Wednesday, 29 January 2014

Want to Sell Your Kidney?

We read stories about selling kidneys with a lot of distaste.  Usually some person from a very poor country receives a small amount of money (which might seem like a lot to them), them a middle-man receives a much much larger amount, passing it on to a surgeon (or rather passing on the poor person for surgery) and the surgeon makes an even larger amount for carrying out the operation.

We found several such reports back in 2011, although the links to the news items don't seem to work. but the article is still worth reading.

A recent article in the Wall Street Journal looks at the number of people in the US who are on the waiting list for a new kidney and the number who get one, and asks the question is there a case of a market for organs.

The article is by Gary S. Becker and Julio J. Elias.
Mr. Becker is a Nobel Prize-winning professor of economics at the University of Chicago and a senior fellow at the Hoover Institution.
Mr. Elias is an economics professor at the Universidad del CEMA in Argentina

The article says
"Finding a way to increase the supply of organs would reduce wait times and deaths, and it would greatly ease the suffering that many sick individuals now endure while they hope for a transplant. The most effective change, we believe, would be to provide compensation to people who give their organs—that is, we recommend establishing a market for organs."

Then points out that
"For example, people age 45 to 49 live, on average, eight additional years if they remain on dialysis, but they live an additional 23 years if they get a kidney transplant. That is why in 2012, almost 4,500 persons died while waiting for kidney transplants."

It goes on to compare the cost of dialysis over the average waiting time for a transplant (they say it's $350,000) with the cost of a transplant operation (they say it's $150,000).  Clearly it would be cost effective to pay someone, say $100,000 for a kidney and after adding in the cost of the transplant operation, taking the total up to $250,000, compared to the total for the dialysis and the operation - $500,000.  And of course significantly lengthen the life of the recipient, rather than risk them dying before they ever receive a new kidney.

The paper estimates that you could probably find people willing to sell a kidney for around $15,000 although they think the price could be between $5,000 to $25,000. (For $100,000 you could have mine tomorrow, but not for $25,000. Especially if the cost of dialysis over four or five years is $350,000.)

You can legally sell your kidney in some countries, and the article says that in Iran the price is a mere $4,000 and this has eliminated waiting times. Given the incomes in Iran (one quarter of that in the US), this roughly matches their estimate of what it would cost in the US. They suggest that such a scheme could totally eliminate the kidney shortage, as many people would be willing to sell at that sort of price.

They also suggest payments to people who say their organs can be used when they die (any organ). The payment would then go to their relatives (damn I was just about to check what I could go with that money if only it was paid in advance...)

The article points out that the rich can simply go to another country and deal in the underground illegal kidney market, leaving more kidneys for those who would have to wait their turn.

The article finishes by suggesting that this will happen one day, and then people will wonder why it took so long to become acceptable.

Thought proving, isn't it.  Immoral? To be honest, when a donor is paid a fair amount, rather than exploited, it's not that bad.  It's those from poor backgrounds getting a few $100 that is the immoral bit, especially if the surgeon is counting his/her pay in the tens of thousands.  Would altruistic donors continue to just give? Perhaps.  They can still be generous to help those from a poor background, the ones who currently suffer the most.

And finally, have you tried putting kidney for sale in to Google? !