Would You Donate a Kidney for $10,000?

A program that pays people for their organs could help save lives and money. And it may work better than the current U.S. organ-transplant system.

National Journal
Marina Koren
Oct. 28, 2013, 9:38 a.m.

There are roughly 96,000 people on the trans­plant list for kid­neys in the United States. About 4,500 of them will die wait­ing for a match this year.

Kid­ney dis­ease is on the rise in the na­tion. For pa­tients near­ing kid­ney fail­ure, trans­plants are the best and of­ten only meth­ods of treat­ment. However, the rate of dona­tions, from both liv­ing and de­ceased donors, has re­mained re­l­at­ively un­changed in the last dec­ade.

So how can the U.S. meet the de­mand for donors? Give people a couple thou­sand dol­lars in ex­change for their kid­neys, sug­gests a study pub­lished last week in the Clin­ic­al Journ­al of the Amer­ic­an So­ci­ety of Neph­ro­logy, which fo­cuses on kid­ney-dis­ease re­search and pa­tient care.

The idea goes like this: Pay liv­ing kid­ney donors $10,000. The mon­et­ary in­cent­ive would then in­crease the num­ber of trans­plants by 5 per­cent, which the re­search­ers call a “very con­ser­vat­ive es­tim­ate.” More trans­plants would mean bet­ter pa­tient out­comes. And hos­pit­als and in­sur­ance com­pan­ies would save money on dia­lys­is and oth­er care for now-health­i­er pa­tients.

Last year, 16,812 kid­ney trans­plants were per­formed in the U.S. Of these, 5,769 came from liv­ing donors. A 5 per­cent in­crease, ap­plied to these fig­ures, would add about 288 kid­ney dona­tions a year.

In the study, the re­search­ers used av­er­age costs of dia­lys­is and sim­il­ar care, trans­plant­a­tion and sur­viv­al rates, and time spent on trans­plant lists to com­pare a pay­ment pro­gram with typ­ic­al or­gan-dona­tion sys­tems. Some of the fig­ures and data­bases were Ca­na­dian, but the re­search­ers say the res­ults hold for the U.S. A hy­po­thet­ic­al gov­ern­ment or third-party-ad­min­istered pro­gram that paid donors, they ar­gue, would be less costly and more ef­fect­ive than the cur­rent Amer­ic­an sys­tem, which is man­aged by UN­OS, a private, non­profit or­gan­iz­a­tion.

In the U.S., it is il­leg­al for “any per­son to know­ingly ac­quire, re­ceive, or oth­er­wise trans­fer any hu­man or­gan for valu­able con­sid­er­a­tion for use in hu­man trans­plant­a­tion,” un­der the Na­tion­al Or­gan Trans­plant Act. While liv­ing donors don’t get paid for their kid­neys, Medi­care or private health in­sur­ance does cov­er the pro­cess.

Pro­ponents of leg­al­iz­ing pay­ment for or­gans point to the gen­er­ally ac­cep­ted dona­tion of hair, blood, sperm, and eggs. While these have min­im­al med­ic­al risk for the donor, “it is ac­cep­ted that they are sold for fin­an­cial gain,” wrote sur­geon Amy Fried­man in a 2006 study in fa­vor of leg­al­iz­ing pay­ments for  liv­ing or­gan dona­tions. Many of these dona­tions come from eco­nom­ic­ally dis­ad­vant­aged pop­u­la­tions, and a hy­po­thet­ic­al pro­gram that ex­changes money for or­gans runs the same risk of ex­ploit­ing the most needy.

There have been at­tempts to at least some­what com­pensate liv­ing donors for their kid­neys. In 2002, a former Sens. Chris Dodd, D-Conn., and Bill Frist, R-Tenn., in­tro­duced le­gis­la­tion that would have provided re­im­burse­ment for travel ex­penses for liv­ing donors. In 2009, the Na­tion­al Kid­ney Found­a­tion, a New-York based non­profit, re­com­men­ded cov­er­ing fu­ner­al ex­penses for fam­il­ies who donate a re­l­at­ive’s or­gans. For some, however, even pick­ing up the tab for travel and fu­ner­al ex­penses is go­ing too far, near­ing bribery. “You’re edging to­wards fin­an­cial in­cent­ives rather than com­pens­a­tion,” one bioeth­i­cist told USA Today in 2009.

What We're Following See More »
SHE’LL HAVE A ROLE WITH CLINTON CAMP
Wasserman Schultz to Resign at Week’s End
4 hours ago
THE LATEST

"After hours of private talks," Debbie Wasserman Schultz agreed to step down as chair of the Democratic National Committee after the convention ends. In the wake of the convention intrigue, Hillary Clinton announced she's making Wasserman Schultz "the honorary chair of her campaign's 50-state program."

Source:
MARCIA FUDGE TO PRESIDE
Wasserman Schultz Stripped of Convention Duties
13 hours ago
THE DETAILS

Democratic National Committee Chairwoman Debbie Wasserman Schultz "will not have a major speaking role or preside over daily convention proceedings this week," and is under increasing pressure to resign. The DNC Rules Committee on Saturday named Ohio Democratic Rep. Marcia Fudge as "permanent chair of the convention." At issue: internal DNC emails leaked by Wikileaks that show how "the DNC favored Clinton during the primary and tried to take down Bernie Sanders by questioning his religion."

Source:
EARLY BUMP FOR TRUMP?
New Round of Polls Show a Tight Race
2 days ago
THE LATEST
  • A Rasmussen Reports poll shows Donald Trump ahead of Hillary Clinton, 43%-42%, the fourth week in a row he's led the poll (one of the few poll in which he's led consistently of late).
  • A Reuters/Ipsos survey shows Clinton leading 40%-36%. In a four-way race, she maintains her four-point lead, 39%-35%, with Gary Johnson and Jill Stein pulling 7% and 3%, respectively.
  • And the LA Times/USC daily tracking poll shows a dead heat, with Trump ahead by about half a percentage point.
BELLWETHER?
Candidates Deadlocked in Ohio
3 days ago
THE LATEST
17-POINT EDGE AMONG MILLENNIALS
Clinton Dominates Among Younger Voters
3 days ago
THE DETAILS

In an election between two candidates around 70 years of age, millennials strongly prefer one over the other. Hillary Clinton has a 47%-30% edge among votes 18 to 29. She also leads 46%-36% among voters aged 30 to 44.

Source:
×