Saturday, March 06, 2010

Legalize It!

The graph above highlights the grim reality for those on the growing kidney waiting list - demand for kidney transplants keeps growing, while the supply of transplant operations is basically flat.

As of today 83,573 patients are on the waiting list, according to the United Network for Organ Sharing, and only about 20% of those patients will actually get a kidney this year. As recently as the early 1990s, patients on the waiting list had a greater than 50 percent chance of receiving a kidney in a given year, but the situation has worsened every year since 1991. Almost 13 patients on the waiting list die every single day of the year, and most of those deaths would be easily preventable, except that a 1984 federal law (co-sponsored by Al Gore) makes it illegal for organ donors to receive any financial compensation.

Think about it: Everybody involved in a kidney transplant operation gets paid and profits financially: the surgeons, the nurses, the hospitals, the pharmaceutical companies, the companies that make the hospital equipment and supplies, etc., in other words everybody EXCEPT the kidney donor, who gets nothing? How can that possibly make sense?

Basic Economics: When the demand for kidneys exceeds the supply by a factor of 5 and increases every year, simple economics tells us that the chronic kidney shortage results from an artificial price that is too low, in this case zero. The only way to effectively and permanently solve the kidney shortage is to legalize the victimless crime of accepting financial compensation for donating a kidney.

Read more here in my Washington Post editorial "
More Kidney Donors Are Needed to Meet a Rising Demand," co-authored with my colleague Sally Satel, resident scholar at American Enterprise Institute, and author of "When Altruism Isn't Enough: The Case for Compensating Kidney Donors."

10 Comments:

At 3/06/2010 12:25 PM, Blogger Michael said...

This comment has been removed by the author.

 
At 3/06/2010 12:26 PM, Blogger Michael said...

The solution to this problem is easy. Stop putting people on the list.

 
At 3/06/2010 2:21 PM, Anonymous Anonymous said...

Countries that solve this problem do so by having a default opt in for organ donation on the driver's license.

Read behaviouralist Thaler's book: Nudge.

No need to pay for what you can get for free with a good public policy choice.

Unless you like to spend money.

Your choice.

 
At 3/06/2010 2:59 PM, Blogger sethstorm said...

The only proper response from this is not to incentivize organ-robbing. It would be to develop solutions that do not require it - yet still provide the same working biological organ.

You legalize it, that is what will happen.

 
At 3/06/2010 3:47 PM, Blogger Michael said...

Come on seth. What's to stop someone from hacking in to the marrow donor bank now to find a kidney match and kill that person for the organ. Much less the forth coming government medical database.

Having a compensated, non-identifying donor list will increase organs with out your urban ledge scare tatics.

 
At 3/06/2010 4:05 PM, Blogger sethstorm said...


Michael said...


What I'm suggesting is that instead of legalizing this is to go about the process of organ cloning.

The reality is that informed consent will go out the window when you legalize compensated organs. Organ-robbing is what will happen - just that it will be from those whom never had a choice in the matter.

 
At 3/06/2010 10:07 PM, Blogger randian said...

The only proper response from this is not to incentivize organ-robbing. You legalize it, that is what will happen

The illogic of this is astounding. I have no reason to steal your organ if I can buy it. The inability to buy organs is what creates a black market in organs.

Nobody is suggesting that you be able to buy organs where you can't prove their provenance. Donor anonymity though, if requested, should still be respected by the organ broker or hospital. What we are suggesting is that you be able to sell your organs, for whatever price you deem appropriate.

You could have eBay reverse auctions. Persons in need could post an auction for a kidney or liver. Prospective donors get tested and look for auctions that match. Donors bid down the price to the patient, lowest price wins. The patient pays up subject to verification of compatibility, organ health, and successful transplantation.

 
At 3/07/2010 4:11 PM, Anonymous Doc Sam said...

Wrong on so many levels: 1. Let's not even go into the ethics, you've clearly dismissed them already, 2. Everybody involved does NOT profit from transplants besides the donor. Often the doctor gets little or no money as well as the hospital, and 3. Think a lot of people die from having organs stolen now? Take that number and multiply it by at least 10 if you allow legal selling of organs. Surgery of this magnitude has fatalities, lots of them, particularly when you include the long term.

Two comments contain the answer: 1. Michael's right, stop putting people on the list, and 2. change the law so people not only have to elect NOT to be an organ donor, but perhaps have to give a very good reason why not.

 
At 3/07/2010 9:55 PM, Blogger randian said...

1. Let's not even go into the ethics, you've clearly dismissed them already

What ethics? Somebody wants to give me $20k for my kidney, I say yes. It's none of your business to interfere. It doesn't matter whether you think I'm being insufficiently compensated, it doesn't matter how "deserving" you think the recipient is, and it doesn't matter that somebody else won't get my kidney. What matters is I get what I want for the organ, and that my values, not yours, determine the outcome of the negotiation.

Everybody involved does NOT profit from transplants besides the donor. Often the doctor gets little or no money as well as the hospital

The distinction you're trying to make between profit and compensation is meaningless. How much the doctor makes is irrelevant, what matters is he can demand compensation but the donor can't.

Think a lot of people die from having organs stolen now? Take that number and multiply it by at least 10 if you allow legal selling of organs.

If people were being kidnapped off the streets of LA and having their organs removed it would be front page news. The number of people getting organs stolen is basically zero. Nothing is going to get multiplied, because the doctor doing to surgery is going to ask where the organ came from. People in the business of acquiring organs by murder won't have a verifiable paper trail.

change the law so people not only have to elect NOT to be an organ donor, but perhaps have to give a very good reason why not

So now you can take my organs for free? Sorry buddy, my body is not state property.

 
At 3/08/2010 7:56 AM, Anonymous geoih said...

"Countries that solve this problem do so by having a default opt in for organ donation on the driver's license."

Welcome to the world where we're all truly owned by the state. The state will let you use your body, until it decides somebody else needs it more.

Between people who advocate this sort of perverse forced "donation", to people who support mandatory national "service", I'd never thought I'd see so many people in favor of slavery.

 

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