First of all, my condolences to Steve Jobs’ friends and family. I’ve been a Mac user for nearly two decades; every day I’m thankful for his contribution to the technology landscape.
It’s scary to think someone could die of an awful disease like pancreatic cancer at the age of 56, which is far too young. That said, I could not hear the news of his passing without reflecting on the Tennessee connection: namely, that Jobs was able to use his wealth and resources to “game the system” when he received his 2009 liver transplant here:
Jobs couldn’t pay for an organ. Nor could he pay to cut the queue. But what someone with Jobs’ resources could do, according to liver transplant surgeons and ethicists, is to use money and mobility to improve the odds either by going to an area of the country where there are more organ donors, or by signing up at multiple transplant centers.
“It’s not for anybody but the rich. It’s called multiple-listing, a practice some would say is unethical,” said Arthur Caplan, co-chair of the United Nations Task Force on organ trafficking and chair of the department of medical ethics at University of Pennsylvania.
Paschke said UNOS requires transplant centers to encourage patients to do “multiple listings” at transplant centers in multiple geographic areas to increase the odds of being matched to a liver. The only catch, Paschke said, is that health insurance policies often cover only one medical evaluation to get on one transplant center list. Most people simply don’t have the money to pay for multiple extensive evaluations at far-flung locations.
“[Multiple listing] is not common. I think you have to have the means to do it and most centers are looking for patients that have a support system within the area,” said Dr. Michael Porayko, medical director of Liver Transplant at Vanderbilt University in Nashville, Tenn.
“So, most people don’t travel all around the country to get on a liver transplant list,” he said.
The fact that anyone with Steve Job’s level of wealth could use money to get a numerical advantage within the national system irks ethicists like Caplan. According to Caplan 3 to 5 percent of the names on organ waiting lists are “multiple listing,” including U.S.citizens and wealthy foreigners who moved to the United States for medical treatment.
Steve Jobs did what anyone in his position with his resources would do. I’m not faulting him for it. I’m just pointing out that a healthcare system which can be so easily gamed by those with vast wealth is not a functioning, equitable system. Steve Jobs lived another two and a half years; last year over 1,500 people died awaiting a liver.
It’s certainly something worth discussing.