As of today, 83,904 Americans are waiting for a kidney transplant, the oldest and most cost-effective organ transplant surgery, according to the United Network for Organ Sharing, which comprises data from all transplant programs in the country. In 2006, there were 18,052 kidney transplant operations performed, and while that figure has been trending up from 3,785 in 1980, because the five-year survival rate for patients requiring dialysis is only 33%, the prospects look rather grim. To a parent, helpless to donate to her own child, they are heartbreaking.
The simple libertarian solution derives from our assertion that we and we alone own our bodies, and may therefore sell our spare parts if we choose. (Another of The Free Agent’s guiding principles, ‘if it’s legal to do it for free, it probably should be legal to do for money’ also applies to the donor situation, it’s legal to donate a kidney, just not to receive money for it.) The BBC reports that in Iran, where it’s legal to sell organs, donors are complaining of a glut of donated kidneys, resulting in depressed prices. The obviously-foreign website sellkidney.com quotes $70-$80,000. I’d get that in cash.
Of course, this “simple solution” is illegal in the United States, and is likely to remain so. The lion’s share of objections to selling organs seem to be an attempt to protect the poor from “exploitation”. (Which only begs the question, is there a point at which a person is rich enough to gain the right to sell her kidney?) A market of sorts has arisen among desperate families who find one another over the Internet, in hopes that they will be compatible with each other’s patients. Only 74 of these paired donation surgeries were performed in the U.S. in 2006.
Voila, the “even simpler solution”–combining paired donation with the current waiting list. Paired donation is inefficient because patients have to find each other. But if I am willing to donate a kidney for my patient, why not just donate it to the first match on the donor list, and in return, “my” patient goes to the top of the list for the next matching kidney? Those who believe the money motive is immoral will not object, I am donating out of “pure” motives, to cure my own loved one. And the influx of new kidneys into the donor pool will benefit many patients, even if they have no one to donate on their behalf.
What would the effect be on the 80+ thousand patients awaiting kidney transplants? The Free Agent won’t speculate on how many friends, family members, or fans would donate a kidney for her, but she can instantly name a dozen people to whom she would gift Old Lefty. Just as long as we don’t taint our pure love with filthy lucre.