The plight of Ruth Bernal de Villalta and her failing kidneys is complex. In confronting it, we must deal with our feelings about immigrants here illegally, our health care system, and an organ transplant network that needs far more donors. But we also must confront our feelings about motherhood, compassion, charity and the law.
Bernal de Villalta is a 30-year-old woman who came here in 2009 from El Salvador and overstayed her visa. Her kidneys are failing and she gets regular dialysis, which keeps her alive. She has been unable to get a kidney transplant. The national organ registry is, in theory at least, blind to citizenship status. The federal government pays for kidney transplants for anyone here legally. But Bernal de Villalta's emergency Medicaid will not. So the Brentwood woman falls through a crack. Neither her lack of money and insurance, nor her lack of legal status, would alone bar her from receiving a transplant, but the combination does.
With more than 100,000 Americans waiting for a kidney transplant and only about 17,000 getting the organs each year, there's an argument that this woman doesn't deserve to get a kidney that could save an American's life. But her husband says he's willing to donate one of his own kidneys, so she might not be taking one from the donor pool. Unfortunately, because doctors stopped looking into the possibility of getting Bernal de Villalta a kidney because she wasn't eligible, it's unknown whether her husband would be a match.
The broadest issue that needs addressing is the shortage of available organs in the United States: It's allowing parents and children and loved ones to die every day, but could be largely alleviated through presumed consent. That is a system in which the organs of anyone who died would be available for donation unless that person explicitly declined to be a donor. It also would help tremendously if families and doctors respected the stated wishes of the dying to be donors, which they often do not.
If the organ shortage weren't so severe, how would we view this woman's plight? The dialysis she is entitled to by state law costs $72,000 a year, and she could need it for decades. So the estimated $260,000 transplant could be a money saver. But put aside what we feel government should have to do, and consider what we as a society want to do for the ailing mother of a 9-year-old girl.
Her husband should be tested to see whether his kidney is a match for his wife, or for anyone who needs a kidney. If the family is willing to donate a kidney to the transplant system, why not give them one back? If there is a way of donating his organ that saves the life of any American, wouldn't we gladly welcome his wife getting a kidney?
As for the cost of her transplant, if a path to an organ can be found that does not block another recipient, then the money can be found, too. We are a big-hearted country. The technology of crowdsourcing allows donors of small amounts to make a very big difference.
It seems as if our government should not have to fix this problem for a woman here illegally. But society can and should. All it would take is a bit of creativity, a bit of prudence and a bit of generosity.