Organ transplants

Banning Organ Sales Kills People


Sally Satel (who herself received a donated kidney from former Reason editor Virginia Postrel) talks in the Washington Post about all the lives lost because lawmakers think there is something vulgar or awful or dangerous about allowing any sort of market compensation for human organs.

Excerpts from the introduction to the Satel interview:

About 30 Americans a day either die on the waiting list or are removed from it because they have become too ill to receive a transplant. Taxpayers also bear a significant burden in the case of kidneys because of the special status of renal dialysis within the Medicare program. In 1972, Congress mandated that Medicare cover the costs of care for end stage renal disease regardless of patient age. In 2011, over 500,000 people took advantage of this benefit at a cost of over $34 billion, which is more than 6% of Medicare's entire budget…..

What might change this? The culturally unspeakable but economically sensible solution of allowing compensation for donors (though Satel doesn't want to go for a full "free market" model, which would likely do even better in matching willing donors to needy recipients).

Satel told the Post of a possible model toward allowing some compensation in organ donation:

a governmental entity, or a designated charity, would offer in-kind rewards, like a contribution to the donor's retirement fund, an income tax credit or a tuition voucher, or a gift to a charity designated by the donor. Because a third party provides the reward, all patients, not just the financially secure, will benefit.

Meanwhile, imposing a waiting period of at least six months would ensure that donors didn't act impulsively and that they were giving fully informed consent. Prospective compensated donors would be carefully screened for physical and emotional health, as is done for all donors now. The use of in-kind benefits coupled with a waiting period would screen out financially desperate individuals who might otherwise rush to donate for a large sum of instant cash and later regret it.
The donors' kidneys would be distributed to people on the waiting list, according to the rules now in place.

It's a mild change, perhaps not too frightening to those with a deep-seated and irrational disgust-aversion to the notion of selling body parts, though it wouldn't do all that full market incentives could to save lives.

Satel sums up, offering inadvertently a quiet defense of the full free-market model she does not publicly embrace:

 If we keep thinking of organs solely as gifts, there will never be enough of them. Deaths will mount, needless suffering will continue, and the global black market in organs will continue to flourish.

Reason has written about this topic for many years.

A graet Reason TV video from March on how organ sales could save 30 lives a day: