Tomorrow at this time, 12 people will die because no one was able to give them a kidney.
My personal experience is that I have twice received kidneys from two incredible people.
So I'm one of the lucky ones.
So I thought, what if we compensated kidney donors?
So kidneys in this country, in fact, all organs in this country are donated on the basis of
altruism.
In fact, there is a law against a donor receiving anything of value.
It's called "valuable consideration" in the law, and it's against the law for somebody
to offer anything of valuable consideration, which means cash or something tangible, in
exchange for an organ.
I think everybody kind of agrees, "Gee, wouldn't it be nice if we could solve the organ shortage
through volunteerism."
Everybody just signing their organ donor card, and giving organs.
The problem is that it hasn't.
The number of people who need organs is forever growing.
It's now 120,000 for all organs, and about 98,000 just for kidneys.
We tried so many things over the years.
We've tried recruitment.
There are tax credits.
That hasn't made huge difference, although it's the right thing to do.
And transplant doctors have also lowered the standards for the quality of the organs that
they procure.
So the consequences of the shortage also cause the federal government an enormous amount
of money to maintain people on dialysis.
It's about $35 billion to $40 billion a year which is a lot of money.
That's 7% of the Medicare budget which is huge, especially when you consider that only
1% of the Medicare beneficiaries are people with what's called "end-stage renal disease."
Now, if there were no alternative, then 7% is what it would be, because otherwise, these
people would die without dialysis.
But they could live so much better lives and more free lives if they had a kidney.
There is a way to compensate people in a safe and ethical way.
So the idea here is that there will be a third party, either the federal government or state
government or some sort of charity that's government-approved, that would offer a reward,
a benefit to someone willing to donate a kidney while they're alive to a needy stranger.
And what kinds of rewards could this be?
It could be, for example, a tax credit.
They could be loan forgiveness.
They could be a contribution to a person's 401(k) account.
It could be guarantee of healthcare for the next 10 to 20 years.
It could be a contribution to a charity of that person's choice.
The point is that there's this third party that's providing the reward, so it doesn't
come from the needy person, because there will needy people who couldn't afford to do
such a thing.
So this way, everyone who needs a kidney would be eligible into such a system.
People tend to think there's an informal consensus that about a $50,000 value is what seems fair.
And the funding for these rewards would come from the savings from dialysis.
Keeping a person on dialysis is about a $90,000 a year project.
So there would be ample funds to underwrite these rewards.
So one of the biggest questions and concerns is won't poor people rush to donate?
The way you guard against the situation that no one wants, which is someone who's desperately
rushing to donate and then regret their impulsive act, is by incorporating two elements.
One is by not offering what a desperate person wants, which is immediate cash; and two, building
in a waiting period to donate.
Everything we've paid for in the realm of body products has yielded more of it.
We don't have a shortage of sperm donors.
We don't have a shortage of egg donors.
We don't have a shortage of plasma donors.
We are the world's largest exporter of blood plasma.
But we don't pay for blood, and we have blood shortages.
So if we could compensate organ donors, and at the very least, test the idea of compensation
for organ donors, we could see less death, less needless suffering on dialysis, considerable
cost savings.
For too long, there's been an emotional attachment to altruism, without a recognition that it's
just one model of recruiting donors, and there are other ways to do it, and we should be
open minded and expansive and be willing to try other creative ideas.
So what do you think of this proposal?
Please leave a comment.
I'm really interested in hearing other ideas.
And also, this was only a few minutes.
We couldn't cover everything, but if you're interested in learning more, please check
out my writing.