An undocumented Mexican immigrant in New York City is stuck in a medical Catch-22: He can receive a lifetime of dialysis treatment for a serious kidney condition, but he doesn’t have access to a transplant that would greatly improve his chances of survival—and potentially save the government hundreds of thousands of dollars.
Nina Bernstein of The New York Times reports:
Without treatment to replace his failing kidneys, doctors knew, the man in Bellevue hospital would die. He was a waiter in his early 30s, a husband and father of two, so well liked at the Manhattan restaurant where he had worked for a decade that everyone from the customers to the dishwasher was donating money to help his family.
He was also an illegal immigrant. So when his younger brother volunteered to donate a kidney to restore him to normal life, they encountered a health care paradox: the government would pay for a lifetime of dialysis, costing $75,000 a year, but not for the $100,000 transplant that would make it unnecessary.
The irony of the situation runs deep, since hospitals routinely harvest organs from undocumented immigrants:
“As a physician, it puts you in a real ethical dilemma,” said Dr. Eric Manheimer, Bellevue’s medical director, noting that a transplant would sharply reduce Angel’s risk of death from complications. “The ultimate irony is it’s cheaper to put in a transplant than to dialyze someone for the rest of their life.”
Bellevue performs no transplants but, as a trauma center, often supplies organs harvested, with family consent, from illegal immigrants fatally injured at work.
“Here’s the paradox: he could donate, but he can’t receive,” Dr. Manheimer said, calling the imbalance troubling. Organ registries do not record illegal status, but a study estimated that over a 20-year period noncitizens donated 2.5 percent of organs and received fewer than 1 percent.