Policy

Yes, You Tend to Get More of Something When You Pay For It: Bone Marrow Edition

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John Wagner, in the L.A. Times, rebels against the paper's own terribly dumb wisdom regarding compensation for bone marrow donors:

As a bone-marrow transplant specialist who is continuously faced with finding suitable donors for many children with deadly illnesses such as relapsed leukemia, my task is to leave no stone unturned. All too often, donors back out or are not available at the time they are needed. Unless recent updates suggest otherwise, prior reports from marrow donor registries have documented a 30% attrition rate, a persistent problem despite intensive efforts in donor education and awareness…..

The way the proposed [compensation] program would work is simple: Potential marrow donors would sign up with a nonprofit group, MoreMarrowDonors.org, at the time they register. Then, if called on to donate because the tissue type matches a patient's (which could be months or years after registering, if ever), the donor would be entitled to either a $3,000 college scholarship, a $3,000 housing allowance or a $3,000 payment to the charity of his or her choice as compensation. 

The hope is that these modest payments would encourage more people to sign up and follow through with the marrow collection at the time requested should a patient need their lifesaving marrow. The funds for the compensation would come from charitable giving. Wealth or influence wouldn't matter, as we "choose" the donor on the basis of genetic type, rather than the donor "choosing" simply to make a random donation for money.

Contra Dr. Wagner, we should also absolutely make it legal to make "random donation[s] for money" as well, for all the same reasons.

Now, federal law prevents us from considering the option of compensation, which promises to at least reduce the number of donors -- currently about one-third -- who aren't available when we need them. As an advocate for our patients, I believe we should consider all options for overcoming this major obstacle, which all donor registries have tried unsuccessfully to address for decades.

When the ban was proposed, lawmakers didn't consider the fact that we actually choose the donor, that the "organ" -- bone marrow -- regenerates itself, or the relative ease of extraction. Comparing this to selling a kidney is foolish.

Again, contra Dr. Wagner's attempts to seem "reasonable" with unreasonable people, we should allow kidney sales, again for all the same reasons, as Ron Bailey explained here at Reason back in 2001.