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“He Could Donate, but He Can’t Receive”: Undocumented Waiter May Die Without Funds for Transplant

by Van Le on 12/21/2011 at 3:50pm

angel on dialysis

Front paged at the New York Times today is the jaw-dropping story of Angel, a New York waiter and undocumented immigrant who may soon die because he doesn’t have the money for a kidney transplant.  You should really read the whole story here.

Angel, a husband and father of two in his early 30s, has been battling late-stage renal disease without health insurance and without papers for almost two years.  His condition, likely passed down from his father, who died of kidney failure when Angel was 8, suddenly flared up in January 2010, raising enormous complications in a life where Angel had been quietly working, supporting his mother and half-siblings, paying taxes, and learning English.

His brother volunteered to donate a kidney, but without legal status or insurance, there is no way they can afford the $100,000 operation.

Through a quirk of history, nearly all Americans suffering from late-stage renal disease, regardless of insurance status, are covered under federal Medicare for dialysis and transplantation.  Some of these benefits extend to undocumented immigrants—the government is willing to pay for a lifetime of dialysis for Angel at $75,000 a year.  But it is not willing to cover the $100,000 one-time cost of transplantation.

For some, even the thought of the government offering dialysis to save an immigrant’s life is too much.  U.S. Rep. Dana T. Rohrabacher (R-CA) believes that care for undocumented immigrants is “bankrupting American health care” and is a proponent of the idea that hospitals should hand undocumented emergency room patients over for deportation.  Rohrabacher had no sympathy for Angel and in fact, responded to his story with one of the most heartlessly crass statements to come from a public official this year:

They [undocumented immigrants] should not get any benefit from breaking the law, especially something as expensive as organ transplants or dialysis…If they’re dead, I don’t have an objection to their organs being used.  If they’re alive, they shouldn’t be here no matter what.

Angel and his brother looked at non-government options, but a private insurance plan cited his “pre-existing condition” and refused to cover him for his first year.  At one hospital, administrators overruled surgeons who volunteered to waive their operation fees.  At another, a counselor told Angel he would have to pay twice the usual $100,000 cost in advance, to cover any complications.

Surgery back in Mexico would only cost $40,000.  But because Angel and his brother have already taken out loans, they would have to sneak back into the U.S. afterward to pay them back, or risk being completely cut off from their U.S. citizen children in New York.

Everywhere they look, Angel and his brother find dead ends.  If Angel could only obtain legal status, he could be covered by government Medicare.  But as millions of undocumented immigrants know, there are very, very few routes to legalization, and in any case it would likely take years.

In the ultimate irony, undocumented immigrants in the U.S. can donate organs, but cannot receive them.  “Organ registries do not record illegal status,” wrote the New York Times, “but a study estimated that over a 20-year period noncitizens donated 2.5 percent of organs and received fewer than 1 percent.”

For Angel, time is running out.  Many undocumented immigrants with life-threatening illnesses neither find a way to cover their costs or find any other solution.  According to the Times story, a Mexican mother of two died waiting for a small-bowel transplant, just as lawyers won a yearlong legal battle with Medicaid to pay for it.

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