I agreed, knowing how important this is and having cared for children who had received bone marrow transplants as well as for others for whom no donor could be found, during the course of my training. I accompanied her to a table where I was asked to fill out a form and have my cheeks swabbed.

Once this was done, she reviewed the inner portion of the form to make sure that all of my contact information had been filled out legibly (in my case, a real concern), and asked me for my health insurance information. I was surprised at this, assuming that the registry was either funded by the government or through donations. Not so, she explained. It turns out that per State law the health insurance companies are obligated to pay for the cost of the genetic testing for members who join a national donor panel. Excellent, I thought.

However, as I was gathering up my things to go, she handed me a small postcard with instructions for what to do in case I am sent a bill for the testing anyways, complete with a toll-free phone number I could call to get assistance.

I thought that this was sad and just one more example of what is wrong with our health care delivery system. As so many have pointed out, the lack of preventive care in this country relative to what is considered standard of care in most other developed countries results both in increased disease and higher costs to the individual and the system as a whole once complications occur (for those interested in reading about how health care is delivered in Canada, Britain, France, Germany and Japan, and how it compares with the current system in place in this country, T.R. Reid's book "The Healing of America" is an excellent resource). While a bone marrow donor registry doesn't quite fall into the category of preventative care, it certainly can save the lives of desperately ill children and adults who without being matched with a suitable donor would otherwise die. The fact that people who are otherwise willing to enroll in such a registry need to be intimidated by the prospect of invoices and bills from either their insurance companies or the labs doing the testing can significantly hamper the efforts to enroll as many people as possible so as to increase the chances of finding suitable donors. I know that when I was told that I might get caught up having to make phone calls and write letters to cancel charges I was promised I wouldn't have to bear, it made me wonder if I had made the right decision and whether it was worth the hassle. Despite all the demagoguery about the evils of "socialized medicine", facilitating this kind of registry, not hindering it, is exactly what I expect of my government. When I lived in Israel, which has universal health care, I enrolled in a similar donor registry, and the issue of payment for the testing never came up, because it was borne by the Ministry of Health.

While it is still unclear what health care reform will look like in this country, or whether the attempts to bring it about will even succeed, I can only hope that it will include provisions to make participation in something as clearly of benefit to the public good as a bone marrow donor registry easier than it is today.