Kidney Kickbacks

Organs and incentives

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Congress officially banned the exchange of body parts for "valuable consideration" in 1984, based on the principle that human beings shouldn't treat their organs as commodities. Mindful of that proscription, state governments are suggesting that people treat their organs as tax breaks instead.
Donating a kidney can involve lost wages, travel expenses, medical costs, and financial hardships that limit the number of potential donors. Legislators in eight states are debating the possibility of providing some relief, allowing living organ donors to deduct as much as $10,000 on their state income tax returns for costs related to their donations. Eleven states already have such deductions, which Wisconsin pioneered in 2004.

Such incentives may chip away at the taboo against trading organs for cash, but they're far from the ideal of a free market. They're regressive, since people who pay lower income taxes will find it harder to cash in. Unemployed or sporadically employed donors are unlikely to be compensated at all. And even for the well-off, the tax breaks can dissipate once they start wrangling with the complexities of the tax code.

"Details matter," says Benjamin Hippen, a prominent North Carolina nephrologist. "In Wisconsin, the deduction is applied to adjusted gross income. For a donor who is a member of a family of four of median income in Wisconsin, a $10,000 deduction works out to an actual tax refund of $534.?

With demand for organs far outstripping supply and with markets still prohibited by federal law, states will keep looking for convoluted ways to increase the number of available kidneys. South Carolina is already looking at a new source of possible donors: prisoners. Under a proposed law, convicts who offer up an organ would get out of prison 180 days earlier. Lawmakers are not sure whether a get-out-of-jail-free card constitutes "valuable consideration."

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