Will Saletan accuses Apple CEO Steve Jobs of "gaming the system" to get a liver transplant:
Jobs lives in Northern California, but he got his liver in Tennessee. Why? Different parts of the country have different waiting lists, and the wait in Northern California was three times longer than the wait in Tennessee. In fact, the median wait in the Tennessee area where Jobs snagged his liver was around 15 percent of the national average. Jobs confirmed last year that this is why he went to Tennessee: "My doctors here advised me to enroll in a transplant program in Memphis, Tennessee, where the supply/demand ratio of livers is more favorable than it is in California here."* Legally, you're allowed to get on multiple waiting lists around the country. That's how you game the system.
You can't list-shop unless you can afford to show up in person to register and then transport yourself on a few hours' notice when an organ becomes available. Also, you have to be able to pay the full cost of your surgery out of pocket.
If you can afford to list-shop, you increase your odds relative to other patients who would might have had a better chance of long-term survival. Saletan suggests that Jobs wouldn't ordinarily have been considered a top candidate for a new liver because he already had cancer.
I dislike the term "gaming the system." Saying that Jobs gamed the system seems to imply that he found some unique loophole to exploit, that he somehow cheated. The thing is, for-profit medicine is the system. If you're a poor Arizonan waiting for a transplant, you die. If you're Steve Jobs, you can buy the very best.
"Gaming the system" makes Steve Jobs out to be the bad guy, but he's no different from anyone else who wants to survive. He just has way more money than most of us.
We've got a system where human livers are bought like foie gras. If that makes us uncomfortable, we should change the system, rather than pointing fingers at Steve Jobs.
[Photo credit: Mark H. Andbinder, Creative Commons.]