Kidney disease is the ninth leading cause of death in the US. Every year about 87,800 people die from kidney disease. As the population ages this number is expected to increase. Dialysis and kidney transplants are the two best treatments. Dialysis is time consuming, not very effective, and very expensive. Dialysis is covered under Medicare regardless of age and currently makes up 28% of Medicare spending or 58 billion dollars. For comparison the total cost of the Department of Homeland Security is 39 billion dollars.
Kidney transplants are much better in that they are low risk surgeries that allow the recipient to carry on with normal life, they do not impact lifespan at all for the donor and followup care is 25% of the cost of dialysis. The problem with kidney transplants is that there are not enough kidneys to transplant. There are 17,700 transplants each year but 101,000 people on the waiting list. 4,270 people die each year on the transplant list without receiving a kidney and 3,620 will grow too sick to be eligible for transplant.
If you legalized letting people sell kidneys it would solve these problems. Iran legalized the sale of kidneys and went from a waiting list for recipients to a waiting list for donors. The time spent waiting for a kidney transplant is about two months for all the medical screenings to be completed and processed.
This would also benefit those who are young and healthy but need access to capital for schooling or to start a business but have no credit.
This one change in the law, would save tens of billions of government money, save the lives of tens of thousands of people every year, and help the poor. Yet no politician I know of is proposing to change the law. This should be a no brainer.
From the World Health Organization, The state of the international organ trade:
I’m all in favor of encouraging more people to register as postmortem organ donors, and dispelling myths about religious prohibition of organ donation. But I don’t think we as a society should be encouraging healthy people to undergo a major operation and organ removal for financial gain. In particular, I can hardly think of a worse indictment of a developed wealthy society under the rule of law than the prospect of healthy smart ambitious young people having to sell their kidneys to be able to afford college.
Also, given that a high percentage of kidney disease cases are apparently associated with Type II diabetes and high blood pressure (with diabetes apparently accounting for 45% of cases of kidney failure), ISTM that reducing the incidence of those diseases with healthier living would significantly diminish the need for kidney transplants.
I would be concerned that people would feel too pressured to sell a kidney. What I would really like to see are resources to cover expenses for all living kidney donors. Even if you can’t sell a kidney, it shouldn’t cost money to donate one. (The surgery may be free, but travel and time off work aren’t).
When I went to college one of the ways I paid was to take a work study job cleaning my dorms bathrooms and stairwells. I think it is much preferable to get paid to save a life then it is to clean toilets. If you think differently that is your right, but it should not be illegal for other people to choose differently.
You can cure alot of kidney disease by curing hypertension and diabetes. But that is like solving traffic problems by waiting for the invention of the teleporter. Tens of thousand if not hundreds of thousands of people will die while waiting and they could be getting help right now.
I think people ought to have considerable choice over what they do with their bodies. And if that includes selling organs - or killing themselves, that is fine. Yeah, the argument is that poorer people will feel pressured to do so. But they also have fewer opportunities to raise cash.
Are surrogate mothers, or egg donors allowed to accept payment for their services?
One weird question - if someone sells one kidney, then develops problems with the remaining one, what level of care ought society pony up for?
What an inspiring way of putting it. Really, it’s kind of odd that in countries where living-donor organ sale is legal we don’t see more of the wealthy college kids choosing to sell an organ for some easy extra income, isn’t it?
But for some reason, it seems to be almost entirely the poor people with limited opportunities, desperately seeking a rare chance to better their lot financially, who are willing to go through a major organ-removal operation for money. Hmm. Might be just a coincidence, of course.
There’s nothing illegal about choosing to save a life by donating a kidney without getting paid for it.
I’m all in favor of people who freely and generously decide to donate an important organ out of their living body to save the life of another person being legally allowed to do so. And in fact, they are allowed to do so.
I’m just not convinced that we as a society ought to be throwing the mighty muscle of market forces into the scales of their decision-making process.
I cannot nor have I ever seen anything wrong with selling a kidney. What is this nonsense about pressure? In fact, the value of kidney would drop considerably in an open market, the hard part will be finding anyone who would give up a kidney for the small amount of money that would be offered.
“Poor people with limited opportunities.” What is limiting their opportunities? Generally a lack of cash, selling a kidney would provide them cash and thus more opportunities.
If you uncouple the transaction you get two outcomes, a poor person getting money and a sick person getting health. Since both outcomes are desirable why does it become undesirable when the outcomes are linked?
If I’m not persuaded that it’s a good idea for society to promote people’s undergoing a completely unnecessary major operation to remove a very important organ in exchange for a large sum of money, I’m even less convinced that it’s a good idea for society to promote people’s undergoing that ordeal in exchange for a small sum of money.
If the risks and trauma of the process for the seller remain the same, but the financial compensation has sharply decreased, then the only thing that’s changed is the increased desperation of the seller.
What’s your view on combining the two? Should the market accommodate people offering to be killed in exchange for money, say, in the making of snuff-porn movies?
You also get the concurrent outcome of the poor person getting serious risks to their health, both in the short term via the surgical procedure and potentially in the long term if they eventually develop problems with their one remaining kidney.
As a society, we limit the degree and kind of serious risks to health that we’re allowed to offer people money to incur. That’s why there are, say, OSHA regulations that require employees to be provided with various health and safety protections, even though there are certainly many workers out there who would be willing to forego those protections for the sake of more money.
People who donate kidneys are in no more danger of long term kidney disease than those with two and if they do develop kidney disease as some point they can receive a transplant.
Why does society limit this type of risk? We let people smoke cigarettes, base jump, skydive, play professional football, and drive motorcycles. None of these save tens of billions of dollars or save thousands of lives.
Letting free independent individuals incur significant health risks just because they want to is not the same thing as trying to get them to incur significant health risks for financial incentives. After all, we let free independent individuals donate kidneys just because they want to, too.
The only specifically financial transaction on your list of examples is the employment of pro football players. Until recently, professional football wasn’t considered to be as gravely dangerous to health as neurologists are beginning to realize it is. We may see changes in the future to the rules about what football players are allowed to do for money.
We let people donate kidneys, too.
I’m not absolutely against allowing donors to be paid. I think counting on it for a paycheck could have influenced me if I had wanted to back out of my donation, though.
I still think it would be better to focus on making sure that people who want to donate can do it without worrying about money. If we can’t make sure donors don’t have to pay, I don’t see how we can move on to the argument about whether they can be paid.
Our society is so good about protecting people from themselves. Thank goodness we would never allow companies to profit from selling addictive products which - if used as intended - are likely to result in health problems. :rolleyes:
Why do surrogate mothers get $30k a pop?. Heaven knows there have never been any risks associate with pregnancy and childbirth.
Would legalization of kidney sales be accompanied by management of recipient lists to ensure fairness?
Or is the proposal that those w/ renal failure and means be able to purchase a suitable kidney?
And are we just talking kidneys, or any allograft?
For example, can I sell my cornea to someone who wants a really good one for a price acceptable to me?
I’m kind of a free market guy, but selling organs seems like a slippery slope that would be hard to manage in a healthcare world of 3rd party payers and a bit of divide between the poverty-stricken and the well-to-do.
I would definitely be in favor of charitable voluntary unilateral kidney donation as long as there was a proscription of identifying the recipient. The money part gets me woozier.
I think I detect some sarcasm? In any case, noting that we sometimes fail to avoid influencing people’s health decisions with market power doesn’t logically imply that we shouldn’t ever bother even trying to avoid influencing people’s health decisions with market power.
I completely agree that one can find all sorts of hypocrisy, although I’m not sure that’s a good argument to create more…
W/ a baby in particularly, it’s kind of a voluntary desire on both sides though, whereas renal disease is more of an involuntary condition (on average) with life or death ramifications (or, at least, severe physical quality of life ramifications).
Isn’t one of the reasons we don’t allow people to sell blood is that the monetary incentive might make people try to cheat the screenings and donate blood when they would be otherwise excluded from donating for health reasons? Today there’s not much incentive for someone who is has hepatitis to donate blood, but if they paid for blood some people probably would.
The same could be true of kidney donation but obviously the impact to the person donating is much greater. They might try to game the system, bribe the folks doing the testing, etc, in order to get paid.
I guess I see at least two separate categories of questions. Whether we wish to allow individuals to profit from the sale of their bodies and body products is the question we have to answer, before we consider the extent and manner in which we wish to regulate it.
I find it curious that people seem to be so eager to draw such distinctions - as between surrogacy and organ sales. What if I’m fortunate enough that my blood/DNA is unique and valuable? Ought I not be able to profit from that? What if I’m terminally ill? Could I offer myself for a fee for experimental treatment? Why shouldn’t I be able to sell rights to my carcass after I die?
Like I said, I’m pretty much in favor of people having control over their bodies. If we agree on that, then the issue boils down to how/whether society could regulate/oversee it to avoid certain abuses.
What if two desperately ill people happen to need your unique blood/DNA for their treatments, and one of them is rich and the other is poor? Should their lives and health be dependent on their ability to pay treatment costs?
One problem with increasing the power of market forces in healthcare decisions is that we generally consider it a humanitarian duty not to regulate the provision of healthcare by market power (at least not entirely). So opening up a new part of the healthcare process to financial transactions is inevitably going to introduce some distortions.
If you deserve to get paid for your good fortune in having a rare and useful type of blood, don’t you equally deserve to pay for your bad fortune if you get an illness or injury that’s expensive to treat? How come only your good fortune should be individually monetized?