These numbers were obtained from official OPTN data. I did not include non-citizens who claim the US as their primary place of residency, nor those whose citizenry was ‘unreported’. I began this venture because a proposed OPTN policy sought to ‘gather’ data on this matter* and ultimately loosen restrictions on giving organs to non-citizen, non-residents.
685 – the number of non-citizen, non-residents (aka foreign nationals) given deceased donor kidney transplants in the US between 2000-2010.
The biggest culprits, percentage-wise?
45% – Arrowhead Regional Medical Center – California
26% – UCI Medical Center – California
25% – St. Mary’s Hospital (Mayo Clinic)
And by flat numbers?
47 – U of California, San Francisco, Medical Center
45 – St. Vincent Medical Center – California
43 – Jackson Memorial Hospital – Florida
27 – Brigham and Women’s Hospital – Teaching affiliate of Harvard, Boston MA
What’s important to keep in mind when assessing these numbers is that while Medicare has a provision for the treatment of end-stage renal disease, it is only available to US citizens. Resident, low-income, non-US citizens can obtain Medicaid benefits, but those programs are a mix of federal and state money, administered by the state, and generally do not pay for kidney transplants. Unlike liver, hearts or other organs, kidney disease has another viable treatment – dialysis, which Medicaid does cover.
Consider: the average onset of end-stage renal disease in the US is 64.4 years old, so the vast majority of kidney transplants are paid for by Medicare. Medicare’s reimbursement rate is far lower than that of private insurance, and big-time lower than the hospitals’ actual charges.
This means that all of the non-resident foreign nationals that come to the US are paying full freight for their transplants. Needless to say, this can be quite the lucrative revenue stream. Seen from that perspective, we can understand why the US hasn’t followed in the footsteps of England or other countries in prohibiting non-citizen, non-residents from obtaining deceased donor transplants.
*You have every right to be confused. Why would they need to gather data when I have it in my hot little hands? Because the guy heading the committee is affiliated with a transplant program that makes big cash doing these sorts of transplants and he really doesn’t want the gravy train to stop.