Music producer Tomas de Niero urgently needs a new kidney.
And it's not the first time.
He had a transplant 14 years ago when both his own kidneys failed.
He was already living on the Spanish island of Mallorca at the time.
And that might have saved his life.
"It was pure luck.
I emigrated to Spain in 2001.
And then two years later, when my kidneys failed, I was in a country where you can get
kidneys four or five times faster than in Germany.
It was pure luck!"
He's hoping this time he'll also get a new kidney without too much delay, because in
Spain, more people donate organs after they die than anywhere else in the world.
That's because by law, everyone there is automatically an organ donor unless they actively opt out.
It's a well-organized system.
For the moment, Tomas still has to have to have peritoneal dialysis every day.
It takes hours, and limits his activities dramatically.
He'd have to wait about eight years on average in Germany for a new kidney.
In Spain, the waiting list is just two years long.
Reason enough for some to try to fiddle the system:
"Some Germans are now declaring that they live in Spain.
I know two or three who've created a pretend life here...buying houses, setting up small
firms...all so they can benefit from the Spanish healthcare system."
Miguel Ángel Feriol had a liver transplant 10 years ago.
Today, he's back in good shape.
Miguel has a problem with people coming from abroad just to benefit from the Spanish system...although
he also sympathizes: "I can't imagine what it must be like to have
wait for so many years.
I know what waiting means.
It's not a life.
But for me it went by fast.
." Miguel understands the need.
But he also regrets that the rise in transplant tourism means that people who really do live
in Spain will have to wait longer for a donor organ.
"Spaniards donate their organs for people in Spain.
Of course, we know that an organ -- a liver, a kidney -- might be sent elsewhere if it's
not needed here.
But if more and more people come here for transplants, then this will have to be stopped.
That's the only thing that makes sense."
Transplant tourism is technically banned in the EU, but it's also difficult to control.
Many kidney transplants are carried out at the university hospital in Palma de Mallorca.
The senior consultant here has operated on many Germans.
He treats anybody with a need.
It's not his job to determine whether a foreigner actually lives in Spain, or just pretends
to in order to benefit from the system.
"There's freedom of movement in the EU.
So it's hard to distinguish.
That's why the authorities have to ensure there's order, and why they have to set clear
rules."
The pressure is rising.
Now the National Transplant Organization at the Spanish health ministry has developed
new criteria for foreign patients.
In the future, only people who have lived in Spain for a minimum of two years will be
eligible to receive organs.
"We have to check things much more closely.
Only people who have a lot of money can pretend to be living here.
People with less fall by the wayside, and have to wait longer in their own countries
for an organ donation."
Tomas de Niero can't understand why there aren't more organ donors in Germany.
He blames a lack of coordination, and the fact that you have to expressly state that
you want to donate your organs when you die.
"It's terrible that people from Germany are going abroad -- even to India -- to get an
organ they can't get at home because of a dumb rule, which really needs to be changed
now."
Everyone who dies on Spanish soil is a potential organ donor.
So who knows?
One day, a German tourist could be the one to save Tomas de Niero's life.