President Trump has caused us to think about what his slogan "America First" really means.
Reasonable people can differ depending on the specific issue at hand. Restrictive immigration policies and Trump's reluctance to embrace free-trade treaties may or may not really put America first. Depends on whose analysis one believes.
But ProPublica, an investigative news organization, has shined a spotlight on the American medical industry's practice of selling liver transplants to wealthy foreigners and leaving Americans to die.
Dr. Sander Florman, director of the transplant institute at Mount Sinai Hospital in New York, said he struggles with "in essence, selling the organs we do have to foreign nationals with bushels of money."
This is not a close call. We say, "Americans first!"
Some hospitals even seek out foreign patients in need of a transplant, according to the ProPublica report. Its story says a Saudi Arabian company, Ansaq Medical Co., aims to "facilitate the procedures and mechanisms of medical tourism." Ansaq signed an agreement with Ochsner Medical Center in New Orleans in 2015.
Between 2013 and 2016, 252 foreigners came to the U.S. purely to receive livers at American hospitals. In 2016, the most recent year for which data is available, the majority of foreign recipients were from countries in the Middle East, including Saudi Arabia, Kuwait, Israel and United Arab Emirates. Another 100 foreigners staying in the U.S. as non-residents also received livers.
The proportion of available livers that go to foreigners is tiny -- slightly less than 1 percent of liver transplants nationwide from 2013 to '16. The figure appears to be dropping further in 2017.
But the small number does not negate the ethical question.
Here's the rub: While rich foreigners were getting the red-carpet treatment, an estimated 14,000 American citizens waited for liver transplants. Many of them became too sick to receive transplants or died and were removed from waiting lists, according to records reviewed by ProPublica.
We hope and pray that American hospitals have not fallen prey to the old saying that "money talks." Surely we as a society have not devolved to the point where a wealthy Saudi prince could move to the front of the transplant line while Americans of modest means are left begging.
But we can only guess what "America First" really means these days.