Steve Jobs, the heart of Apple, is back at work after a liver transplant at a Tennessee hospital. The Methodist University Hospital Transplant Institute in Memphis told the media that "He received a liver transplant because he was the patient with the highest MELD score (Model for End-Stage Liver Disease) of his blood type and, therefore, the sickest patient on the waiting list at the time a donor organ became available. Mr. Jobs is now recovering well and has an excellent prognosis.”

The 54-year-old has been ill for a long time and Apple's share price has been bouncing up and down with rumours about his health. About six months ago, he went on medical leave. Now he is back to work with an excellent prognosis according to his doctors.

Questions were quickly asked, though, about why Mr Jobs, a California resident, found his liver in Tennessee. Did he jump the queue ahead of sicker patients? That's not really the problem, wrote bioethicist Arthur Caplan in his column for msnbc.com. The real issue, in his opinion, is that in the US rich and well-connected people are more likely to get transplants than the poor. He compared Jobs's case with that of a 17-year-old who also needed a liver transplant, Nataline Sarkisyan. She died in 2007 after her insurer declined to pay, arguing her transplant would be experimental. There are many reasons which might make a particular patient unsuitable for a transplant. But there seem to be more solutions for the rich, argues Caplan.

"The current system is hardly fair. People die every day from a lack of good care or the ability to pay for it. The truth is, those with resources can make the system work in their favor. And celebrity, money and the promise of future gifts can help procure access to scarce, life-saving resources. The health care system is a broken mess, but not because a Steve Jobs can get a liver. Rather, it is because all too often only the wealthy and privileged can take full advantage of the best our health care system has to offer." ~ msnbc.com, June 23