Making life worth it

In what she calls “a gory indicator of inequality in access to health care in the United States” in Insuring Hearts (and Kidneys, Lungs and Livers), Nancy Folbre reports that “a recent study by the physicians Andrew A. Herring, Steffie Woolhandler and David U. Himmelstein based on hospital data for 2003 finds that 16.9 percent of organ donors were uninsured, compared to 0.8 percent of transplant recipients.”

Perhaps even more startlingly the report (p644) shows that “Most transplant recipients (60.7%) were men, while men accounted for a minority of donors (43.9%)“

Even with our NHS however we are not necessarily free of such imbalances. I do not know if anyone has compared donors & recipients for characteristics such as social class, income or level of educational attainment, but we might find that not dissimilar differences arise here, even though these cannot be related directly to insurance status.

A Radio 4 programme The Call, broadcast yesterday told the story of someone waiting to be told that a heart was available for transplant. As I listened I thought – it would be very difficult to cope with all that if you were not living in fairly comfortable circumstances. And sure enough, the consultant who spoke stressed that ‘good family support’ was a necessary prerequisite for getting accepted on to the transplant list.

I was reminded of another Radio 4 programme some time ago, which looked into the question of why men are (allegedly) much less likely to go to the doctor, even when they have grounds for some concern about their health.

One of the interviewees was a man who worked in the construction industry – not a youngster, probably past 50 from the sound of his voice. He said that he would not go, even if he suspected cancer, he would prefer to just keep going for as long as possible then accept his fate. For him, being ill, being off work, living on benefits, would be next to unbearable, & he doubted that he could expect to recover to be fit enough ever to return to the kind of work he was trained for & used to.

That reminded me of another article I once read in an upmarket magazine about the difficulties of being a cancer patient, the need for the support of friends, & the (expensive) kinds of treats, amusements & unguents which would help.

Of course a good income is neither necessary nor sufficient for a good quality of life. Plenty of people could settle, even with the loss of their job, for other pleasures & compensations from family, friends & hobbies.

But it is important to remember that it is not just politicians who need a hinterland.

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