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Kidneys'R Us

boooeee

Dart Fener
boooeee
Joined
Aug 14, 2002
Messages
2,671
Because not every thread can be about Iraq, Israel, or Bush.

I read an editorial in The Economist the other day advocating for a free market solution to kidney transplant waiting lists. Unfortunately, most of the Economist's online content is now locked off, so I'll try to summarize:

About 4,000 people a year die in the US while waiting for a kidney transplant. As I understand it, the way the transplant system works now is that a donor is either a) recently deceased or b) a freind or family member who has agreed to donate their kidney to their loved one. Apparently, it is currently against the law to pay compensation to the person donating their kidney.

The Economist argued that lifting this ban would dramatically increase the number of available kidneys and eliminate the waiting list. Currently, Iran (that hotbed of free market thinking) is the only country that allows people to sell one of their kidneys and they have no waiting list for transplants.

It is not too surprising that The Economist is advocating a free market solution to a problem. I am inclined to agree with their proposed solution, but I was wondering what other people thought about the issue.
 
boooeee said:
Because not every thread can be about Iraq, Israel, or Bush.

I read an editorial in The Economist the other day advocating for a free market solution to kidney transplant waiting lists. Unfortunately, most of the Economist's online content is now locked off, so I'll try to summarize:

About 4,000 people a year die in the US while waiting for a kidney transplant. As I understand it, the way the transplant system works now is that a donor is either a) recently deceased or b) a freind or family member who has agreed to donate their kidney to their loved one. Apparently, it is currently against the law to pay compensation to the person donating their kidney.

The Economist argued that lifting this ban would dramatically increase the number of available kidneys and eliminate the waiting list. Currently, Iran (that hotbed of free market thinking) is the only country that allows people to sell one of their kidneys and they have no waiting list for transplants.

It is not too surprising that The Economist is advocating a free market solution to a problem. I am inclined to agree with their proposed solution, but I was wondering what other people thought about the issue.
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[sarcasm]Organ harvesting off of death row, and speedier executions might help. Likewise, let's step up organ harvesting on the streets of Baghdad, to correct this imbalance in supply and demand. It's all about the Benjamins, of course. [/sarcasm]

DR
 
Darth Rotor said:
[sarcasm]Organ harvesting off of death row, and speedier executions might help. Likewise, let's step up organ harvesting on the streets of Baghdad, to correct this imbalance in supply and demand. It's all about the Benjamins, of course. [/sarcasm]

DR
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A modest proposal?

Sarcasm tags duly noted, but I want to be clear that the decision to become a donor would be voluntary. As I understand it, you can live quite healthily with only one functioning kidney. Although, if anybody has evidence to the contrary, I would like to hear about it.
 
I don't like the idea of monetary compensation for organs for the same reason I don't like state lotteries. It offloads a societal cost onto the poor.

It's like legalizing child labor so that poor families have better access to capital.
 
boooeee said:
Sarcasm tags duly noted, but I want to be clear that the decision to become a donor would be voluntary.
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So, in theory, was enrollment in social security. (Look up Hoover's "Volunteerism.")

I see no reason to believe that the decision to become a kidney donor would remain voluntary for long enough for the ink to dry on the paper.
 
drkitten said:
So, in theory, was enrollment in social security. (Look up Hoover's "Volunteerism.")

I see no reason to believe that the decision to become a kidney donor would remain voluntary for long enough for the ink to dry on the paper.
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FWIW, my DL lists me as an organ donor, has for over 25 years. If someone comes for my organs before I'm done with them, there may be some friction. :cool:

I am not sure the Economist's writer considered the long term effects, or the laws of unintended outcomes, in his advocacy of "letting the market dictate" blah blah blah. I'll offer the harvesting of rare animals in Africa, to fill another market niche, for an example.

DR
 
drkitten said:
So, in theory, was enrollment in social security. (Look up Hoover's "Volunteerism.")

I see no reason to believe that the decision to become a kidney donor would remain voluntary for long enough for the ink to dry on the paper.
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What do you mean, exactly? The US government would start picking citizens at random and force them to give up one of their kidneys?

First, do you really think that's a possibility?

Secondly, what makes you think demand won't be met under a voluntary system? As mentioned, Iran has no waiting list.
 
Almo said:
I don't like the idea of monetary compensation for organs for the same reason I don't like state lotteries. It offloads a societal cost onto the poor.

It's like legalizing child labor so that poor families have better access to capital.
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I'm not against state lotteries, although I can understand the reasons people oppose them. However, with state lotteries, there are other viable methods of revenue generation (taxes, bond measures, etc.). I know of no other solution that would eliminate the need for a transplant waiting list.
 
Darth Rotor said:
[sarcasm]Organ harvesting off of death row, and speedier executions might help. Likewise, let's step up organ harvesting on the streets of Baghdad, to correct this imbalance in supply and demand. It's all about the Benjamins, of course. [/sarcasm]R
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It's working fine for China.
 
boooeee said:
.The Economist argued that lifting this ban would dramatically increase the number of available kidneys and eliminate the waiting list. Currently, Iran (that hotbed of free market thinking) is the only country that allows people to sell one of their kidneys and they have no waiting list for transplants.
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I don't think I've ever encountered a stupider application of free market thinking.

First of all, would the price of a kidney be capped? Or would those in need have to enter a bidding war against each other wherein the wealthy will always get kidneys and the poor will always get screwed?

With a true free market, those kidney donors with exceedingly rare blood types could literally hold the dying for ransom. If an O+ donor didn't like a bid, there's another O+ donor right behind him. But if an AB- donor didn't like a bid, he could sit quietly and just watch the numbers go up. Hell, AB- blood donors are, I think, the only blood type that still gets paid. They could hold out for literally millions.

But the real problem with this very dumb idea is that it creates a society that I, at least, do not want to live in. Prostitution is illegal in part because no little girl grows up thinking "I want to be a prostitute someday." Kidney donation for profit should be illegal for the same reason. The only people who will ever do it are those who have to because their minds, their efforts, and their creativity have no value. Let's spend money making everyone valuable, not cutting off pieces of the ones who aren't.
 
I hope technology and medicine progresses, soon, to a point where this will not be considered because we'll have better options. Such as growing a new kidney from the patient's own stem cells. How neat would that be, being able to regrow damaged or missing organs! Blind? New eyes! Accident messed up your liver? Grow a new one! Not only would that dodge all the ethical concerns, but it would end the risk of getting diseases from infected donors, and transplant rejection. That would be very sweet.
 
Loss Leader said:
But if an AB- donor didn't like a bid, he could sit quietly and just watch the numbers go up. Hell, AB- blood donors are, I think, the only blood type that still gets paid. .
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I'm AB, and I'm positive I'm negative- I think. My understanding is that AB is a universal receptor- I can use any blood type. The blood bank stopped calling me, yet kept after my B father.

But I think transplant matchs go for much deeper data than just blood type. Remember the difficulty with trying to find matchs for bone marrow? And the testing costs? So, while perfect matchs are few, the closer the better. Blood type would become inconsequential, any random donor might be the more valuable asset.

Then, back to the market. What effect would sales have on the post-mortem donors? Million of organs go to waste now, but if the heirs could sell Pop's parts that he isn't using anymore... That segment alone ought to flood the market, and keep the prices down.
 
TragicMonkey said:
I hope technology and medicine progresses, soon, to a point where this will not be considered because we'll have better options. Such as growing a new kidney from the patient's own stem cells. How neat would that be, being able to regrow damaged or missing organs! Blind? New eyes! Accident messed up your liver? Grow a new one! Not only would that dodge all the ethical concerns, but it would end the risk of getting diseases from infected donors, and transplant rejection. That would be very sweet.
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OK, besides saving the poster boys for liver or kidney problems (like a Walter Payton), or one of thousands of children whose kidneys fail, this capability will extend more and more lives a decade or so longer for those who can affort the "grow me a new kidney/liver/prostate/heart" process.

Pseudo immortality.

Then what?

DR
 
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Almo said:
I don't like the idea of monetary compensation for organs for the same reason I don't like state lotteries.
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According to the article, organs from deceased people are already legitimately traded and companies generate revenue from it. It's only individuals who are denied any participation. Why is this state of affairs better?

drkitten said:
I see no reason to believe that the decision to become a kidney donor would remain voluntary for long enough for the ink to dry on the paper.
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But does the problem of enforcing against non voluntary kidney donations mean that compensation for donating them must be outlawed?

Loss Leader said:
I don't think I've ever encountered a stupider application of free market thinking.

First of all, would the price of a kidney be capped? Or would those in need have to enter a bidding war against each other wherein the wealthy will always get kidneys and the poor will always get screwed?
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The poor "get screwed" whenever they can't afford something that rich people can. Why does that mean that the market should not exist? And sure the price could be capped (although that would simply remove the market from existing above the cap and stop some donations from happening), and aid could be available for the poor.


With a true free market, those kidney donors with exceedingly rare blood types could literally hold the dying for ransom. If an O+ donor didn't like a bid, there's another O+ donor right behind him. But if an AB- donor didn't like a bid, he could sit quietly and just watch the numbers go up. Hell, AB- blood donors are, I think, the only blood type that still gets paid. They could hold out for literally millions.
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Yes. What's the alternative? He is not allowed any compensation and so decides not to donate at all. Is the person who would have paid better off? From where does their substitute kidney come then?


But the real problem with this very dumb idea is that it creates a society that I, at least, do not want to live in. Prostitution is illegal in part because no little girl grows up thinking "I want to be a prostitute someday." Kidney donation for profit should be illegal for the same reason. The only people who will ever do it are those who have to because their minds, their efforts, and their creativity have no value. Let's spend money making everyone valuable, not cutting off pieces of the ones who aren't.
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This is not correct. People will donate if the value of so doing is greater than the cost in their view. At the moment the only value can be an altruistic one. What is wrong with allowing monetary value?

a_unique_person said:
It's the standard solution when there is a shortage, just make the poor go without.
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Is exacerbating the shortage so that more people go without better?
 
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Darth Rotor said:
I am not sure the Economist's writer considered the long term effects, or the laws of unintended outcomes, in his advocacy of "letting the market dictate" blah blah blah. I'll offer the harvesting of rare animals in Africa, to fill another market niche, for an example.
Click to expand...

In defense of the market, though, that is also a tragedy of the commons problem. Though I'd agree that a little trepidation concerning the creation of markets for human body parts seems pretty reasonable to me.
 
boooeee said:
Are you against paying people for blood donation?
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Where I am currently living, it is legal to pay for blood plasma, and I've seen advertisements. In California, it had previously been legal to pay for blood plasma, but it is not anymore. The reason for the change was not because of moral qualms, it was because they were getting too many HIV-positive donors when they were paying for plasma.

That said, paying for blood or plasma isn't the same as paying for a kidney. You regenerate your blood, you don't regenerate a kidney. And while most people can live fine with only one, it IS a permanent loss, and it could have negative consequences for some people (for example: traumatic car accident which damages the remaining kidney). I'm not yet sure how I feel about the idea - it would likely increase the number of donations, and that's a good thing, but I do worry about possible subtle, unintended consequences.
 
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