Introduction to the Crisis
More than 5,000 Americans died waiting for a kidney transplant in 2025. About a dozen a day. One of them was my first cousin Harrison Roberts. He was a rambunctious little boy. My earliest memories of Harry are him bouncing on my back at our grandmother’s house on Thanksgiving. He was a hefty kid, so that took some indulgence on my part. But I’m seven years older. I managed.
The Journey of Harrison Roberts
His father Bill died when Harry was 15. Cancer. Then 20 years ago Harry got cancer himself — colon cancer, Stage 4. Doctors told him to go home, get his affairs in order and die. That wasn’t acceptable to Harry, in his late 30s, with two young daughters. He fought, enduring intensive rounds of chemotherapy. Harry lived near Boston. Years would pass when we didn’t speak. But I happened to be in town doing research around 2005 and visited him. We spent a few hours at Mass General while he underwent chemo. It wasn’t a big deal, to me; saying goodbye seemed the decent thing to do. I didn’t realize that when you get cancer others tend to avoid you. Harry later told me he had friends who were reluctant to step inside his house. Like they’d catch it or something. We were closer after that.
Harrison Roberts as a young boy at our grandmother’s house in Cleveland in the early 1970s. He died of complications from kidney disease last August.
The Struggle for a Transplant
Harry beat the cancer. But the chemo fried his kidneys, and they began to fail. For the past four years, he was on dialysis. Dialysis forces a person to sit in a chair three hours at a stretch, five days a week. Harry made calls, often to me. We talked about books, politics, family, everything. We spoke almost every day. Sometimes we ran out of things to say and would just silently sit for five or 10 minutes, the phone line open. I’d hear ambient sounds from the hospital or dialysis center, which Harry once described as “a cross between a medical clinic and a bus station.” He needed a kidney. Harry had friends and relatives line up to offer one — at least six people. We were all rejected. Harry’s theory was that Mass General didn’t want to risk reducing its success rate by giving him a kidney. He’d not only had cancer but a quadruple bypass. Dialysis erodes your heart. If he got a transplant and died, it would lower Mass General’s batting average.
The Systemic Issue
Harry might have been onto something. A nurse pulled him aside and told him he was wasting his time there. I’d been urging him to go someplace else for years. There are other great hospitals. Barnes in St. Louis. The University of Chicago Medical Center. The University of Illinois Hospital has a well-regarded transplant program. I reached out to UIH. They were enthusiastic. Sure, if Harry gets to Chicago, they’ll evaluate him. By then he’d had another setback with his heart. Plus vein problems. He’d lost part of his foot. Travel was out of the question. We watched his oldest daughter graduate college on Zoom last year; I stayed with him while his wife Yi attended the ceremony — two weeks driving him to dialysis, hanging out, talking. He taught me to play Go.
The Revelation
None of this would have made print — not everything belongs in the newspaper. But on Dec. 16 The New York Times ran a front-page story, “Hospitals Cater to ‘Transplant Tourists’ as U.S. Patients Wait for Organs.” At first glance I thought the story was about Americans going overseas to get organs while patients here languish — Harry and I had joked about buying a black-market kidney in Southeast Asia. But no, those were American hospitals doing the catering. The story was about rich foreigners coming to the United States and going to the top of the transplant list by dropping a few million bucks on American hospitals. And not obscure ones, either. The story starts with the wife of a Japanese hotel magnate coming to the University of Chicago Medical Center to get a heart. Shortly thereafter, her husband made a big donation to a charity run by the surgeon’s wife. About 1,000 foreign patients a year get transplants in the United States, paying as much as $2 million to cut in line. U of C wouldn’t answer questions about the practice, telling the Times it “significantly improved access to organ transplantation in recent years.”
The Injustice
Harrison Roberts was my hero, though when I told him that, he replied, “Nobody’s a hero for running out of a burning building.” He was modest and smart, and faced death with great bravery and little self-pity. He never gave up, struggling to win a nightmarish game that turned out to be rigged against him. It isn’t fair he died on the waiting list on Aug. 31 at age 58, while rich folks bought the medical version of a fast pass. I know, I know. Another system skewed to favor the wealthy. Stop the presses.
Conclusion
The story of Harrison Roberts highlights a critical issue in the American healthcare system, where wealth and influence can determine one’s access to life-saving medical procedures like organ transplants. The fact that rich foreigners can bypass the waiting list by paying large sums of money to American hospitals raises ethical concerns and underscores the need for a more equitable system. As we move forward, it’s essential to address these disparities and ensure that everyone, regardless of their financial situation, has access to the medical care they need.
FAQs
- Q: How many Americans die waiting for a kidney transplant each year?
A: More than 5,000 Americans die waiting for a kidney transplant each year. - Q: Can foreign patients buy their way to the top of the transplant list in the United States?
A: Yes, according to a New York Times story, about 1,000 foreign patients a year get transplants in the United States, paying as much as $2 million to cut in line. - Q: Is the practice of allowing foreign patients to pay for transplants common in all American hospitals?
A: The story mentions that not all hospitals engage in this practice, but some prominent ones like the University of Chicago Medical Center have been involved. - Q: What is the main issue with the current organ transplant system in the United States?
A: The main issue is that the system allows wealth and influence to play a significant role in determining access to life-saving medical procedures, leading to disparities and injustices. - Q: How can the organ transplant system in the United States be improved?
A: Improving the system requires addressing the disparities and ensuring that everyone, regardless of their financial situation, has access to the medical care they need. This could involve policy changes, increased funding for public health programs, and stricter regulations on the practice of allowing foreign patients to pay for transplants.
