Kidney disease, which is often associated with diabetes, is an epidemic among black Americans. "We all know someone who needs kidneys," the Rev. Nelson "Fuzzy" Thompson, a local civil-rights activist, told Kansas City Star columnist Steve Penn after Thompson received a kidney from his goddaughter. He didn't say "we black people," but it's clear that's what he meant; relatively few white people know someone who needs kidneys, which may be one reason the system is so hard to reform. African Americans make up a third of the nearly 70,000 Americans on the waiting list for cadaver kidneys, even though they are less likely to be put on the transplant list than whites with kidney disease. (The reasons for the disparity are disputed.) Columnist Penn, whose brother received a kidney transplant, has used his column to encourage more blacks to become donors.
As legal scholar Michele Goodwin points out in her book Black Markets: The Supply and Demand of Body Parts
, opponents of incentives for organ donors often treat blacks only as potential victims of markets and never as beneficiaries--even though they would likely benefit most. And the ideology that says that the families of deceased donors should have no say over who gets their loved ones' organs discourages blacks to donate. Distrustful of the medical system for historical reasons Goodwin documents--Did you know that southern medical schools used to be known for teaching anatomy better than northern ones, because their suppliers could easily rob black graves to get cadavers?--many blacks indicate that they would be more likely to donate organs if they could be sure the parts would go to other blacks. That idea would horrify many ethicists, who hate the idea of race-conscious organ allocation, but it would benefit everyone on that humongous waiting list.
Meanwhile, as the NYT's Richard Pérez-Peña reports there are 350,000 Americans on dialysis, and those in New York State tend to fare worse than others. In an article that could have been headlined, "Anti-Corporate Bigotry Hurts Poor, Sick Blacks," he reports:
At New York dialysis centers, those being treated are more likely to suffer from anemia and are less likely to have enough impurities and excess fluid removed from their blood, allowing more damage to their bodies, according to the records.
Experts say the disparity is caused in part by the fact that New York is dominated by small dialysis providers, many of them run by people with little background in medicine who entered the business to meet the surging demand.
Many of the smaller centers provide good care, experts say, but a lot also lack the money and staff training to compete on a quality-of-care basis with the national dialysis chains that dominate the market across the rest of the country.
Newly released patient data show that people who receive their dialysis from a national chain generally fare better than those treated by an independent provider.
But the chains are largely blocked from operating in New York by a state law that effectively bars publicly traded companies from owning health care facilities in the state.
In a system that is terribly difficult to reform, fixing that law should be relatively simple--if only the beneficiaries weren't too sick and weak to campaign for reform.
Posted by Virginia Postrel on January 15, 2007 • Comments
No, the answer isn't "nothing." Guest blogging on Organization and Markets, Professor Postrel explains his research on that question.
Posted by Virginia Postrel on January 11, 2007 • Comments
In an excellent Slate slideshow, Witold Rybczynski traces the evolution of the American bathroom to its current luxurious state. Reflecting a common equation, the headline writer mistitled the piece to suggest that today's fancy bathrooms are status symbols, when Rybczynski concludes otherwise: The trend is about pleasure--though it's easier to purchase that pleasure if you've got the dough (and, as I note in The Substance of Style, if the prices of marble and granite are falling).
The widespread consensus that marble is the pinnacle of bathroom aesthetics is tough on people like me, who far prefer ceramic tile in all its gorgeous incarnations. The pursuit of resale value says put in marble, while current consumption argues in favor of tile. So far, I've stuck to tile.
Posted by Virginia Postrel on January 11, 2007 • Comments
Movie buff Steve Kurtz dares to name 100 comedies better than Groundhog Day. Commenters disagree. One question: Are these supposed to be better movies or better comedies?
Posted by Virginia Postrel on January 11, 2007 • Comments
Steve Portigal explains.
Posted by Virginia Postrel on January 10, 2007 • Comments
Professor Postrel is guest blogging at Organizations and Markets. His first post, on "physics envy," is here.
Posted by Virginia Postrel on January 09, 2007 • Comments
Eugene Volokh emails, "So what do you think is at http://docnet.dc.state.ks.us/POSTREL.htm? Not anything about our family, that's for sure.
Posted by Virginia Postrel on January 09, 2007 • Comments
My new Atlantic column looks at what happened to airline glamour and why luxury and service can't bring it back. (Link is good for three days.) For more on the glamour of aviation, see this 2004 article on the aviator as an archetype of masculine glamour.
UPDATE: I've mentioned it before, but I want to again recommend Naked Airport by Alastair Gordon, who tells the history of commercial flight through the history of airport architecture. It's a lively, well-researched book that does a great job of recreating the different eras of air travel.
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Posted by Virginia Postrel on January 08, 2007 • Comments
The WSJ's Jason Fry looks back at Internet World predictions for 1995. (Tthe Internet wasn't actually new in 1995, but the Web was.) For another trip back in time, check out my early Forbes ASAP columns.
Posted by Virginia Postrel on January 08, 2007 • Comments
Reader Tom Royce sends this link to what he rightly calls "a great kidney story" from the Atlanta Journal Constitution. The AJC's John Mannaso recounts how Thrashers fan Brandi Shaw was inspired to donate a kidney to another fan she knew only from his postings on a message board devoted to the team. Andy Freeman had added "Does anybody have an extra kidney they can give me?" to his sig line. The surgery was done in August. There's more on the Atlanta Thrashers site here. I doubt that Dr. Douglas Hanto would approve, but, fortunately, he didn't have to.
Meanwhile, Sydney hairdresser Jennie Maley is preparing to donate a kidney to her client Bernadette Keegan, who has been on dialysis since 2003. "I was blow-waving Bernie's hair one Saturday and I asked her what she was up to that night and she said she had a 'hot date' --at the renal unit. I thought of her sitting there, all on her own," Maley told a local reporter, recalling how she decided to volunteer. The surgery is scheduled for January 31. According to the Daily Telegraph story, here are 1,500 Australians waiting for kidneys, with an average wait of four years.
Posted by Virginia Postrel on December 31, 2006 • Comments