Monday, June 11, 2012

The Case for Legalized Organ Sales: Kidneys


    
Something I have been thinking recently about is the organ transplant market which limits the amount of organs that can get to people. More than 92,000 people are waiting for a kidney in the United States but there are less than 17,000 that were made available for transplant last year. In the world there were less than 65,000 kidney transplant operations in 2007. More than 5,000 people die waiting every year waiting for a kidney. The chance that people will get a kidney has also been decreasing over time. In 1992, there was a 50% chance of getting a kidney on the waiting list. These days that percentage is down to only 20%. People who have to wait have to be placed on dialysis which is not only time consuming but also usually have to go three times a week for many hours. People who have a kidney transplant live on average 10 to 15 years longer than if they were on dialysis.  The cost of dialysis is not cheap either. Dialysis alone consumes 10% ($17 billion per year) of the Medicare budget.

Due to the 1984 law entitled the National Organ Transplant Act (NOTA) it is illegal to except payment for organs. This is interesting because people accept payment for donations like blood, sperm, and we all sell our brains on a daily basis. Due to this act it has lead to the underground system of illegal organ donations. According to Havoscope the average price paid for a kidney buyer is $150,000. This recent article talks about how in China, India, and Pakistan people are paying $200,000 for kidney even though they only offer the donor $5,000. The high price of what someone would pay for a kidney signals that there are not enough kidneys to go around. Economist Gary Becker has done some work on this subject and in this paper estimates that at a price of $15,200 per donor there would be a large supply of available kidney donors. Iran has actually paid people $1,200 along with some health insurance and no longer have a shortage. 

In a market system people who donated their kidneys would be rewarded if they kept their kidneys in pristine condition. This would allow them to get a premium which would increase the quality of the kidney that was donated which I would predict increase the quality of life the donee would have. The risk of dying in a kidney transplant is 0.1% and if we legalized it would decrease even further as transplant surgeons figured out how to make it not only better but safer. People who are against organ sales or “do-gooders” argue that people who want to donate their kidney  are of course not rational, have no idea what the consequences are, and left to their own devices would not be able to make a decision unless a bureaucrat decided for them.  If someone regardless of their financial position wants to sell something that they own who are we to tell them what they can or can’t do? If a person is offered $20,000 for their kidney which they could use to pay down debt, go to college, or start an investment fund what is the harm in that?

Allowing people to sell their kidneys would work wonders for all the people that have to suffer and worrying about waiting for a kidney. What do politicians tell to the families of the 5,000 people that died waiting for a kidney?  The donors will be better off because they will be compensated and the donee will be better off because they will not have to go on dialysis which is time consuming and expensive. By doing this the amount of government support for dialysis would be reduced which I think is highly desirable. As Walter E. Williams would say the true test of whether one owns something is whether or not he can sell it. By definition according to the government individuals do not own their own kidneys. 

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