costs down nearly $250 million over five years. To meet the goal of reducing disparities, increasing access, and ensuring fairness in the nation’s organ distribution system, there must be a system in place that puts patient need –not wealth—first.

Billy Wynne