Paying for organs would save lives

[RS Davis]

FOR A CLASSIC illustration of the Law of Unintended Consequences, consider the National Organ Transplant Act.

Passed by Congress in 1984, the statute makes it illegal to pay any compensation to organ donors or their families. The lawmakers' intentions were good: They were loath to allow the spectacle of human organs being bought and sold like mere commodities. And they wanted to prevent any chance that the poor would be exploited to supply body parts for the rich.

Those things have indeed been prevented. But by making it a crime to offer donors any "valuable consideration" for organs, Congress achieved something else, too: the unnecessary deaths of tens of thousands of Americans who could have been saved if only the organs they needed had been available....

Some advocates have been making this argument for years, urging an amendment to the 1984 law that would permit the families of cadaveric donors to be compensated. As Carey Goldberg reported last week in The Boston Globe, Pennsylvania congressman James Greenwood has introduced a bill to do just that. The American Medical Association used to oppose financial incentives for organ donation; now it says the "time has come" to give them a serious test. Its call has been endorsed by two key institutional players, the American Society of Transplant Surgeons and the United Network for Organ Sharing.

- Rick

[Jodi]

Without rehashing all the arguments against this idea from the other board, I'll ask ya-

Would you accept a compromise of the following sort:

Donors are reimbursed (not the best word for it, but it'll do) by the gov'ment, rather than recipients, in order to avoid organs simply going to the wealthy, rather than those in most urgent need.

If cash payments would, as some believe, greatly increase the donation rate, this approach would seem the best way- and would likely be a net gain monetarily, since the expense of keeping patients alive while waiting for organs is so great...

[RS Davis]

Jodi said:

Without rehashing all the arguments against this idea from the other board, I'll ask ya-

Would you accept a compromise of the following sort:

Donors are reimbursed (not the best word for it, but it'll do) by the gov'ment, rather than recipients, in order to avoid organs simply going to the wealthy, rather than those in most urgent need.

If cash payments would, as some believe, greatly increase the donation rate, this approach would seem the best way- and would likely be a net gain monetarily, since the expense of keeping patients alive while waiting for organs is so great...

Yeah, but I think I would rather see some sort of private fund created for reimbursement. It would be more efficient.

- Rick

[Jodi]

If by private fund, you mean privately administered by subject to auditing (both financially and operationally) by the gov'ment, you might be on to something.

[RS Davis]

Jodi said:

If by private fund, you mean privately administered by subject to auditing (both financially and operationally) by the gov'ment, you might be on to something.

I also mean privately funded by philanthropists and grants from insurance companies.

- Rick

[Jodi]

RS said:

I also mean privately funded by philanthropists and grants from insurance companies.

I thought you probably did. Certainly there's nothing wrong with philanthropists kicking into the kitty, as long as they have absolutely no say in who does or doesn't receive organs.

[RS Davis]

Jodi said:

I thought you probably did. Certainly there's nothing wrong with philanthropists kicking into the kitty, as long as they have absolutely no say in who does or doesn't receive organs.

Right. And I think that insurance companies would be glad to kick in, with all the savings the increased supply will bring for them.

- Rick

[penguin]

RS said:

Right. And I think that insurance companies would be glad to kick in, with all the savings the increased supply will bring for them.

- Rick

Hell, they get people where I work to show up to give blood just by offering a casual day in return. Imagine how many would show up for cold, hard cash.

I heard that a bar or brewery somewhere recently offered free beer for blood in a "pint for a pint" drive. I wonder if that actually violated the congressional ban on parts for pay?

[Jodi]

penguin said:

Hell, they get people where I work to show up to give blood just by offering a casual day in return. Imagine how many would show up for cold, hard cash.

I heard that a bar or brewery somewhere recently offered free beer for blood in a "pint for a pint" drive. I wonder if that actually violated the congressional ban on parts for pay?

That's an amusing commentary, but blood isn't the same as a kidney.

Meanwhile, here's a question for y'all.

If, as y'all contend, there would be a significant increase in the number of organ donors if we allowed donors to charge for organs, and since this has only been illegal since the NOTA in 1984-

Why were organ donors so scarce pre-1984?

[RS Davis]

Jodi said:

That's an amusing commentary, but blood isn't the same as a kidney.

Meanwhile, here's a question for y'all.

If, as y'all contend, there would be a significant increase in the number of organ donors if we allowed donors to charge for organs, and since this has only been illegal since the NOTA in 1984-

Why were organ donors so scarce pre-1984?

Were they? I don't know. Got any numbers?

- Rick

[Jodi]

RS said:

Were they? I don't know. Got any numbers?

- Rick

It's tough to find stats dating back to 1983, but the reason given for the NOTA itself was scarcity of donated organs.

I found a web site which put the number of donors at just over 3000 in 1980, but it was a personal site which didn't site a source or anything that seemed trustworthy, so I don't have any faith in that one.

This site says the number of donations since 1983 has tripled, but again- it's hard to be sure why.

The earliest stats I can find are from 1991, but it's interesting that over that period donations have steadily increased each year, from about 7 thousand then to over 12 thousand in 2002.

[RS Davis]

Jodi said:

It's tough to find stats dating back to 1983, but the reason given for the NOTA itself was scarcity of donated organs.

I found a web site which put the number of donors at just over 3000 in 1980, but it was a personal site which didn't site a source or anything that seemed trustworthy, so I don't have any faith in that one.

This site says the number of donations since 1983 has tripled, but again- it's hard to be sure why.

The earliest stats I can find are from 1991, but it's interesting that over that period donations have steadily increased each year, from about 7 thousand then to over 12 thousand in 2002.

It makes me wonder if anyone actually tried before that to be an organ broker. I wonder if anything actually happened that made them ban the sale of organs in the first place. I suspect that it really hasn't been tried, so there's probably no information on it.

Maybe a test market might illustrate the feasability, calm some fears, or throw some flags.

- Rick

[penguin]

Jodi said:

That's an amusing commentary, but blood isn't the same as a kidney.

Sorry. I missed the part where we were only talking about kidneys.

[RS Davis]

penguin said:

Sorry. I missed the part where we were only talking about kidneys.

I'd always assumed we were talking about kidneys. ;D

- Rick

[penguin]

RS said:

I'd always assumed we were talking about kidneys. ;D

- Rick

Retitle the thread, and then we can talk about why the market dynamics for kidneys would be different than that for any other bodily product.