Philanthropy now comes with a price

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Rad Royer, 58, gave the extraordinary gift of a kidney to his daughter, Erika, when her lupus led to kidney failure.

The reward for this act of grace: No health insurance.

Royer’s father, Orv, lives in Osakis and is in frequent contact with his son.

Rad Royer is in good health. “I’m doing fine,” he said. “After six weeks, I could do everything.” He hasn’t noticed any residual effects from the surgery.

Despite a general well-being, Royer was denied health insurance coverage by Blue Cross and Blue Shield of Minnesota (BCBS) after donating his kidney. Royer had been covered under a group policy with his wife prior to applying for coverage under BCBS. After her diagnosis of leukemia, Royer’s wife converted to BCBS insurance. Royer was to be covered by them as well.

Three days before Royer was to receive coverage, he was contacted and informed he was not eligible for insurance. When Royer initially contacted BCBS, they had told him they covered patients with solitary kidneys – they went back on their word, according to Royer.

The creatinine level in blood is indicative of whether someone has kidney disease. BCBS set its acceptable creatinine level at 1.4 or lower – Royer’s was 1.6. A level of 1.4 is normal for two kidneys, though, not the one Royer has. Royer’s high creatinine was a result of his kidney donation. BCBS had told him he was not denied coverage because of his solitary kidney. If he hadn’t donated, his creatinine would have been an acceptable level.

Royer’s surgeon disagreed with BCBS’s decision. “I don’t think you realize you’re refusing him on bad data,” he had told BCBS.

Before donating, Royer was given little precaution as to how problematic his future would be. He was told he may have some difficulty getting insurance with a solitary kidney, but that there wasn’t usually much trouble. After a month without health insurance, Royer was finally covered by Minnesota Comprehensive Care. This insurance isn’t as well-suited for him.

He pays an extra $1,560 per year for an annual checkup.

The Affordable Care Act is light at the end of the tunnel for Royer. “For me, 2014 means BCBS can’t deny me coverage anymore,” he said, “so that’s a big plus.”

Royer said his case exemplifies the injustices in the healthcare system. “I think people need to realize health insurance should be a right, not a privilege.”

When asked if Royer had doubts after he was warned of the prospect of no health insurance, Royer said, “It was a no brainer. It was my daughter.” For some, this isn’t enough.

Forty percent of people considering donating kidneys are deterred by the possibility of being uninsured.

According to Royer, this statistic is what really saddens Erika – to know there are other people her age, suffering the way she was, without help because of injustices in the healthcare industry.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, 17,413 transplants were performed in 2008 (the last year figures were available). In February of 2011, there were 87,820 people awaiting kidney transplant – this number has only increased.

Hypothetically, if risks involving health insurance were eliminated, more than 10,000 additional people each year would benefit from a donated kidney.

Royer is acquainted with another kidney donor. This donor’s case creates a stark contrast to Royer’s misfortunes.

Royer’s acquaintance not only has health insurance, but receives “perks,” like increased vacation time, for donating on the grounds of humanitarianism. What makes the two cases so different? Royer’s acquaintance lives in Sweden.

The Swedish government is cognizant of the benefits of donating a kidney, he said.

According to one estimate, transplant surgery pays for itself in two years, as opposed to dialysis, the alternative to transplant surgery.

What’s more, dialysis is extremely detrimental to patients. It has been compared to a transcontinental flight three times a week – exhausting.

Long-term studies have concluded that donors live as long as other healthy people. One study even reported that donors live longer.

Despite complications involving health insurance, Royer has no regrets about donating his kidney. When asked if he would recommend kidney donation, his confident response was, “Oh, absolutely.”

The New York Times and Miami Herald are also running stories on Royer. Royer thinks something good will come out of the publications.

Tags: local news, news, philanthropy, transplant