Oakland resident Jesus Navarro has health insurance and a matching kidney donor but UCSF has denied him the procedure that could save his life because they say there is "no guarantee he will receive adequate follow-up care, given his uncertain status."
Navarro, 35, is a steelworker who’s had insurance for 14 years, but he recently lost his job and doctors are concerned he may not have the means to pay for medical cost in the future.
"UCSF’s policy for financial clearance requires candidates to present evidence of adequate and stable insurance coverage or other financial sources necessary to sustain follow-up care long after transplant surgery," she said. "Immigration status is among many factors taken into consideration."
Navarro was caught up in an immigration audit and lost his foundry job earlier this month. His private insurance continues for now, and he is trying to extend it. But he may well end up on the state’s Medi-Cal program.
That would deepen Navarro’s dilemma. While Medi-Cal will cover his daily dialysis — which now costs $17,000 a month — because of his illegal status, it will not pay for the immunosuppressive drugs that ward off organ rejection. The drugs cost $20,000 annually. Medi-Cal also won’t pay for organ transplants for illegal immigrants.
The hospital won’t perform the transplant without a guarantee that the drugs and accompanying treatment will be paid for.
Some bioethicists say the hospital should have performed the surgery because Navarro would not be taking resources away from other patients or putting his wife at serious risk.
After all, many legal residents fail to follow their post-surgical plan.
"Why was this patient denied the opportunity to comply?" asked Santa Clara University bioethics professor Margaret McLean.
Other experts suggest that the possibility of saving a life should outweigh concerns about follow-up care.
"He has the organ — the critical resource — if he can get it transplanted," said University of Southern California bioethics professor Michael Shapiro. "That’s a serious chance at life."
Critics say that providing any long-term care to undocumented immigrants is irresponsible and discourages home countries from investing in an adequate health system.