Since 2003, UNOS has required that transplant centers inform all candidates that they can be evaluated and listed at more than one center, and that they can also transfer their care from one center to another without losing the time they have accrued on the waiting list. However, not everyone can afford to fly around the country and be evaluated at more than one transplant center. In fact, many people can’t afford a liver transplant, period.
According to the most recent estimates, the cost of a liver transplant is $519,600—a price tag that excludes roughly one-third of Americans because they don’t have sufficient insurance (or any insurance), Caplan estimates. According to data collected for UNOS, only about 5% of liver transplants are paid for out of pocket.
“What your insurance covers is very different from everyone else’s,” says Anne Paschke, a spokesperson for UNOS. Some insurance companies won’t cover evaluations at multiple transplant centers, Paschke explains, and in at least one case, an insurance company has restricted its coverage to a single transplant center that the company itself owned.
Moreover, your insurance continues to be important during the evaluation process. The decision to accept a transplant candidate takes place before UNOS enters the picture, and the committees that determine whether a patient is added to the transplant center’s waiting list have access to a patient’s full medical and financial history.
“There’s a huge triage involved in getting in,” says Caplan. “If you’re a homeless alcoholic sleeping on the streets of L.A., and you’re going toe-to-toe with Steve Jobs, you’re going to lose.”
For most people, the ability to pay is a precondition for acceptance at more than one transplant center. Wealthy people who are, in effect, financially “pre-approved” for a liver transplant, can shop around and identify the transplant centers that will give them the best chance of receiving a new organ.
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Did Steve Jobs’s Money Buy Him A Faster Liver Transplant? Vote
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There’s one question that nobody seems to be asking about Steve Jobs and his liver transplant: is Steve Jobs a registered organ donor?
It’s not fair to give an organ to a non-donor as long as there is a donor who needs it. But about 50% of the organs transplanted in the United States go to people who haven’t agreed to donate their own organs when they die. It’s no wonder there’s such a large organ shortage. If organs were allocated first to organ donors, more people would agree to donate and fewer people would die waiting for transplants.
Anyone who would like to donate their organs to other organ donors can join LifeSharers at http://www.lifesharers.org or by calling 1-888-ORGAN88. Membership is free. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.
Regarding the question of whether Steve Jobs is a registered donor, we should hope that he is not. Anyone who has been diagnosed with an metastatic cancer, such as Jobs’ pancreatic cancer, is inelibible to donate blood or tissues. There have been cases in which tissues were transplanted from dead people to patients, and later it was determined that the donors had undiagnosed cancers that had already invaded the grafted tissues. Transplanted cancer cells can spread in recipients quickly due to the immunosuppressive drugs these people take to prevent rejection of the grafts.