Vincent is 43 years old. He suffers from terminal kidney failure and, like 620 other Quebecers, he is awaiting a transplant. To stay alive, he must undergo dialysis treatments three times a week, for four and a half hours.
Posted at 2:00 p.m.
Last year, he met the one who would become the woman of his life via Facebook. His catheter bothered him, he simply offered him a motorcycle ride. A few months ago, she undertook a series of examinations to find out if she could donate a kidney to her lover. Miracle, Vincent and Melanie’s genes are as compatible as their personalities. The surgery is scheduled for the end of the year. The story could have ended there and would have generated hearts on social networks, giving hope to those waiting for a transplant as well as love. But, there is a but. Mélanie does not have salary insurance. The couple had to turn to crowdfunding to absorb the losses that Melanie’s sick leave will cause.
An insufficient program
In Quebec, a living donor expense reimbursement program was established in 2011 by the Quebec government and is administered by Transplant Quebec. The problem is that it is only a last resort aid. The program compensates lost wages for a maximum of $400 per week, once all other sources of income have been subtracted (employment insurance, vacation, sick leave, etc.). According to IRIS, a household made up of a single person needs $483 to $669 a week to live in dignity, out of poverty.
From a medical point of view, a transplant from a living donor is generally the best treatment for people who suffer from kidney failure.
The five-year survival rate is close to 90%, and the graft remains functional for 15 to 20 years on average.
Financially too, the transplant is the best option. According to the Canadian Institute for Health Information (CIHI), dialysis costs $60,000 per year per patient. By comparison, a kidney transplant costs only $23,000, to which is added some $6,000 annually for anti-rejection drugs. I’ll do the math for you: a transplant saves the state $250,000 per person, over five years.
Refusal of compensation
When I started the process of donating a kidney anonymously, I contacted my group insurance plan to make sure that I would have an income during my eight-week sick leave. I was lucky, this type of intervention was covered. But other plans coldly refuse to compensate people who wish to donate a kidney since it is a voluntary intervention, such as breast augmentation.
Donors are asked to undergo countless tests and multiple hospital visits. To expose himself to the risks of a major surgery, to spend two months in convalescence.
All this without any real benefit, except the satisfaction of helping. Isn’t that enough without them also having to lose revenue?
Recent studies show that removing financial barriers can increase the number of kidney transplants from living donors. In 2020, Quebec was one of the Canadian provinces with the lowest living donation rates per million inhabitants at 4.9, compared to 12.8 for the country as a whole.
Elsewhere in the world, countries like Israel, the Netherlands and New Zealand are doing much better than us, with rates between 18.75 and 31.6. These countries have in common a generous financial loss compensation program for donors that goes up to 100% of financial losses in New Zealand and includes tax deductions and reimbursement for psychotherapy sessions in Israel. The Dutch program is cited as an example by the European Union. It compensates for financial losses up to €2,600 per week (the equivalent of $3,400) and reimburses the costs of domestic help (for example, for meals or cleaning) up to €300, i.e. nearly $400.
People who suffer from kidney failure need more donors, and there are certainly dozens of Quebecers ready to suffer some inconvenience to offer a new life to a fellow citizen. But we must improve the living donor expense reimbursement program to prevent their gesture of solidarity from costing them an arm and a leg.