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Thousands of people die every year waiting for an organ transplant. The Indicator's Adrian Ma and Wailin Wong report on an idea to address that problem. It involves compensation.
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ADRIAN MA: Whenever you have a demand for something and a limited supply, you've got a market. And when it comes to the market for human organs, Harvard economist Alex Chan says the stakes are brutally clear.
ALEX CHAN: So the level of inefficiency is also staggering, right? In this market, more than 5,000 people every year die waiting for organs.
MA: They're waiting for kidneys, livers, hearts and lungs. The government spends billions of dollars a year on health care for people on the waiting list.
WAILIN WONG: Recently, Alex and his colleague, Kurt Sweat, came up with a proposal to help.
MA: And here's their idea in a nutshell. When a person dies in the hospital, their organs might be donated if they're a registered organ donor or the family gives consent. In either situation, Kurt says the government should reimburse donors' families for their funeral expenses. But that's not all.
CHAN: Other things that might be covered are things like support for the donor family.
MA: Think travel and hotel rooms for family that want to be near their loved one throughout the donation process. The amount of compensation might be capped at 6- to $8,000, the typical cost of funeral services. And the result, they estimate, would be a 9- to 35% increase in the number of organ donations each year.
WONG: And as a result, they say thousands more lives would be saved, and the government would save money, as there would be fewer people on the waitlist in need of expensive, long-term medical treatment. So on paper, seems like a pretty good idea, right?
MA: Right, except for a few potentially glaring issues. The first being that under the current law, this whole proposal is illegal.
WONG: Oh. Minor detail.
MA: Minor detail.
WONG: Yeah. In 1984, Congress passed the National Organ Transplant Act, which, among other things, outlawed the exchange of any human organs for, quote, "valuable consideration" - cash for organs, basically. Like, imagine if the market for organs revolved around wealthy people paying for the organs of poor people. That would be incredibly dystopian, like an episode of "Black Mirror."
MA: What Alex and Kurt are proposing here is far from that. And Alex argues that tweaking the law to allow compensation for donation has some existing precedent. Like, after all, he points out that people can get paid for donating blood plasma, and a person who donates their whole body to medical research is actually allowed to have their funeral costs covered.
WONG: But let's put aside the legal issues for a moment and talk about another potential issue with their proposal, the ethics. Is it even right to offer this sort of incentive to people in exchange for their decision to donate? Here is how Alex sees it.
CHAN: People worry that financial incentives will corrupt sort of this gift of life that is a pristine thing, the whole transplant process. But if we think about the process more holistically - right? - a lot of players already have incentives.
MA: He says the transplant surgeon is paid to do the surgery. The organizations that procure organs are paid for that work. But the donors and their families?
CHAN: They are the true heroes of a story. They are the folks who actually are left out of the system where incentives are embedded.
WONG: He says allowing them to be compensated for funerals, hotel and travel costs - that would actually make the system more fair, particularly for people who might struggle to afford those things. Wailin Wong.
MA: Adrian Ma, NPR News.
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