The Chicago Tribune recently reported a story about a woman named Emily Grudzinski who is preparing to donate her kidney to her mother. The mother is a patient at Kovler Organ Transplant Center at Northwestern Memorial Hospital. The hospital requested that the younger Ms. Grudzinski undergo an additional echocardiogram because of a known heart condition. The woman has no health insurance and could not afford the test. Because it is a pre-existing condition, her mother’s insurance wouldn’t cover the cost as part of the transplant. The newspaper’s problem solvers team intervened and was able to get the hospital to absorb the cost.
Emily Grudzinski. Photo from Chicago Tribune
I assume the problem with coordination of insurance coverage between the patient and donor is very common (see Sept 2009). In order to control costs, the patient’s insurance, whether it is private or Medicare, doesn’t want to pay for any of the donor’s medical costs that are not directly related to the transplant. The donor’s insurance, or in this case the donor, doesn’t want to pay for a test they would only get because of the transplant.
I wonder how many transplants are cancelled because the donor or patient aren’t savvy enough to navigate through the medical and financial obstacles required to be accepted by a transplant program. This is another area where a community outreach program, like the one I plan to start, could help patients and thus improve medical outcomes.
[Update: Ms Grudzinski was able to get the test paid for and donate a kidney to her mother (Chicago Tribune Jun 2010).]