Kidney Donor Denied Health Insurance
When Erika Royer’s lupus led to kidney failure four years ago, her father, Radburn, was able to give her an extraordinary gift: a kidney.
Ms. Royer, now 31, regained her kidney function, no longer needs dialysis and has been able to return to work. But because of his donation, her father, a physically active 53-year-old, has been unable to obtain private health insurance.
More from Roni Caryn Rabin in the New York Times.
It may seem cruel but fact is he is a greater risk to the insurance company now. Admittedly a better system would be covering him on a claim-by-claim basis, but if they don’t want to cover him then they have a right, as a business, to not cover him. Business is voluntary, for both the customer and the company.
Not sure how I feel about this. This is of course, very tragic, but doesn’t donating a kidney increase the risk of various conditions? Perhaps the numbers were ran and it did not make sense to insure him, from a risk perspective. Free markets, right?
According to the following study, most living organ donors did not afterwards have a problem getting health or life insurance, and most did not see an increase in premiums.
Insurability of living organ donors: a systematic review.
http://www.ncbi.nlm.nih.gov/pubmed/17430400
Too bad he doesn’t live in Michigan, BCBS here accepts everyone and charges community rates. If only he could buy insurance across state lines…
More shocking (or perhaps not) in the article is that he is 53 years old, active, and…. RETIRED.
Maybe he should get a job and get employer provided coverage. Instead of living off a public pension paid for by taxes of people older, in poorer health than him, who still have to work.
Don’t feel bad for him, feel bad for the 60 year old hair dresser with arthritis who is working and paying taxes so he can be an active retiree at 53.
I don’t know how much risk kidney donation entails. If health insurers have the data to back up their claim of increased risk, then I don’t have a problem with them turning down anyone who has an elevated risk factor. On the other hand, it the insurer turned down someone who statistically is not likely to incur higher medical costs, it’s truly sad to see this happen.
Is something else going on that may not quite fit the article’s template? Mr. Royer was also denied life insurance. A 2007 Canadian study found that kidney donation had no effect on the ability to get life insurance. The article stresses that Mr. Royer is “active,” but one can be “active” and uninsurable. Furthermore, saying that Mr. Royer’s kidney was fine does not mean that Mr. Royer was fine.
The article says Mr. Royer was a retired teacher but does not explain why he wasn’t covered by the retirement plan in whatever district he was retired from.
Towards the end, the author tries to add further weight against insurers by saying that a person signed up for kidney donation was unable to get health insurance right before the surgery. That isn’t exactly a surprise. Why on earth would an insurer approve someone planning surgery?
From the article: But Blue Cross and Blue Shield of Minnesota rejected his application for coverage last year, as well as his appeals, on the grounds that he has chronic kidney disease…Mr. Royer was also unable to purchase life insurance.
Officials with Blue Cross and Blue Shield of Minnesota refused to discuss Mr. Royer’s case because of privacy laws, but said in a statement that Minnesota residents who are rejected by private insurers can buy coverage through the Minnesota Comprehensive Health Association high-risk pool, which is what Mr. Royer said he did, though he is paying more for less comprehensive insurance.
Perhaps there is a way to give tax credits to insurance companies who insure organ donors despite the increased risk. That might help.