Why do you think people are so stupid? What will happen is that the price of a kidney will adjust to it’s actual market value. Guess what, nobody can form a kidney monopoly, it will be as fair a transaction as you’ll ever see.
Why are you saying that? The donor’s situation hasn’t changed at all, and right now the donor doesn’t have the option of getting a fair value for his kidney.
That’s what always happens. People wouldn’t bother getting rich if they didn’t get something out of it. Why would you deny the person with the unique physiology their opportunity to profit from it? Do you want to fix the price of kidneys? Sure go ahead, if it saves the people now who die waiting for a kidney because they can’t buy one that’s fine.
rather than letting desperate people sell their kidneys as a way to solve the kidney shortage, how about an opt out on donating ONE kidney when you die.
ISTM that a two-tiered system will arise, one for recipients with the financial resources to buy their way onto the short waiting list, and one for everybody else.
Which tier do we expect people will be willing to sell their “product” to?
Sure. Why not. If I’m selling my used car, do I have to sell it for less to the poorer person?
We already do. Many ill people receive treatment far exceeding any taxes/premium they’ve ever pain. And poor people can receive disability benefits from SSI. I think our some portion of our disagreement may reflect a matter of degree.
I’m a huge supporter of socialized medicine to provide certain basic treatment for everyone. But if I were king, my system would draw all kinds of lines. If you are unfortunate enough to develop some condition requiring costly care, and you are not fortunate/wealthy enough to have super platinum insurance, you might either get palliative care or simply take your place in line. Sucks to be poor, and sucks to be sick. I can sympathize with someone’s light, without agreeing that they ought to receive unlimited treatment.
I don’t care how many tiers there are. Right now there’s a one tier system and people dying from lack of a kidney. You’ll have a lot more kidneys available if people get paid for giving up one. The price won’t be that high. Regulate it if you like, fix the price, fund the cost of kidneys.
There’s a thought. How do the kidney-sale advocates in this thread feel about having a modified option of “kidney leasing”, say? You can pay to receive a donated kidney for a few years, but then you have to give it back.
I’m also wondering how many of the kidney-sale advocates have donated a kidney themselves. If you feel that the lack of available kidneys for transplant is such a serious emergency, do you really need a financial incentive in order to do something about it by voluntarily sacrificing one of your kidneys to save somebody’s life?
Or are you just hoping to be able to displace the burden of saving those lives onto poor people who are sufficiently desperate for money?
Let’s shift the debate a bit. Suppose some billionaire decided to offer $10,000 to any woman who would have an abortion. He wants to reduce the global population. The abortion must be legal-- that is, no late term abortions, and the woman has to comply with all state laws. And’ limit one per customer, so no women turning into abortion factories.
I think that should be illegal, as there would be lots of women starting unwanted pregnancies just in order to get paid for aborting them. Abortion policy should focus on reducing unwanted pregnancies, not incentivizing them.
But I am not sure that it’s okay with the OP to move the discussion from kidneys to uteruses.
For purposes of prevention. Although surgical abortion is a very minor procedure compared to, say, kidney removal, every pregnancy and every abortion carries some nonzero risk. It’s a valid public-health policy to encourage women who don’t want to bear a child to avoid getting pregnant in the first place. The safest abortion is the one you don’t need because you successfully prevented conception.
That said, of course it’s ultimately up to an individual woman to choose whether she wants to get pregnant and whether she wants to terminate a pregnancy, for whatever reason. But I don’t think society should be introducing market forces into those individual choices by monetizing abortions for pregnant women.
[QUOTE=John Mace]
And how would you make it illegal? Who would you punish and how?
[/QUOTE]
AFAICT, it might be already illegal, perhaps under the laws against the sale of human body parts that have been so prominent in the news lately due to the artificially manufactured kerfuffle about Planned Parenthood’s fetal tissue donations. If we can say it’s illegal to pay someone for the discarded tissue from their abortion, ISTM we can surely say it’s illegal to hire them to have the abortion in the first place.
Leave the individual choices about pregnancy termination up to individual women, and don’t try to exploit their economic vulnerability to influence their reproductive choices.
So, you would punish the billionaire for giving the money, but not the woman for accepting it? I’m sort of guessing here, because you weren’t really clear about how you thought the legality of this should be enforced. Whether it is legal now or not is pretty much irrelevant. Lots of thing are illegal that you and I think should not be.
Two kidney patients, one rich and one poor. Under the current system they both die. Under the proposed system as you predict one will die and one will live. Which is the better outcome?
In Iran there is one province where all the payment for kidneys is done by charity. In the US charity would be provide for alot of transplants because we are a much richer country. Even if charity did not provide enough for everyone, the government could buy alot of kidneys with some of the 47 billion in annual savings this would provide.
If you don’t think money should be involved in healthcare. Why not practice this in your life. Stop going to doctors that charge money, only get prescriptions from pharmacies that give donated medicines, only go to charity hospitals, etc. If charity is good enough for people of dying of kidney disease, why isn’t it good enough for you?
I think you misunderstood what I was saying. I don’t have a problem with money being involved in healthcare. I have a problem with exploiting the economic desperation of poor people to provide resources in healthcare at the expense of the poor people.
Returning to the WHO analysis I cited back at the start of this thread:
If many poor people who sell their kidneys out of financial necessity end up regretting their choice and not even getting significant financial benefit from it in the long term, then I remain unconvinced that allowing the sale of kidneys is a good idea.
If selling a kidney were really such a win-win process for the seller, I think we would see a lot more non-poor people choosing to sell their kidneys in order to earn a substantial sum of money easily and cheaply. (And presumably, we’d see a lot more of the people who now seem so concerned about the kidney shortage voluntarily choosing to donate a kidney whether they got paid for it or not.) The fact that kidney sellers are overwhelmingly impelled by poverty and many end up unhappy with their choice smacks to me of economic exploitation.
Still, this thread has at least convinced me that non-sale donations of kidneys are a good and necessary thing, and we should encourage people to do more of them. In particular, I was struck by articles I read about increasing use of kidneys from older living donors, which I like the sound of. As I approach old age and higher probability of needing major surgical intervention, I’m definitely going to keep in mind the fact that if I end up needing an operation I might be able to have them take out a kidney while they’re at it.
The problem that people are afraid of, and does happen, is the poor selling their bodies and body parts to be marginally less poor, or to afford a necessity. That is exploitation and should be wrong. However, I propose an easy solution:
Kidneys, or any body part really, should be for sale, but the price is fixed at something astronomical like $10 million. No kidney should be sold for less than that.
This plan ensures that while kidneys can be sold, it only goes to a very select few, a practically insignificant amount of people who both need kidneys and can afford them, so it wouldn’t become an epidemic. In return, the person selling the kidney gets enough money to offset any future issues that comes from selling a kidney. If you’re poor, you’re instantly catapulted to the 1%. You’re not selling a kidney to pay for food or afford college, you’re selling a kidney so you can afford a mansion and buy a Lamborghini.
The only problem is that of forced coercion. Some people might see others as walking $20 sacks of money. I admit I haven’t come up with that solution yet. I don’t want anyone to be forced to sell their kidney, nor should anyone be able to sell a kidney that isn’t theirs. Maybe something where only a few hospitals are authorized to do the surgery, and both donors and recipients go through rigorous background checks and psych tests to ensure there is no coercion.
The WHO analysis does not study Iran which is the only country that has legal kidney purchasing. It describes donors who do not receive follow up care, presumably because of either financial reasons or because what they did was illegal. Also the illegality of the organ trade makes it hard to study. One of the reasons we don’t see more on-poor selling their kidneys is that it is illegal so only the most desperately poor do it, since the middle class has more risk.
I have a friend whose Grandfather died of a heart attack when relatively young. The widow was then forced to take a job at a nursing home caring for the residents. In your parlance, her economic desperation was exploited to provide resources for healthcare. Because we allowed her to be paid for this, she was able to provide for herself and live independently for almost thirty years after this. I think her being able to sell her time and labor to provide for herself was a good thing as I think it is a good thing that I am able to do likewise.
When someone is poor they do not lose their agency or their ability to make decisions. If someone feels like it is in their best interest to sell a kidney then I trust them and not some paternalist opining from atop Mt Pious.
I agree we should encourage people to donate kidneys but we should encourage them with one of the strongest motivators around, money.
And for all of those thirty years there were legal restrictions on the types of work she could be assigned to do, the types of environment in which she could be made to work, the maximum number of consecutive hours she could be made to work, the minimum amount of pay she could receive for doing her work, the amount and types of risks she could be allowed to incur in the course of her work, etc. etc. etc.
I’m sure that either she or some other applicant for her job would have been desperate enough to put up with a lot fewer legal restrictions on the safety and health of her working conditions, just in order to scrape up enough money to survive. But the law set some limits on what she could agree to put up with in exchange for money. Was your friend’s grandfather’s widow worse off overall because those legal restrictions existed, or better off?
Currently, legal restrictions on what employees can agree to put up with in exchange for money rule out the bodily harm and risks involved with removal of major organs. Just because there are probably lots of poor people who would be desperate enough to accept those harms and risks because they really need the money does not convince me that those legal restrictions ought to be removed.