Commentary

Donating a kidney is a good deed that doesn't go unpunished

By Cathleen Cotter

Cathleen Cotter, St. Paul, is a business analyst with the state of Minnesota.

Sometime in the next few days, I'll get a thank-you card in the mail. It won't say much, but it'll contain the date June 19, 2007, and will be signed "With love from Bill & Joanie."

That's the day I donated a kidney to Bill and Joanie's son Luke. Since then, Luke has gotten married and had a son of his own. Since then, I've never given a thought to possible negative consequences of my choice — until now.

Now I know that my insurance company, Blue Cross and Blue Shield, would deny me health insurance if I were applying as an individual. BCBS apparently believes I am high risk, even though I had to be in excellent health in order to donate a kidney. BCBS seems to think that people like me will be fine getting health insurance through the Minnesota Comprehensive Health Association high-risk pool.

And BCBS doesn't realize it holds these opinions about me, because I have been a client for over 15 years through my employer.

Last week the New York Times ran a story about Radburn Royer, a retired teacher in Eveleth, Minn., who donated a kidney to his daughter, Erika, four years ago. Last year he applied for private insurance through BCBS. He was denied coverage, on the grounds that he suffered from kidney disease, although his doctor said his kidney was healthy.

When people ask why I donated a kidney, I have trouble explaining what an easy choice it was for me. Luke and I are second cousins; his grandmother and my grandfather were siblings. I had never heard of him until I read a letter his parents had written to friends and family, a letter one of my aunts shared with our "Cotter cousins" email group. We're a far-flung clan and for years we've had a newsletter that has evolved with technology.

When I read Bill and Joanie's letter, my reaction was, "I'd do this in a heartbeat for one of my kids. Shouldn't I be willing to do it for someone else's kid?"

For me, it was that simple. But I understand others who struggle with the decision to donate. It's major surgery. Recovery takes months. And no matter how often you ask, the surgeons will not perform even a tiny bit of liposuction while they have you on the table.

Dialysis is awful; it causes bloating and cramping and it leaves patients exhausted. Luke once told me he couldn't ever remember seeing the end of a movie before the transplant. Kidney transplant surgery is cost effective; studies have estimated it pays for itself in two years. So why would BCBS, or any insurer, deliberately tip the scale against the choice to donate?

This policy horrifies me. And it makes me angry. How can a nonprofit health service corporation justify this practice when it's neither good fiscal policy nor good public policy?

I never wanted to be compensated for donating my kidney. I danced at Luke's wedding and I've made his son laugh. That's enough for me. But I never expected to be penalized, and especially not by my insurance company.

I work for a large employer and haven't faced discrimination trying to obtain private insurance. I like to think it wouldn't have affected my decision to donate. But I like to think lots of noble things about myself. I am grateful I don't have to face the question again.