Paying to Stay Alive

Our friend and fellow health care scribbler Sally Satel, MD makes a great case for why we should provide economic incentives for everything health care related including organ transplants in her recent NY Times op-ed“Death’s Waiting List”: Sally writes:“March was National Kidney Month. I did my part: I got a new one. My good fortune, alas, does not befall nearly enough people, and the federal government deserves much of the blame. Today 70,000 Americans are waiting for kidneys, according to the United Network for Organ Sharing, which maintains the national waiting list. Last year, roughly 16,000 people received one (about 40 percent are from living donors, the others from cadavers). More are waiting for livers, hearts and lungs, which mostly come from deceased donors, bringing the total to about 92,000. In big cities, where the ratio of acceptable organs to needy patients is worst, the wait is five to eight years and is expected to double by 2010. Someone on the organ list dies every 90 minutes. Tick. Tick. Tick.Until my donor came forward, I was desperate. I had been on the list only for a year and was about to start dialysis. I had joined a Web site, MatchingDonors.com, and found a man willing to give me one of his kidneys, but he fell through. I wished for a Sears organ catalog so I could find a well-matched kidney and send in my check. I wondered about going overseas to become a ”transplant tourist,” but getting a black market organ seemed too risky. Paradoxically, our nation’s organ policy is governed by a tenet that closes off a large supply of potential organs—the notion that organs from any donor, deceased or living, must be given freely. The 1984 National Organ Transplantation Act makes it illegal for anyone to sell or acquire an organ for ”valuable consideration.” In polls, only 30 percent to 40 percent of Americans say they have designated themselves as donors on their driver’s licenses or on state-run donor registries. As for the remainder, the decision to donate will fall to their families who are as likely as not to deny the hospital’s request. In any event, only a small number of bodies of the recently deceased, perhaps 13,000 a year, possess organs healthy enough for transplanting. The verdict is in: relying solely on altruism is not enough. Charities rely on volunteers to help carry out their good works but they also need paid staff. If we really want to increase the supply of organs, we need to try incentives—financial and otherwise.”The rest of Sally’s excellent article can be found here:http://www.aei.org/publications/pubID.24390,filter.economic/pub_detail.aspAnd we are glad that she is doing great!