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:
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